Enhancement of the antihypertensive effect of hydrochlorothiazide in dogs after suppression of renin release by beta-adrenergic blockade.

1. Renal hypertensive dogs were treated with hydrochlorothiazide (8-2 mumol/kg or 33 mumol/kg daily for 7 days), or timolol (4-6 mumol/kg daily for 4 days), a potent beta-adrenergic blocking agent, or combinations of these drugs). Changes in mean arterial blood pressure and plasma renin activity were measured over the treatment period. 2. Neither drug significantly lowered arterial blood pressure when administered alone. Plasma renin activity, which did not change during treatment with timolol, was substantially elevated during treatment with hydrochlorothiazide. 3. When timolol was administered concomitantly with hydrochlorothiazide, plasma renin activity was suppressed and blood pressure was significantly lowered. 4. These observations suggest that compensatory activation of the renin-angiotensin system limits the antihypertensive activity of hydrochlorothiazide in renal hypertensive dogs and suppression of diuretic-induced renin release by timolol unmasks the antihypertensive effect of the diuretic.