Related Experiment Videos
Long-term humoral and hemodynamic effects of celiprolol
A R Lucarini1, N Simonini, L Palmieri
1Cattedra di Terapia Medica Sistematica, Clinica Medica I-University of Pisa, Italy.
Insights
Celiprolol effectively lowers blood pressure and heart rate in patients with essential hypertension. This antihypertensive effect is sustained over six months without adverse kidney effects or changes in renal hemodynamics.
Area of Science:
- Cardiology
- Pharmacology
- Nephrology
Background:
- Essential hypertension is a common condition requiring effective long-term management.
- Understanding the hemodynamic and humoral effects of antihypertensive drugs is crucial for patient care.
Purpose of the Study:
- To assess the chronic effects of celiprolol on systemic and renal hemodynamics.
- To evaluate the humoral impact of long-term celiprolol treatment in hypertensive patients.
Main Methods:
- A 6-month, placebo-controlled study in six out-patients with essential hypertension.
- Measurements included blood pressure, heart rate, renal plasma flow, glomerular filtration rate, plasma renin activity, aldosterone, and noradrenaline.
- Urinary enzymes (NAG, AAP) were also monitored.
Main Results:
- Celiprolol significantly reduced blood pressure and heart rate compared to placebo.
- Systemic hemodynamic effects were consistent, but renal effects and plasma noradrenaline reduction diminished by month six.
- No significant changes were observed in plasma renin activity, aldosterone, glomerular filtration rate, or urinary enzymes.
Conclusions:
- Celiprolol demonstrates sustained antihypertensive efficacy over six months.
- The drug exhibits a favorable safety profile regarding renal function and hemodynamics.
- Chronic celiprolol treatment does not negatively impact kidney function or renal hemodynamics.
Abstract:
To evaluate the humoral and hemodynamic (both systemic and renal) effects of chronic treatment with celiprolol, six out-patients with mild to moderate uncomplicated essential hypertension received placebo for 1 month and celiprolol (400 mg qid) for 6 months. At the end of placebo and of the first and sixth month of treatment, blood pressure (BP), heart rate (HR), renal plasma flow (RPF), glomerular filtration rate (GFR), plasma renin activity (PRA), aldosterone (ALD) and noradrenaline (NA), urinary enzymes (NAG: N-acetyl-beta glucosaminidase, AAP: alanine aminopeptidase) were measured. Compared to placebo, celiprolol significantly and steadily reduced BP and HR. However, although the systemic hemodynamic effect was constant during the whole period of the study, the reduction of renovascular resistance and of plasma noradrenaline, detectable at the first month of therapy, disappeared at the sixth month. However, PRA, plasma aldosterone, GFR, and urinary enzymes did not change. These findings suggest that the antihypertensive effect of celiprolol is well maintained over the 6-month period; the drug did not exert any adverse effect on the kidney, and chronic celiprolol treatment does not influence renal hemodynamics.