Diurnal variations of cardiac rhythm, arterial pressure, and urinary catecholamines in borderline and established essential hypertension

Messerli, Franz H.; Glade, Louis B.; Ventura, Héctor O.; Dreslinski, Gerald R.; Suárez, Daniel; MacPhee, Allan A.; Aristimuno, Gerardo G.; Cole, Francis E.; Fröhlich, Edward D.

doi:10.1016/0002-8703(82)90649-4

Cited by 72 publications

(29 citation statements)

References 23 publications

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“…Normotensive individuals exhibit a decrease in systolic blood pressure before the sleep phase that corresponds to a decreased activity. 23 A similar anticipatory decrease was observed in the WKY-CR rats approximately 1 hour before the lightson period. However, we were unable to determine locomotor activity on an hour-to-hour basis and therefore cannot correlate this drop in arterial pressure in WKY-CR rats with decreased motor activity before the lights-on period.…”

Section: Henry Et Alsupporting

confidence: 60%

Diurnal cardiovascular patterns in spontaneously hypertensive and Wistar-Kyoto rats.

1990

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This study was designed to determine whether diurnal patterns of blood pressure, heart rate, or locomotor activity differed among two substrains of Wistar-Kyoto rats, derived originally from Charles River or Taconic Farms stock, or the spontaneously hypertensive rat Cardiovascular parameters were continuously monitored over 24 hours. Resting systolic and diastolic blood pressure values were statistically different among the three groups both during the lights-on (rest) and lights-off (active) phases of the cycle with blood pressure of spontaneously hypertensive rats greater than that of Wistar-Kyoto rats from Taconic Farms, which was greater than that of Wistar-Kyoto rats from Charles River. The largest difference in arterial pressure between Wistar-Kyoto/Taconic Farms and Wistar-Kyoto/Charles River was during the lights-on period. Heart rates of all rats decreased during the lights-on period; Wistar-Kyoto/ Charles River had the largest decrease ( -7 0 ± 5 beats/min), Wistar-Kyoto/Taconic Farms had the least (-17±2 beats/min), and in spontaneously hypertensive rats the decrease was intermediate (-29±3 beats/min). The pronounced diurnal variation in pressure and heart rate exhibited by Wistar-Kyoto/Charles River was not present in either Wistar-Kyoto/Taconic Farms or spontaneously hypertensive rats. Blood pressure magnitude correlated with locomotor activity during both periods, although all groups showed minimal activity during the rest period. Observed differences between Wistar-Kyoto/Charles River and Wistar-Kyoto/Taconic Farms were not due to a lack of or an abnormality in baroreceptor reflex function. Because most investigations that use these rat strains are performed during the lights-on phase of the diurnal cycle, the results demonstrate the need for a careful analysis of individual experimental protocols as well as the determination of the appropriate control for the spontaneously hypertensive rat (Hypertension 1990;16:422-428) T he suitability of the Wistar-Kyoto (WKY) inbred rat strain as the appropriate control for the spontaneously hypertensive rat (SHR) has been questioned by several groups within the past 2 years. Our concerns were raised in the early 1980s when we noted differences between WKY rats purchased from different vendors.After completion of a period of inbreeding by the National Institutes of Health (NIH) (20 generations of brother-sister mating), distribution of Wistarderived SHR obtained initially from Okamoto and Aoki 1 commenced in 1969. 2 The SHR strain has since achieved wide acceptance as an experimental model for essential hypertension. -4 For a control rat strain

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Section: Henry Et Alsupporting

confidence: 60%

Diurnal cardiovascular patterns in spontaneously hypertensive and Wistar-Kyoto rats.

1990

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“…This, however, does not exclude the fact that when expressed as a percentage change from baseline, the variation coefficients are similar in the different stages of arterial hypertension. 7 The reason for the discordance between the rule and the fact may well be that seeing a doctor or visiting a hospital is a stronger stimuli in some subjects than in others. The white-coat effect may also vary from country to country, eg, a study indicates that American patients find their doctors less exciting than do Italians.…”

Section: Discussionmentioning

confidence: 99%

Difference in blood pressure, but not in heart rate, between measurements performed at a health centre and at a hospital by one and the same physician

Enström¹,

Pennert²,

Lindholm

2000

J Hum Hypertens

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Background: Blood pressure (BP) has been found to vary between examiners, for example it is often higher when measured by a physician than by a nurse. Whether the location for the physician-measured BP is also a source of variation has, however, not been studied. Hence, we found it of interest to find out if the location used for examination was of any significance. Objective: To explore if BP and/or heart rate measured in the same subjects by the same general practitioner in the health centre and at the hospital, differed. Method: Twenty-five hypertensive and 25 age-matched normotensive middle-aged men had their office BP and heart rate recorded by one and the same female general practitioner (IE) who was well known to them, at both the health centre before ambulatory BP equipment was attached to the subject and at the clinical physiological department before an exercise test. The hypertensive patients performed an exercise test and ambulatory BP was measured before and after being treated. Results: The hypertensive patients' office BP was lower at the health centre than at the hospital, both when they

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“…Detailed, multiple sampling studies of 24-hour plasma levels of E and DA have not been previously reported, but a number of reports have suggested the existence of circadian rhythm of plasma and urinary £18, 19,22,24 T n e detectability of a diurnal rhythm of plasma E level in the aged and its obvious relation to the 24-hour cycle blood pressure levels suggest that at least some inherent chronobiological functions related to sympathetic outflow are preserved in the elderly. The reason for the dichotomy between the nocturnal decline in plasma E levels, MAP, and heart rate and the persistent high NE levels ( Figure 5) is not clear.…”

Section: Discussionmentioning

confidence: 99%

“…Urinary excretion of catecholamine metabolites has been observed to be higher during the day than at night. 16 " 19 Several investigative groups have reported a diurnal variation in plasma NE levels and noted a significant fall in NE levels during sleep in recumbent young normotensive 13 ' ' *• 2O " 22 and hypertensive subjects.…”

Section: Essential Hypertension • Catecholamines Norepinephrine • Epimentioning

confidence: 99%

Dissociation of 24-hour catecholamine levels from blood pressure in older men.

Stern¹,

Beahm²,

McGinty³

et al. 1985

Hypertension

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SUMMARY Increased plasma norepinephrine levels have been observed in some persons with early essential hypertension. Although both plasma norepinephrine level and mean arterial blood pressure rise with age, little is known about the state of catecholamine secretion in elderly patients with essential hypertension. We studied the 24-hour cycle levels of plasma norepinephrine, epinephrine, and dopamine in 12 elderly hypertensive subjects and 13 age-matched normotensive controls (mean ages, 63.8 ± 1.2 yr and 64.8 ± 1.8 yr [SEM] respectively). Blood samples were obtained at bihourly intervals from 0900 to 2100 hours and every 30 minutes from 2100 to 0900 hours, during which time sleep and breathing were continuously monitored. A circadian rhythm was displayed in both groups by plasma epinephrine levels (mesor, 49 ± 2 pg/ml and 38 ± 1 pg/ml; amplitude, 15 ± 2 pg/ml and 11 ± 1 pg/ml; acrophase, 12.20 ± 0.40 hr and 14.41 ± 0.34 hr in the normotensive and hypertensive groups respectively) but not by plasma norepinephrine or dopamine levels. During the 24-hour cycle plasma epinephrine, but not norepinephrine or dopamine, levels were positively related to mean arterial blood pressure (r = 0.60 for the normotensive subjects, r = 0.57 for the hypertensive subjects, p < 0.01 for both). Mean 24-hour plasma norepinephrine (377 ± 9 pg/ml vs 455 ± 9 pg/ml; p < 0.001), epinephrine (34 ± 2 pg/ml vs 45 ± 2 pg/ml; p < 0.01), and dopamine (40 ± 2 pg/ml vs 62 ± 3 pg/ml; p < 0.01) levels were lower in the hypertensive group, although groups did not differ in parameters known to affect catecholamine secretion such as body weight, sodium intake, sleep efficiency, or sleeprelated breathing disorders. Mean 24-hour plasma norepinephrine level was inversely related to the 24-hour mean arterial blood pressure (r = -0.48, p < 0.05). High norepinephrine levels in the elderly may reflect decreased baroreceptor sensitivity as well as compensatory response to decreased /3-adrenergic receptor sensitivity. It is unclear why elderly hypertensive persons, unlike younger hypertensive persons, have lower plasma catecholamine levels than do elderly normotensive persons. Whereas increased sympathetic outflow has been implicated in the induction of early "neurogenic" essential hypertension, 4 the age-dependent increase in NE is observed in normotensive subjects. Whether the ob- served increment in circulating NE is related to the age-associated rise in blood pressure or to the increased incidence of hypertension in aging humans is unclear. 5 The increase in NE with advancing age instead could reflect a compensatory mechanism to a declining peripheral response to adrenergic stimuli 6 -7 or an age-related decrease in clearance of NE. 8 Moreover, a recent study based on single NE samples obtained from a large number of subjects with a wide age range concluded that NE increases with age in normotensive subjects but not in subjects with essential hypertension. 9 However, there is relatively little direct information about the state of plasma catecholamines in...

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Diurnal variations of cardiac rhythm, arterial pressure, and urinary catecholamines in borderline and established essential hypertension

Cited by 72 publications

References 23 publications

Diurnal cardiovascular patterns in spontaneously hypertensive and Wistar-Kyoto rats.

Diurnal cardiovascular patterns in spontaneously hypertensive and Wistar-Kyoto rats.

Difference in blood pressure, but not in heart rate, between measurements performed at a health centre and at a hospital by one and the same physician

Dissociation of 24-hour catecholamine levels from blood pressure in older men.

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