The sympathetic nervous system: the muse of primary hypertension

DeQuattro, Vincent; Feng, Ming

doi:10.1038/sj.jhh.1001346

Cited by 37 publications

(27 citation statements)

References 23 publications

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“…Third, plasma NE concentrations are the result of peripheral sympathetic nerve ending, adrenal medulla secretion and removal mechanisms and therefore allow only for preliminary interpretation when used as an index of systemic SNS activity. 58 To conclude, our data give evidence for an autonomic imbalance in young healthy ss subjects, indicated by a higher HR rise and larger decrease of HRV. The sympathetic hyperactivity and/or stronger withdrawal of parasympathetic tone under the influence of stress may represent a mechanism by which vascular damage occurs in the long run.…”

Section: Cortisolsupporting

confidence: 59%

Salt-sensitive men show reduced heart rate variability, lower norepinephrine and enhanced cortisol during mental stress

et al. 2008

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Salt sensitivity (SS) represents a risk factor for essential hypertension, which has been related to enhanced cardiovascular stress reactivity possibly mediated by increased noradrenergic susceptibility. We investigated biophysiological responses to mental stress in salt-sensitive (ss) and salt-resistant (sr) subjects, hypothesizing lower heart rate variability (HRV) and higher cortisol in the ss. A total of 48 healthy normotensive Caucasian men (age 25.6±2.6, body mass index 22.9±2.3) were phenotyped for SS (defined as significant drop in mean arterial pressure43 mm Hg under the low-salt diet) by a 2-week high-versus low-salt diet. Subjects underwent a standardized mental stress task with continuous cardiovascular monitoring before, during and after the test (Finapres; Ohmeda, Louisville, CO, USA). Blood samples were drawn to examine cortisol and catecholamines before, after and 20 min after stress. The task elicited significant increases of systolic blood pressure (SBP), diastolic BP (DBP) and heart rate (HR) and a significant decrease of HRV (all time effects Po0.0001). The ss subjects showed lower norepinephrine (NE) and higher cortisol, indicated by significant group effects (P ¼ 0.009 and 0.025, respectively). HR increased and HRV decreased more in the ss under the stress, shown by significant time by group interactions (P ¼ 0.045 and 0.003, respectively). The observation of a more pronounced HR rise coupled with a greater decrease of HRV in healthy ss men under the influence of brief mental stress confirms their enhanced physiological stress reactivity. The lower peripheral NE may represent an effort to compensate for increased noradrenergic receptor sensitivity. The enhanced cortisol levels are backed by recent genetic findings on HSD11B2 polymorphisms and may promote hypertension.

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Section: Cortisolsupporting

confidence: 59%

Salt-sensitive men show reduced heart rate variability, lower norepinephrine and enhanced cortisol during mental stress

et al. 2008

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“…There are numerous studies demonstrating that essential hypertension is accompanied by sympathetic activation. 4,19,20 It has been shown that noradrenaline plays an important role in the regulation of blood pressure, and the increased plasma catecholamine levels have been observed in the development of hypertension. As the rate-limiting enzyme in catecholamine biosynthesis, the TH gene is considered as a logic candidate for the etiology of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the biological process of blood pressure regulation, we focused on 11 candidate genes associated with: (1) renin-angiotensin-aldosterone system (RAAS), including ACE, angiotensin II receptor type I (AGTR1), and aldosterone synthase (CYP11B2) 15,18 ; (2) sympathetic nervous system, including ␣-1 adrenergic receptor 1A (ADRA1A), ␤-2 adrenergic receptor (ADRB2), and tyrosine hydroxylase (TH) 4,19,20 ; (3) lipoprotein metabolism, including lipoprotein lipase (LPL) 21 ; (4) intracellular messengers, including G protein ␤ polypeptide 3 (GNB3) and epithelium nitric oxide synthase (NOS3) 22,23 ; and (5) sodium and electrolyte balance, including G protein-coupled receptor kinase 4 (GRK4) and protein kinase lysine-deficient 4 (WNK4) 24,25 (as shown in Table 1). …”

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confidence: 99%

Association Study With 33 Single-Nucleotide Polymorphisms in 11 Candidate Genes for Hypertension in Chinese

et al. 2006

Hypertension

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Abstract-Essential hypertension is considered to be a typical complex disease with multifactorial etiology, which leads to inconsistent findings in genetic studies. One possibility of failure to replicate some single-locus results is that the underlying genetics of hypertension are not only based on multiple genes with minor effects but also on gene-gene interactions. To test this hypothesis, a case-control study was constructed in Chinese subjects, detecting both single locus and multilocus effects. Eleven candidate genes were selected from biochemical pathways that have been implicated in the development and progression of hypertension, and 33 polymorphisms were evaluated in 503 hypertension patients and 490 age-and gender-matched controls. Single-locus associations, using traditional logistic regression analyses, and multilocus associations, using classification and regression trees and multivariate adaptive regression splines, were both explored in this study. Final models were selected using either Bonferroni correction or cross-validation. Three polymorphisms, TH*rs2070762, ADRB2*Q27E, and GRK4*A486V, were found to be independently associated with essential hypertension in Chinese subjects. In addition to these individual predictors, a potential interaction of CYP11B2-AGTR1 is also involved in the etiology of hypertension. These findings support the multigenic nature of the etiology of essential hypertension and propose a potential gene-gene interactive model for future studies.

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“…6,7 Increased peripheral sympathetic activity is suggested to play a key role especially in the early phases of hypertension in young subjects. 3,8 Furthermore, as reviewed by DeQuattro and Feng, 9 several research groups found increased norepinephrine levels in cerebrospinal fluid and increased norepinephrine turnover in hypothalamic centres of hypertensive (HT) subjects. Central catecholaminergic pathways transmit neural stimuli to neuroendocrine hypothalamic centres that regulate endocrine activity of pituitary cells.…”

Section: Introductionmentioning

confidence: 99%

Decreased pituitary response to insulin-induced hypoglycaemia in young lean male patients with essential hypertension

Rádiková

Penesová

Cizmárová³

et al. 2006

J Hum Hypertens

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Essential hypertension is associated with changes in central catecholaminergic pathways which might also be reflected in the pituitary response to stress stimuli. The aim of this study was to determine whether the response of pituitary hormones, cortisol, plasma renin activity, aldosterone and catecholamines to insulininduced hypoglycaemia is changed in hypertension. We studied 22 young lean male patients with newly diagnosed untreated essential hypertension and 19 healthy normotensive, age-and body mass index (BMI)-matched controls. All subjects underwent an insulin tolerance test (0.1 IU insulin/kg body weight intravenously) with blood sampling before and 15, 30, 45, 60 and 90 min after insulin administration. Increased baseline levels of norepinephrine (Po0.05), increased response of norepinephrine (Po0.001) and decreased response of growth hormone (Po0.001), prolactin (Po0.001), adrenocorticotropic hormone (Po0.05) and cortisol (Po0.001) were found in hypertensive patients when compared to normotensive controls. Increased norepinephrine levels and a decreased pituitary response to metabolic stress stimuli may represent another manifestation of chronically increased sympathetic tone in early hypertension.

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The sympathetic nervous system: the muse of primary hypertension

Cited by 37 publications

References 23 publications

Salt-sensitive men show reduced heart rate variability, lower norepinephrine and enhanced cortisol during mental stress

Salt-sensitive men show reduced heart rate variability, lower norepinephrine and enhanced cortisol during mental stress

Association Study With 33 Single-Nucleotide Polymorphisms in 11 Candidate Genes for Hypertension in Chinese

Decreased pituitary response to insulin-induced hypoglycaemia in young lean male patients with essential hypertension

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