Abstract
This study was undertaken to investigate further the CNS actions of commonly employed antihypertensive drugs. Measurements of cerebrospinal fluid (CSF) and plasma catecholamines (CA) were made in an attempt to estimate the activity of central and peripheral noradrenergic neurons during treatment with or after abrupt discontinuation of treatment with clonidine (CLO), propranolol (PRO), hydrochlorothiazide (HCTZ) or placebo, in patients with essential hypertensio. A randomized, parallel, placebo-controlled, single-blind design was employed. BP reductions equal to or greater than 10 mmHg were observed with CLO (0.36 ± 0.07 mg daily), PRO (160 mg ± 0 mg daily) or HCTZ (70 ± 12 mg daily). CLO reduced plasma norepinephrine (NE) by 64% and PRO increased it by 25%. Neither HCTZ nor placebo modified plasma NE. Plasma renin activity (PRA) was reduced by PRO (51%, P < 0.01) and CLO (35%, P < 0.05). CSF-NE levels (pg/ml) were significantly lower in the CLO group (CLO: 175 ± 23 PRO: 278 ± 35; HCTZ: 255 ± 34; placebo: 203 ± 7).
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