Digital Hemodynamics in the Normotensive and Hypertensive States

Caliva, Francis S.; Napodano, Rudolph J.; Stafford, Robert; Loftus, William F.; Lyons, Richard H.

doi:10.1161/01.cir.28.3.415

Cited by 16 publications

(4 citation statements)

References 11 publications

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“…31 " 35 Fitzgerald et al 35 have presented evidence that decreased venous distensibility is associated with reduced renin responsiveness, possibly because a less compliant venous system allows less pooling of blood in the lower extremities during upright posture or thigh cuff inflation. We have found venous capacitance to be lowest in sodium-sensitive borderline hypertensive subjects, and these subjects also had lower renin and aldosterone levels.…”

Section: Discussionmentioning

confidence: 99%

Sodium sensitivity in human subjects. Hemodynamic and hormonal correlates.

Sullivan

Ratts

1988

Hypertension

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SUMMARY To investigate factors associated with sodium sensitivity, 157 subjects were studied while receiving 10 and 200 mEq sodium diets. Measurements included blood pressure (BP), forearm vascular resistance, plasma renin activity (PRA), and plasma aldosterone. Sodium repletion was associated with a greater than 5% increase in mean BP in 16% of the normotensive subjects and 29% of the borderline hypertensive subjects. Sodium-sensitive subjects were compared with sodiumresistant subjects in both the normotensive (n = 92) and borderline hypertensive (n = 65) groups. Forearm vascular resistance was significantly higher (p<0.05) during sodium loading in the sodiumsensitive subgroups of both the normotensive and borderline hypertensive groups (35.8 ± 29 vs 23.8 ± 20 [SD] and 37.5 ± 29 vs 22.5 ± 14 mm Hg/ml/min/100 g, respectively. Venous capacitance was lower in the sodium-sensitive than in the sodium-resistant borderline hypertensive subjects (0.8 ± 0.21 vs 1.69 ± 0.24 ml/100 g). During sodium restriction, PRA was significantly lower (p<0.01) in the sodium-sensitive subsets (2.56 ± 1.6 vs 4.04 ± 2.6; 2.65 ± 2.1 vs 3.88 ± 2.6 ng angiotensin I/ml/hr). Aldosterone was lower (p<0.01) during sodium depletion in the sodium-sensitive subsets (17.3 ± 12 vs 26.3 ± 16; 18.5 ± 18 vs 27.9 ± 17 ng/ml). A significant inverse correlation existed between change in BP with sodium repletion and change in PRA or level of PRA during sodium depletion (p<0.003). We conclude that both normotensive and borderline hypertensive sodiumsensitive subjects are characterized by an increase in forearm vascular resistance during high sodium intake and that this characteristic is associated with decreased responsiveness of the renin-aldosterone system during sodium depletion. (Hypertension 11: 717-723, 1988) KEY WORDS * hypertension • sodium • vascular resistance • hemodynamics renin • aldosterone A LTHOUGH considerable evidence links dietary / \ sodium intake with high blood pressure, sev-A. \ . eral observations suggest that all persons are not affected equally by the hypertensive effects of sodium. By selective inbreeding, Dahl et al.1 have developed strains of rats that become hypertensive when fed a high sodium diet and others that are resistant to the hypertensive effects of sodium. Worldwide studies of sodium intake in various human populations have shown a direct relationship between sodium intake and the prevalence of hypertension, 2 yet in certain populations, the majority of persons remain normotensive despite high sodium intake.3 Over the past several years, a number of investigators have demonstrated

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Section: Discussionmentioning

confidence: 99%

Sodium sensitivity in human subjects. Hemodynamic and hormonal correlates.

Sullivan

Ratts

1988

Hypertension

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“…6 " 8 It would be expected to reduce the volume-storage capacity of veins and thereby cause redistribution of blood within the cardiovascular system. 9 ' l0 Even a small shift of volume from the venous to the arterial circulation would raise arterial blood pressure greatly," and it has been proposed that established hypertension is in part maintained by an imbalance between a normal circulating blood volume and a decreased volume capacitance of the vasculature.…”

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confidence: 99%

“…Both of these have been reported as causes of the reduced venous distensibility that is seen in various forms of hypertension. For example, it has been found in isolated veins of dogs with one-kidney perinephritic hypertension, 2 in plethysmographic studies of the forearm 8 or of the index finger 36 in essentially hypertensive humans, and in the portal vein of spontaneously hypertensive rats. 37 We have no data showing the importance of neurogenic factors.…”

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confidence: 99%

Regional vascular capacitance in rabbit one-kidney, one clip hypertension.

Ackermann¹,

Tatemichi²

1983

Hypertension

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SUMMARY One-kidney Goldblatt hypertensive rabbits (New Zealand White) were studied after durations of renal artery clipping that varied from 6 to 17 days. Measurements included arterial pressure (ABP), iliac venous pressure (IVP), left atrial pressure (LAP), cardiac output (CO) (by thermodilution), blood volume (BV), cardiopulmonary volume (CPV), and hind leg thermodilution volume (HLV). These were determined at steady-state as well as during acute blood volume expansion. In sham-clipped animals, ABP was 74 ± 1 mm Hg. This increased to 92 ± 3 mm Hg by 6 to 9 days post-clipping, to 96 ± 3 mm Hg by 10 to 13 days, to 89 ± 4 mm Hg by 14 to 17 days. CO remained near 150 ml/min kg until Day 13 and fell to 127 ± 8 ml/min kg at 14 to 17 days because of a fall in heart rate. Blood volume and stroke volume did not change significantly from 62 ± 1 ml/kg and 0.60 ± 0.04 ml/kg, respectively. The development of hypertension was due entirely to changes in peripheral resistance. CPV was 8. Even a small shift of volume from the venous to the arterial circulation would raise arterial blood pressure greatly," and it has been proposed that established hypertension is in part maintained by an imbalance between a normal circulating blood volume and a decreased volume capacitance of the vasculature. 12 -l3 From the Department of Physiology, University of Toronto, Toronto, Ontario.Supported by Ontario Heart Foundation Grant 1-31. Address for reprints: U. Ackermann, Ph.D., Department of Physiology, Medical Science Building, University of Toronto, Toronto, Ontario, Canada M5S 1A8.Received March 12, 1982; revision accepted February 25, 1983. Although it has been argued that reduced venous distensibility in hypertension is less likely to be an effect of the raised arterial pressure and more likely to be one of its contributing causes, 5 it is not known whether changes in distensibility are progressive; it is not known whether there are differences among tissues with respect to such changes nor what effect these changes have on regional vascular volumes either at steady state or during an acute volume stress.The purpose of these experiments was to measure, at steady-state and during acute blood volume expansion, the volume in the cardiopulmonary region and in the hindleg region of rabbits with one-kidney Goldblatt hypertension of increasing duration. MethodsExperiments were performed on 36 male New Zealand White rabbits, anesthetized with sodium pentobarbital (25 mg/kg) injected into a marginal ear vein.

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“…Such studies have shown little or no difference in blood flow between hypertensives and normotensives in the following areas: fingers [10], hand and foot [42], forearm [11] and lower leg [30]. Both a decrease [5,17,32] and increase [39] in skin blood flow, with increased flow to forearm muscles [5,13,15,22], have been reported in essential hypertension.…”

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Capillary Blood Flow in Subcutaneous Tissue and Muscle in Essential Hypertension

Ondrejicka¹,

Pechán²,

Janotka³

et al. 1974

Cardiology

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The clearance rate of Na ¹³¹I was measured to assess capillary blood flow in the subcutaneous tissues of the hand and lower leg, as well as in muscle of the forearm and calf, in 21 patients with stage I hypertension and in normotensive controls. Hypertensive subjects exhibited a significantly slower clearance of the tracer from subcutaneous tissues than controls, both at rest and during vasomotor reactions. Clearance from forearm muscle was more rapid in hypertensives than in controls, but the opposite prevailed for clearance from the muscles of the lower extremities. In normal subjects, clearance of ¹³¹I from the subcutaneous tissue and muscle of the leg was significantly slower than clearance from corresponding tissues of the upper extremity. This difference was even more pronounced in the hypertensive group.

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Digital Hemodynamics in the Normotensive and Hypertensive States

Cited by 16 publications

References 11 publications

Sodium sensitivity in human subjects. Hemodynamic and hormonal correlates.

Sodium sensitivity in human subjects. Hemodynamic and hormonal correlates.

Regional vascular capacitance in rabbit one-kidney, one clip hypertension.

Capillary Blood Flow in Subcutaneous Tissue and Muscle in Essential Hypertension

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