β-Endorphin modulation of pressor response to hyperventilation in hypertensive patients

Fontana, Fiorella; Bernardi, P; Spampinato, Santi; Toro, Rosanna Di; Bugiardini, Raffaele

doi:10.1016/s0196-9781(02)00018-9

Cited by 7 publications

(22 citation statements)

References 21 publications

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“…8,9 In this report we show that the responses to hyperventilation reflect differences in pressor profiles assessed by daytime BP monitoring.…”

Section: Discussionmentioning

confidence: 58%

“…9 These different phenotypes, characterizing hypertensive patients with a similar pressor daytime profile but different BP response to hyperventilation, are probably attributable to a different genetic background, as previously described for the responses to mental stress in normotensive offspring of hypertensive parents. 20 Our findings in hypertensive patients are in agreement with previously reported data showing a direct correlation between the increase in BP in response to standardized psychological tests and daytime peak ambulatory BP values, suggesting that mental stress-induced BP increases can be useful to predict daily BP variations.…”

Section: Discussionmentioning

confidence: 81%

“…2,3 Although BP values measured during the doctor's visit may be affected by the patient's emotional reaction, 4 ambulatory BP monitoring provides more reliable measurements of BP values for better assessment of hypertensive patients. 2,[5][6][7] Previously, we showed that in healthy subjects 8 and in patients with mild or moderate hypertension, 9 a prolonged and forced hyperventilation induced different BP responses, dividing the subjects into 3 groups: the first responding with a decrease in BP, the second without any significant change, and the third with an increase. The changes in BP response to the hyperventilation test were associated with corresponding changes in sympathoadrenergic tone.…”

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confidence: 99%

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Blood Pressure Response to Hyperventilation Test Reflects Daytime Pressor Profile

et al. 2003

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Abstract-Recent studies show that healthy subjects and patients with moderate hypertension have different pressor responses to hyperventilation, depending on their sympathoadrenergic reactivity. In the present study, we investigated whether a different response to the hyperventilation test is related to differences in the daily blood pressure profiles recorded with noninvasive ambulatory monitoring. Forty-five healthy subjects and 67 patients with essential hypertension of grades 1 and 2 (Joint National Committee VI and World Health Organization) were investigated. Healthy subjects and hypertensive patients responding to hyperventilation with an increase in systolic blood pressure had, during daytime ambulatory blood pressure assessment Previously, we showed that in healthy subjects 8 and in patients with mild or moderate hypertension, 9 a prolonged and forced hyperventilation induced different BP responses, dividing the subjects into 3 groups: the first responding with a decrease in BP, the second without any significant change, and the third with an increase. The changes in BP response to the hyperventilation test were associated with corresponding changes in sympathoadrenergic tone. There is also evidence that the daily pressor spontaneous fluctuations of hypertensive patients are due to changes in sympathoadrenergic activity. 10,11 Moreover, in these patients, daily BP elevations recorded during ambulatory monitoring are closely related to the increase in BP found during standardized psychophysiological stress tests. 12 To establish whether hyperventilation can yield useful information on daytime pressor profiles, we evaluated the association of pressor responses to hyperventilation with particular pressor parameters recorded by ambulatory BP monitoring (daytime average ambulatory BP values, daytime peak BP values, average of the highest 5 BP values, and daytime fluctuations of BP values). Methods PatientsWe enrolled young healthy subjects (nϭ45, 21 women and 24 men; mean age, 30Ϯ6 years) and subjects with essential hypertension (nϭ67, 30 women and 37 men; mean age, 62Ϯ5 years) of grades 1 and 2 according to the Sixth Report of the Joint National Committee and the World Health Organization (JNC VI/WHO). 13 Healthy subjects were selected among young physicians and medical students at our university. No subject had a personal or family history of hypertension. All had resting systolic blood pressure (SBP) values Ͻ135 mm Hg and diastolic blood pressure (DBP) values Ͻ85 mm Hg.Hypertensive patients were recruited from 3 cohorts: (1) patients who underwent medical examination, (2) patients admitted to the hospital for other diseases in whom hypertension was found for the first time, (3) patients attending the hypertension clinic at our institution during a period of discontinuation of antihypertensive drugs. Patients were asymptomatic and had SBP within 158 and 190 mm Hg and DBP within 85 and 110 mm Hg. Routine laboratory

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“…8,9 In this report we show that the responses to hyperventilation reflect differences in pressor profiles assessed by daytime BP monitoring.…”

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 81%

mentioning

confidence: 99%

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Blood Pressure Response to Hyperventilation Test Reflects Daytime Pressor Profile

et al. 2003

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“…Plasma β-endorphin levels have been found reduced or normal in elderly essential hypertensive patients [5][6][7], whereas increased levels were reported in elderly secondary hypertensive patients with chronic renal failure [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…The relation between cardiovascular parameters, the sympatho-adrenergic system and endogenous opiates have recently been studied using the forced hyperventilation test [6,15,16]. Five minutes of forced hyperventilation induce different blood pressure (BP) responses, dividing healthy subjects [15] and adult patients with mild or moderate essential hypertension [6,16] into three groups: the first responding with a decrease in BP, the second without any significant change, and the third with an increase.…”

Section: Introductionmentioning

confidence: 99%

β-Endorphin in pressor response to hyperventilation in elderly patients with essential and secondary hypertension

et al. 2008

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AbstractIt has been observed that a distinct blood pressure (BP) response to prolonged and forced hyperventilation in adult patients with essential hypertension is associated with significant changes in plasma catecholamine and β-endorphin levels. This paper investigated whether hemodynamic and neuro-endocrine responses to hyperventilation in elderly patients with essential hypertension (n = 39, mean age 81 ± 3 years) differ from those in elderly patients with secondary hypertension (isolated systolic hypertension, bilateral chronic nephropathy, nephroangiosclerosis, diabetic nephropathy and hyperparathyroidism) (n = 39, mean age 80 ± 1 years). Plasma β-endorphin levels were normal in patients with essential hypertension and increased in patients with secondary hypertension. Plasma norepinephrine levels were normal in both populations. Hyperventilation decreased BP and norepinephrine levels and increased β-endorphin levels in essential hypertensive patients, whereas it did not significantly change BP or neuro-hormonal levels in secondary hypertensive patients. Hierarchical cluster analysis based on BP response to hyperventilation disclosed a sub-group of essential hypertensive patients with the highest basal levels of norepinephrine and the lowest β-endorphin levels, in whom the BP decrease following hyperventilation was correlated with the decrease in norepinephrine and increase in β-endorphin levels. This suggests that b-endorphin may be involved in modulating sympatho-adrenergic activity in elderly patients with essential hypertension.

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Plasma nociceptin/orphanin FQ levels in response to the hyperventilation test in healthy subjects

et al. 2010

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β-Endorphin modulation of pressor response to hyperventilation in hypertensive patients

Cited by 7 publications

References 21 publications

Blood Pressure Response to Hyperventilation Test Reflects Daytime Pressor Profile

Blood Pressure Response to Hyperventilation Test Reflects Daytime Pressor Profile

β-Endorphin in pressor response to hyperventilation in elderly patients with essential and secondary hypertension

Plasma nociceptin/orphanin FQ levels in response to the hyperventilation test in healthy subjects

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