Renin-Aldosterone System in Parkinson's Disease

Barbeau, A.; Gillo-Joffroy, Lise; Boucher, R.; Nowaczynski, W.; Genest, Jacques

doi:10.1126/science.165.3890.291

Cited by 68 publications

(39 citation statements)

References 9 publications

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“…21 In IPD, the hypothalamic-pituitary-adrenal axis is compromised, even in patients without clinically evident autonomic failure. 5,22 Generalized sympathetic denervation is common, 3 with decreased catecholamine content of the adrenal medulla, 6 blunted circadian rhythms of circulating cortisol, 8,9 and reduced levels of renin and aldosterone, 7 while cardiac and blood vessel sympathetic innervation is also damaged. 4 The lower blood pressure in our IPD patients than controls likely results from sympathetic denervation of the heart, blood vessels and kidneys, and from involvement of adrenal medulla in the disease process.…”

Section: Discussionmentioning

confidence: 99%

“…5 The adrenal medulla is a major component of the autonomic nervous system, and its catecholamine content is severely depleted in IPD 6 ; low aldosterone secretion and renin activity in plasma are also observed. 7 Furthermore, the circadian variations in plasma corticotropin (ACTH), cortisol, and catecholamines are less marked in IPD patients than in healthy subjects. 8,9 In IPD patients basal plasma levels of ACTH and cortisol are normal, but the increase in the plasma levels of these substances is blunted after pituitary-adrenal axis stimulation.…”

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confidence: 99%

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Reduced Risk Factors for Vascular Disorders in Parkinson Disease Patients

Scigliano

Musicco

Soliveri

et al. 2006

Stroke

167

147

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Background and Purpose-Sympathetic hyperactivity is a contributing cause of vascular disorders because it increases blood pressure, blood sugar, and blood lipids. Pervasive compromise of the central and peripheral autonomic nervous systems is common in idiopathic Parkinson disease (IPD) resulting in reduced sympathetic and parasympathetic function. We hypothesized that IPD was associated with reduced prevalence of cardiovascular disease risk factors as a result of reduced sympathetic activity. Methods-We performed a retrospective case-control study on 178 newly diagnosed consecutive IPD patients, and 533 age-(Ϯ3 years) and sex-matched controls with other neurological diseases seen over the same period at the same hospital. For each case and control the following were noted on admission: smoking, diabetes, hypertension, body mass index, serum glucose, plasma cholesterol, triglycerides and total lipid levels, and blood pressure. Results-Diabetes, history of smoking, high blood pressure, high blood glucose, high blood cholesterol, and triglycerides were significantly less frequent in IPD than controls. Conclusions-IDP is a natural model of impaired hypothalamic-pituitary-adrenal axis activity and generalized sympathetic denervation. We interpret the association of untreated IPD with reduced vascular diseases risk factors as attributable to reduced autonomic activity, suggesting that autonomic hyperactivity may be involved in the pathogenesis of vascular disorders.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Reduced Risk Factors for Vascular Disorders in Parkinson Disease Patients

Scigliano

Musicco

Soliveri

et al. 2006

Stroke

167

147

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“…In 1969, Barbeau et al. I first demonstrated that blood pressure in such patients is usually lower than the mean for their age group, probably as a consequence of a diminished ability to secrete renin.…”

Section: Introductionmentioning

confidence: 99%

Parkinson's disease and hypotension: 24‐hour blood pressure recording in ambulant patients

Brevetti

Bonaduce

Breglio

et al. 1990

Clinical Cardiology

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“…Barbeau et al (28) reported that Ldopa decreases plasma renin activity to undetectable levels in Parkinsonian patients and postulated that this causes orthostatic hypotension. It is also possible that the vasodilation produced by dopamine in the renal and mesenteric vascular beds (24,29,30) may be of sufficient degree to diminish the reflex vasoconstriction produced by postural changes.…”

Section: Whitsett Halushka Goldbergmentioning

confidence: 99%

Attenuation of Postganglionic Sympathetic Nerve Activity by L-Dopa

Whitsett

Halushka

Goldberg

1970

Circulation Research

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In anesthetized dogs and cats, intravenous L-dopa reduced the increase in mean blood pressure in response to bilateral carotid occlusion by 77.5% (P<0.01). In the presence of a dopa decarboxylase inhibitor (Ro 4-4602), this effect was absent. Transmission across the superior cervical sympathetic ganglion in the cat was unaltered by the administration of L-dopa. Carotid artery infusion in the dog of 20% of the effective intravenous dose of L-dopa or dopamine failed to inhibit the response to bilateral carotid occlusion. The pressor response to intravenous tyramine in the dog was potentiated (P<0.05) by L-dopa. In the dog, the increase in femoral vascular resistance to lumbar sympathetic nerve stimulation was attenuated (P < 0.05) by L-dopa while the response to intra-arterial norepinephrine was unchanged. Thus, inhibition of postganglionic sympathetic nerve activity is a possible mechanism by which L-dopa impaired the carotid sinus reflex. ADDITIONAL KEY WORDScat dog carotid sinus reflex decarboxylase inhibition ganglionic transmission dopamine norepinephrine tyramine• Patients with Parkinson's disease treated with L-dopa have frequently experienced orthostatic hypotension (1-6). Although a number of theories have been proposed to explain this phenomenon, the mechanism of action has not yet been elucidated. In the present study we found that the pressor response to bilateral carotid artery occlusion of anesthetized dogs and cats was markedly impaired by intravenous administration of Ldopa. By systematic elimination of several possible mechanisms, we conclude that impairment of the activity of postganglionic sympathetic nerves is the most likely explana- emulation Research. Vol. XXVU, October 1970 tion for the attenuation of the carotid sinus reflex. Methods STUDIES IN THE DOGMongrel dogs (11 to 17 kg) were anesthetized with pentobarbital (25 mg/kg iv). This was followed by a continuous infusion of the drug at a rate of approximately 5 mg • kg" 1 • hour-1 . Ventilation was provided by a Harvard respirator pump. Esophageal temperature was maintained at 37°C by electric heating pads applied to the surface of the body. After bilateral vagotomy, the common carotid arteries were isolated several centimeters proximal to the carotid sinus and loose cotton ligatures were placed around them. To occlude the arteries, the ligatures were pulled gently through a piece of polyethylene tubing for 30 seconds. The response to two or more carotid occlusion tests was obtained before, during, and after L-dopa administration.Blood pressure was measured from a femoral artery by a Statham P23-D transducer and electrically integrated mean blood pressure was recorded on a Grass polygraph. A femoral vein was used for intravenous injections and infusions. An initial loading dose (5 mg/kg) of L-dopa was administered, followed by a continuous infusion ( 0.2 mg • kg-1 • min-1 ). In four animals the infusion rate was increased 25 to 90% to attenuate 561 by guest on May 7, 2018

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Renin-Aldosterone System in Parkinson's Disease

Cited by 68 publications

References 9 publications

Reduced Risk Factors for Vascular Disorders in Parkinson Disease Patients

Reduced Risk Factors for Vascular Disorders in Parkinson Disease Patients

Parkinson's disease and hypotension: 24‐hour blood pressure recording in ambulant patients

Attenuation of Postganglionic Sympathetic Nerve Activity by L-Dopa

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