Response of the renin‐angiotensin‐aldosterone system to upright tilting and to intravenous frusemide: effect of prior metoprolol and propranolol.

S. Sonkodi, E. Agabiti‐Rosei, R. Fraser, BJ Leckie, JJ Morton, AM Cumming, VP Sood, JI Robertson

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1 Upright tilting in normal volunteers caused increases in plasma active and total renin, angiotensin II and aldosterone; a slight but significant fall in inactive renin accompanied these changes. 2 The alterations in the renin‐angiotensin‐aldosterone system on tilting took up to 1 h upright to become fully established. 3 Large intravenous doses of propranolol or metoprolol attenuated, without abolishing, the rises in active renin, angiotensin II, and aldosterone; the attenuation was most evident soon after tilting and was largely overcome by 1 h upright. Inactive renin did not fall significantly after beta‐ adrenoceptor blockade. 4 Intravenous frusemide caused immediate rises in plasma active, total and inactive renin, angiotensin II, and aldosterone, which then declined over 2 h despite increasing cumulative sodium losses. 5 Intravenous propranolol or metoprolol attenuated, without abolishing, these early increases in the components of the renin‐angiotensin‐aldosterone system after frusemide. 6 Prior oral metoprolol or propranolol, while significantly slowing the heart, did not limit the early rise in plasma angiotensin II following intravenous frusemide. 7 Thus in contrast to previous workers, we did not find that propranolol eliminated the response of the renin‐angiotensin system to upright tilting; in part this difference appeared to be due to the longer tilt we employed. 8 Also in contrast to earlier work, we found attenuation by both intravenous propranolol and metoprolol of the immediate rise in renin after intravenous frusemide. 1982 The British Pharmacological Society

Original languageEnglish
Pages (from-to)341-350
Number of pages10
JournalBritish Journal of Clinical Pharmacology
Issue number3
Publication statusPublished - Mar 1982


ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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