Alterations in the responses of the sympathetic nervous system and renin in borderline hypertension.

Robertson, David L.; Shand, David G.; Hollifield, John W.; Nies, Alan S.; Frölich, Jürgen C.; Oates, J A

doi:10.1161/01.hyp.1.2.118

Cited by 46 publications

(20 citation statements)

References 25 publications

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“…We have shown previously that a very low-salt diet can decrease the SBP 4 to 5 mm Hg over several days. 30 Thus, despite our current findings, a chronic high-salt diet does likely increase blood pressure. The latter often requires the use of supplemental NaCl tablets.…”

Section: Clinical Impact Of This Studycontrasting

confidence: 87%

Sodium Paradoxically Reduces the Gastropressor Response in Patients With Orthostatic Hypotension

et al. 2006

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Abstract-Orthostatic hypotension (OH) can cause syncope that is difficult to treat. We have found that 473 mL (16 oz) of water can increase systolic blood pressure (SBP) by Ͼ30 mm Hg in many OH patients (the gastropressor response). OH patients are routinely advised to increase their sodium intake to augment their blood volume. We tested the hypothesis that the ingestion of salt with water would increase the magnitude of the acute pressor response compared with water alone in patients with OH. Key Words: blood pressure Ⅲ sympathetic nervous system Ⅲ sodium Ⅲ hypotension Ⅲ autonomic nervous system Ⅲ water-electrolyte balance O rthostatic hypotension (OH) can be a debilitating condition that is difficult to treat. 1-8 Oral water ingestion has been shown to effect a large pressor response in patients with neurogenic OH, 9 -13 with some patients experiencing increases of Ͼ40 mm Hg in their systolic blood pressure (SBP). 9 This gastropressor response takes place over minutes rather than seconds, with a peak effect between 20 and 40 minutes after the water ingestion. 9,10 The oral route is important, because the increase in SBP was only one-third as great with identical volumes of intravenous 5% dextrose in water (D5W) versus oral water. 10

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Section: Clinical Impact Of This Studycontrasting

confidence: 87%

Sodium Paradoxically Reduces the Gastropressor Response in Patients With Orthostatic Hypotension

et al. 2006

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“…Many prior investigations of the sympathetic nervous system in human hypertension have concentrated on attempts to detect elevated plasma catecholamines in hypertensive subjects. Although these studies varied greatly in design, the data do not support the hypothesis that catecholamine excess is the sole cause of hypertension (1,2). However, recent studies have shown that hypertensive subjects have enhanced pressor responsiveness to catecholamine and sympathomimetic amine infusions (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Plasma catecholamine modulation of alpha 2 adrenoreceptor agonist affinity and sensitivity in normotensive and hypertensive human platelets.

Hollister¹,

Onrot²,

Lonce³

et al. 1986

J. Clin. Invest.

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We measured a2-adrenoreceptor density as well as affinity for and sensitivity to agonist on intact platelets of normotensive and hypertensive subjects before and after physiological increases in plasma catecholamines. In normotensives, posture-induced rises in plasma catecholamines correlated with reduced C2-adrenoreceptor agonist affinity and fewer high affinity state receptors. Platelet aggregation and inhibition of adenylate cyclase by L-epinephrine also was reduced. Hypertensive subjects had similar rises in plasma catecholamines with upright posture, but showed no change in receptor affinity or sensitivity. No change in platelet a2-adrenoreceptor number occurred in-these studies. In vitro incubation with L-epinephrine revealed that platelets from hypertensives had slower desensitization than those from normotensives. Binding studies at different temperatures and with varying sodium concentrations found no thermodynamic or sodium-dependent differences between normotensive and hypertensive groups.These studies demonstrate that platelets from hypertensive subjects exhibit a defect in the ability of physiological concentrations of agonist to desensitize the a2-adrenoreceptor.

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“…Several investigators have demonstrated that in patients with borderline hypertension there is an increased response of plasma catecholamines to mental stress8 9 or orthostatic tilting, 10 suggesting a net increase in the sympathoadrenal tone.11 These observations led us to the hypothesis that not only increased sympathetic activity but also adrenomedullary hyperactivity may be involved in the development of essential hypertension. To assess the adrenomedullary activity in young patients with borderline hypertension, we therefore examined the response of plasma epinephrine after stimulation by the injection of glucagon in young borderline hypertensive and age-matched normotensive subjects.…”

mentioning

confidence: 99%

Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension.

Fujita¹,

Ando²,

Noda³

et al. 1987

Circulation

119

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Recent studies showed that taurine, a sulphonic amino acid, could decrease blood pressure and increase sympathoadrenal tone in DoCA-salt-treated hypertensive rats. To determine whether taurine exerts its antihypertensive action in man in a similar fashion, we studied the effect of oral administration of taurine (6 g for 7 days) on blood pressure and plasma catecholamines in 19 young patients with borderline hypertension in a double-blind, placebo-controlled fashion. Systolic blood pressure in the 10 patients who were treated with taurine decreased by 9.0 ± 2.9 mm Hg (mean ± SE; p < .05 by paired t test), compared with a 2.7 + 2.3 mm Hg decrease (NS) in the nine patients treated with placebo and diastolic blood pressure in the taurine-treated patients decreased by 4.1 + 1.7 mm Hg (p < .05) compared with 1.2 ± 3.0 mm Hg (NS) in the placebo-treated subjects. In the patients receiving taurine plasma epinephrine (E) decreased significantly, with a negligible decrease in plasma norepinephrine (NE). The effect of taurine on plasma catecholamines and the response of plasma E after the stimulation with glucagon was also studied in 12 borderline hypertensive and nine agematched normotensive subjects. Basal plasma E was significantly higher in borderline hypertensive than in normal subjects, but basal plasma NE did not differ in the two groups. The intravenous bolus injection of glucagon (1 mg) caused a rapid and transient increase in plasma E in each subject studied; plasma E reached a peak concentration 2 to 5 min after the injection of glucagon and thereafter declined rapidly to the baseline level. The overall response of plasma E to glucagon stimulation was significantly (p < .01) greater in the borderline hypertensive than in the normotensive subjects. Taurine not only reduced mean blood pressure and basal plasma E, but also attenuated the increased response to glucagon in the borderline hypertensive subjects. In the normotensive subjects, however, the administration of taurine did not significantly change blood pressure, basal plasma catecholamines, or the response of plasma E to glucagon. Overall, there was a direct correlation (r = .670, p < .01) between the decrements in mean blood pressure and those in plasma E after taurine in the 22 borderline hypertensive subjects. Evidence presented suggests, therefore, that sympathoadrenal tone is increased in young borderline hypertensive individuals, and that oral administration of taurine attenuates increased tone, leading to the reduction of blood pressure. Circulation 75, No. 3, 525-532, 1987. YOUNG PATIENTS with borderline hypertension are at least three times more likely to develop established essential hypertension than age-matched normotensive subjects.1'2 Thus, young patients with borderline hypertension have been of particular interest to investigators because they may provide insight into the pathogenesis of essential hypertension. The majority of studies have reported increased average circulating norepinephrine levels in borderline hypertensive sub-

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Alterations in the responses of the sympathetic nervous system and renin in borderline hypertension.

Cited by 46 publications

References 25 publications

Sodium Paradoxically Reduces the Gastropressor Response in Patients With Orthostatic Hypotension

Sodium Paradoxically Reduces the Gastropressor Response in Patients With Orthostatic Hypotension

Plasma catecholamine modulation of alpha 2 adrenoreceptor agonist affinity and sensitivity in normotensive and hypertensive human platelets.

Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension.

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