Are centrally acting imidazoline agents appropriate therapy for renovascular hypertension?

An increased role of the sympathetic nervous system has been suggested to be a major contributor to the chronic elevation of BP in renovascular hypertension. We assessed the effects of rilmenidine, a centrally acting antihypertensive imidazoline agent, on BP and renal sympathetic nerve activity (RSNA) in 2K1C renovascular hypertensive conscious rabbits. Rabbits were made hypertensive with a renal clip or were sham-operated and were studied 3 and 6 weeks later. Acute treatment with rilmenidine reduced BP to a greater extent in the hypertensive rabbits. Although rilmenidine reduced the heart rate by the same extent in all groups, rilmenidine produced much less inhibition of RSNA in the hypertensive animals. These studies suggest that the contribution of the sympathetic nervous system is greater in 2K1C hypertension and that imidazoline agents may be beneficial in treating renovascular hypertension.