Disturbed noradrenergic blood pressure control in normotensive members of hypertensive families.

Bianchetti, Mario G.; Weidmann, P; Beretta-Piccoli, C; Rupp, U; Boehringer, K; Link, L; Ferrier, Claudia

doi:10.1136/hrt.51.3.306

Cited by 31 publications

(17 citation statements)

References 23 publications

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“…We could not reconfirm the observation by Bianchetti et al 31 that a family history of hypertension was related to slope. We relied on unverified self-report of family history; thus, these data are subject to question.…”

Section: Discussioncontrasting

confidence: 99%

Age, race, diagnosis, and sodium effects on the pressor response to infused norepinephrine.

et al. 1987

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SUMMARY We studied the blood pressure responses to infused norepinephrine in 34 normotensive and 21 unmedicated subjects with essential hypertension. The two groups were similar in age, relative body weight, and urinary electrolyte excretion. Patients were studied on two extremes of dietary salt (200 mEq Na and 10 mEq Na per day). The dose-response curves were highly linear (p<0.00001) for both systolic and diastolic blood pressures. There was no evidence for an increased sensitivity to infused norepinephrine among the hypertensive subjects. On the other hand, older subjects had steeper slopes ( p < 0.005). Subjects on a high salt diet had steeper slopes than those on low salt diets (p<0.0025); this trend was especially apparent among blacks (p<0.005). Black and white hypertensive subjects responded to the high salt diet in opposite fashion: The blacks showed an increased pressor sensitivity (p<0.05), whereas the whites demonstrated a nonsignificant decreased pressor sensitivity. These results indicate that age, race, and salt effects must be meticulously controlled in studies of sympathetic nervous system physiology. 1 made the intriguing observation that hypertensive patients seemed unusually sensitive to the blood pressure (BP)-elevating effects of infused norepinephrine (NE). Since then, many investigators have studied the slope of this relationship, comparing hypertensive and normotensive subjects. Since BP is elevated in many essential hypertensive patients because of increased peripheral resistance, many researchers have expected that hypertensive patients would demonstrate an increased vascular sensitivity (or steeper dose-response slopes) to infused NE.2 Over the years, however, this hypothesized increased sensitivity has not been replicated consistently. Although no one has reported that hypertensive subjects are less sensitive than normotensive subjects to infused NE, the findings are mixed,

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Section: Discussioncontrasting

confidence: 99%

Age, race, diagnosis, and sodium effects on the pressor response to infused norepinephrine.

et al. 1987

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“…It has been shown that a common familial disturbance which could possibly predispose to the development of essential hyper tension, was an imbalance between the cardiovascular noradrenaline responsiveness and the circulating noradrenaline [20]. The increased response to norepinephrine in the normotensive siblings of hypertensive parents was due to a reduced threshold to norepinephrine [21].…”

Section: Discussionmentioning

confidence: 99%

The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

Garg

Malhotra²,

Dhar³

et al. 2013

JCDR

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Background: A familial history of hypertension increases the risk of hypertension in the offsprings. Aims and objectives:The present study was undertaken to assess the underlying hypertension by using the Isometric Handgrip (IHG) exercise test in the offsprings of hypertensive parents and to compare it with age-matched controls of normotensive parents. Material and Methods:The isometric handgrip test was performed in the study and control groups. The resting blood pressure was recorded before exercise and afterwards the subjects were asked to perform the isometric handgrip exercise with the dominant hand for 2 minutes. Then the blood pressure was recorded in the sitting position during and 5 minutes after the completion of the exercise.Statistical Analysis: The analysis of the results was done by ANOVA with SPSS, version 17.0, by using the unpaired 't' test. Results:The results showed that the Resting Systolic (SBP), Diastolic (DBP) and the Mean (MBP) Blood Pressures were higher (p <0.001) in the offsprings of the hypertensive parents as compared to those in the control subjects of normotensive parents. During the isometric handgrip exercise test, the rise in the systolic, diastolic and the mean blood pressures was significantly higher (p<0.001) in the offsprings of the hypertensive parents. After 5 minutes of exercise, the SBP, DBP and the MBP were found to be significantly higher (p<0.001) in the study group as compared to those in the control group.Conclusions: An early and a regular screening of the children of hypertensive parents is necessary to prevent any future cardiovascular complications.

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“…l6 Subjects with a family history of hypertension have higher catecholamine levels during stress" and show enhanced pressor response to exogenous catecholamines. 17 Bianchetti et al 18 noted lower mean levels of plasma NE in normotensive subjects with a history of hypertension than in those without such a history, though these differences did not reach statistical significance. Beilin et al" found higher levels of E but not NE in high normal compared with low normal blood pressure groups, although no account was taken of a family history of hypertension.…”

Section: Figure 3 Effect Of Alcohol (*) and Placebo (O) On Plasma Nomentioning

confidence: 96%

The pressor and metabolic effects of alcohol in normotensive subjects.

Potter¹,

Watson²,

Skan³

et al. 1986

Hypertension

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SUMMARY Changes in blood pressure, pulse rate, and plasma catecholamines, renin activity, cortisol, and calcium were studied in 16 normotensive subjects (eight with a family history of hypertension) for 5 hours following ingestion of alcohol-free and alcohol-loaded beer. Both systolic and diastolic blood pressure rose after alcohol consumption; maximum responses occurred at peak blood alcohol concentrations and were significantly higher than those seen after placebo. Pulse rate was also significantly higher after alcohol ingestion and continued to rise throughout the study. There was no difference in the pressor response to alcohol between the groups with and without a family history of hypertension. No difference was found in plasma norepinephrine or epinephrine levels between alcohol and placebo phases. However, subjects with no family history of hypertension had significantly higher plasma norepinephrine levels (p<0.01) than did those with a family history during both the alcohol and placebo phases, although baseline blood pressures were not significantly different. Plasma epinephrine level was similar in both groups. Plasma renin activity was unchanged throughout, but plasma cortisol fell during both phases. Plasma calcium showed a small but significant fall with alcohol consumption in both groups (p<0.001). These results indicate that in normotensive subjects alcohol ingestion causes a rise in systolic and diastolic blood pressure that is not influenced by a family history of hypertension. This effect does not appear to be sympathetically mediated but may be due to a direct vasoconstrictor effect of alcohol, possibly with an alcohol-induced shift in intracellular calcium. Dr. Potter was supported by a research grant from the British Heart Foundation.Address for reprints: Dr. J.F. Potter, Freeman Road Hospital, Newcastle upon Tyne NE7 7DN, UK.Received July 19, 1985; accepted December 30, 1985. and the duration of the study. We have therefore examined, in normotensive subjects, the acute effects of alcohol and placebo on blood pressure in relation to the possible pressor mechanisms. We examined the changes in blood pressure with the rise and fall in blood alcohol levels to determine whether these changes were due to a direct effect of alcohol or were related to a withdrawal response. Subjects and Methods

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Disturbed noradrenergic blood pressure control in normotensive members of hypertensive families.

Cited by 31 publications

References 23 publications

Age, race, diagnosis, and sodium effects on the pressor response to infused norepinephrine.

Age, race, diagnosis, and sodium effects on the pressor response to infused norepinephrine.

The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

The pressor and metabolic effects of alcohol in normotensive subjects.

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