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Rodriguez J, Escobar JB, Cheung EC, Kowalik G, Russo R, Dyavanapalli J, Alber BR, Harral G, Gill A, Melkie M, Jain V, Schunke KJ, Mendelowitz D, Kay MW. Hypothalamic Oxytocin Neuron Activation Attenuates Intermittent Hypoxia-Induced Hypertension and Cardiac Dysfunction in an Animal Model of Sleep Apnea. Hypertension 2023; 80:882-894. [PMID: 36794581 PMCID: PMC10027399 DOI: 10.1161/hypertensionaha.122.20149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/18/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Obstructive sleep apnea is a prevalent and poorly treated cardiovascular disease that leads to hypertension and autonomic imbalance. Recent studies that restore cardiac parasympathetic tone using selective activation of hypothalamic oxytocin neurons have shown beneficial cardiovascular outcomes in animal models of cardiovascular disease. This study aimed to determine if chemogenetic activation of hypothalamic oxytocin neurons in animals with existing obstructive sleep apnea-induced hypertension would reverse or blunt the progression of autonomic and cardiovascular dysfunction. METHODS Two groups of rats were exposed to chronic intermittent hypoxia (CIH), a model of obstructive sleep apnea, for 4 weeks to induce hypertension. During an additional 4 weeks of exposure to CIH, 1 group was treated with selective activation of hypothalamic oxytocin neurons while the other group was untreated. RESULTS Hypertensive animals exposed to CIH and treated with daily hypothalamic oxytocin neuron activation had lower blood pressure, faster heart rate recovery times after exercise, and improved indices of cardiac function compared with untreated hypertensive animals. Microarray analysis suggested that, compared with treated animals, untreated animals had gene expression profiles associated with cellular stress response activation, hypoxia-inducible factor stabilization, and myocardial extracellular matrix remodeling and fibrosis. CONCLUSIONS In animals already presenting with CIH-induced hypertension, chronic activation of hypothalamic oxytocin neurons blunted the progression of hypertension and conferred cardioprotection after an additional 4 weeks of CIH exposure. These results have significant clinical translation for the treatment of cardiovascular disease in patients with obstructive sleep apnea.
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Affiliation(s)
- Jeannette Rodriguez
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Joan B Escobar
- Department of Pharmacology and Physiology (J.B.E., E.C.C., J.D., D.M.), The George Washington University, Washington, DC
| | - Emily C Cheung
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
- Department of Pharmacology and Physiology (J.B.E., E.C.C., J.D., D.M.), The George Washington University, Washington, DC
| | - Grant Kowalik
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Rebekah Russo
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Jhansi Dyavanapalli
- Department of Pharmacology and Physiology (J.B.E., E.C.C., J.D., D.M.), The George Washington University, Washington, DC
| | - Bridget R Alber
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Grey Harral
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Aman Gill
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Makeda Melkie
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
| | - Vivek Jain
- Department of Medicine (V.J.), The George Washington University, Washington, DC
| | - Kathryn J Schunke
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
- Department of Anatomy, Biochemistry & Physiology, University of Hawaii, Honolulu, HI (K.J.S.)
| | - David Mendelowitz
- Department of Pharmacology and Physiology (J.B.E., E.C.C., J.D., D.M.), The George Washington University, Washington, DC
| | - Matthew W Kay
- Department of Biomedical Engineering (J.R., E.C.C., G.K., R.R., B.R.A., G.H., A.G., M.M., K.J.S., M.W.K.), The George Washington University, Washington, DC
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Cappuccio FP. The Role of Nocturnal Blood Pressure and Sleep Quality in Hypertension Management. Eur Cardiol 2020; 15:e60. [PMID: 32944089 PMCID: PMC7479543 DOI: 10.15420/ecr.2020.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
The accurate measurement, prediction and treatment of high blood pressure (BP) are essential to the management of hypertension and the prevention of its associated cardiovascular (CV) risks. However, even if BP is optimally controlled during the day, nocturnal high blood pressure may still increase the risk of CV events. The pattern of circadian rhythm of BP can be evaluated by ambulatory BP monitoring (ABPM). Night-time ABPM is more closely associated with fatal and nonfatal CV events than daytime ambulatory BP. However, the use of ABPM is limited by low availability and the fact that it can cause sleep disturbance, therefore may not provide realistic nocturnal measurements. Home blood pressure monitoring (HBPM) offers an inexpensive alternative to ABPM, is preferred by patients and provides a more realistic assessment of BP during an individual’s daily life. However, until recently, HBPM did not offer the possibility to measure nocturnal (sleep time) BP. The development and validation of new BP devices, such as the NightView (OMRON Healthcare, HEM9601T-E3) HBPM device, could overcome these limitations, offering the possibility of daytime and night-time BP measurements with minimal sleep disturbance.
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Affiliation(s)
- Francesco P Cappuccio
- ESH Centre of Excellence in Hypertension and Cardio-metabolic Research, University of Warwick Medical School Coventry, UK.,University Hospitals Coventry and Warwickshire NHS Trust Coventry, UK
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Bem D, Lordkipanidzé M, Hodgkinson J, Stevens S, Bayliss S, Moore D, Fitzmaurice D, Dretzke J. The Effects of Different Aspirin Dosing Frequencies and the Timing of Aspirin Intake in Primary and Secondary Prevention of Cardiovascular Disease: A Systematic Review. Clin Pharmacol Ther 2016; 100:500-512. [DOI: 10.1002/cpt.438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 06/23/2016] [Accepted: 07/15/2016] [Indexed: 12/19/2022]
Affiliation(s)
- D Bem
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
| | - M Lordkipanidzé
- Montreal Heart Institute; Research Centre; Montréal QC Canada
- Université de Montreal, Faculté de pharmacie; Montreal QC Canada
| | - J Hodgkinson
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
| | - S Stevens
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
| | - S Bayliss
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
| | - D Moore
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
| | - D Fitzmaurice
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
| | - J Dretzke
- Institute of Applied Health Research, College of Medical & Dental Sciences; University of Birmingham; Edgbaston Birmingham UK
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Xu T, Zhang YQ, Tan XR. The dilemma of nocturnal blood pressure. J Clin Hypertens (Greenwich) 2012; 14:787-91. [PMID: 23126351 PMCID: PMC8108933 DOI: 10.1111/jch.12003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 07/07/2012] [Accepted: 07/17/2012] [Indexed: 02/05/2023]
Abstract
During the past decades, blood pressure (BP) measurement technique has evolved rapidly from the traditionally manual measuring to fully automatic monitoring. In terms of management of BP, there have been tremendous changes from the controlling of daytime BP, nondipping pattern to nocturnal BP (NBP). Since the focus has turned to NBP, a number of dilemmas of NBP measurement have gradually emerged in clinical practice and research settings, including methods for monitoring NBP, different period definition of nocturnal time, different diagnostic thresholds of abnormal NBP, whether to control abnormal NBP, and how to manage abnormal NBP. Currently, these issues have hindered progress in the appropriate management of hypertensive patients. Therefore, the purpose of this review is to concisely discuss the dilemmas of NBP.
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Affiliation(s)
- Tan Xu
- Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, ShanTou, Guangdong, China.
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