Renal perfusion is preserved during cardioselective beta-blockade with metoprolol in hypertension

Treatment of hypertension with beta-adrenergic blockers may impair renal perfusion, perhaps because of beta 2-blockade in the renal vascular bed. We evaluated the effects of the cardioselective (beta 1 selective) beta-blocker metoprolol upon renal hemodynamics, intravascular volume, and renal electrolyte handling in nine essential hypertensive men. Metoprolol normalized systemic BP without significant acute or chronic changes in glomerular filtration rate, renal plasma flow, or renal blood flow. Overall renal sodium excretion and fractional sodium excretion increased on chronic metoprolol, without changes in intravascular volume or renal excretion of other electrolytes. Thus, cardioselective beta-blockade with metoprolol normalizes BP without renal hemodynamic impairment.