Abstract
Most studies on renal hemodynamics in uncomplicated established essential hypertension have shown a reduced renal plasma flow. Hypotensive drugs may induce a transient reduction of renal blood flow and glomerular filtration rate due to the decrease in renal perfusion. This represents an untoward effect especially in subjects already presenting with a clinically relevant reduction of renal function. Loop diuretics, cardioselective and intrinsic sympathomimetic activity (ISA) β-blockers, and angiotensin converting enzyme (ACE) inhibitors either do not significantly reduce or even increase renal perfusion. Therefore, these agents should be considered as the drugs of first choice for preserving filtration in these subjects.
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