Differentiated Response of the Sympathetic Nervous System to Angiotensin-Converting Enzyme Inhibition in Hypertension
- 1 October 2000
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 36 (4), 543-548
- https://doi.org/10.1161/01.hyp.36.4.543
Abstract
Abstract —Hypertension with renal artery stenosis is associated with both an activated renin-angiotensin system and elevated sympathetic activity. Therefore, in this condition it may be favorable to use a therapeutic modality that does not reflexly increase heart rate, renin secretion, and sympathetic nervous activity. The purpose of the present study was to assess overall, renal, and muscle sympathetic activity after short-term administration of an angiotensin-converting enzyme inhibitor (enalaprilat) and a nonspecific vasodilator (dihydralazine) to hypertensive patients with renal artery stenosis. Forty-eight patients undergoing a clinical investigation for renovascular hypertension were included in the study. An isotope dilution technique for assessing norepinephrine spillover was used to estimate overall and bilateral renal sympathetic nerve activity. In 11 patients simultaneous intraneural recordings of efferent muscle sympathetic nerve activity were performed. Thirty minutes after dihydralazine administration, mean arterial pressure fell by 15%, whereas plasma angiotensin II, muscle sympathetic nerve activity, heart rate, and total body norepinephrine spillover increased ( P P <0.05). Acute blood pressure reduction by an angiotensin-converting enzyme inhibitor provokes a differentiated sympathetic response in patients with hypertension and renal artery stenosis, inasmuch that overall and muscle sympathetic reflex activation are blunted, whereas the reflex renal sympathetic response to blood pressure reduction is preserved.Keywords
This publication has 23 references indexed in Scilit:
- Angiotensin II exerts differential actions on renal nerve activity and heart rate.Hypertension, 1994
- Neural control of renal function in health and diseaseClinical Autonomic Research, 1994
- Role of nitric oxide and angiotensin II in the regulation of sympathetic nerve activity in spontaneously hypertensive rats.Hypertension, 1993
- Central nervous system and the pathogenesis of hypertension. Sites and mechanisms.Hypertension, 1991
- Muscle sympathetic nerve activity in renovascular hypertension and primary aldosteronism.Hypertension, 1991
- Haemodynamic information encoded in the aortic baroreceptor discharge during haemorrhageActa Physiologica Scandinavica, 1990
- Assessment of human sympathetic nervous system activity from measurements of norepinephrine turnover.Hypertension, 1988
- Determination of norepinephrine apparent release rate and clearance in humansLife Sciences, 1979
- Measurement of angiotensin II in human plasma: Technical modifications and practical experienceClinica Chimica Acta; International Journal of Clinical Chemistry, 1976
- Neurogenic Component of Chronic Renal HypertensionScience, 1963