Antihypertensive Action of Beta-Adrenoceptor Blocking Drugs

The different modes of antihypertensive action of beta-adrenoceptor blocking drugs are reviewed with a special emphasis on renal mechanisms of action. Beta-adrenoceptors occur in the kidney at the level of the juxtaglomerular and tubular cells. Direct intrarenal effects of beta-blockers include the decrease in renin release and the enhanced tubular excretion of fluid and electrolytes. Betablockers also influence renal function in a more indirect way b y altering the activity of different extrarenally formed hormones with an effect on fluid and electrolyte excretion, such as angiotensin II, atrial natriuretic factors and prostaglandins. Several beta-blockers have an additional effect on the renal vasculature. One of these, tertatolol, is a renal vasodilator beta-blocker in different species. The possible mechanisms of renal vasodilatation of tertatolol are reviewed. It is concluded that the shift of the renal pressure-diuresis curve is an essential feature in the mode of long-term antihypertensive action of beta-blockers. Am J Hypertens 1989;2:237S–240S