The importance of central adrenergic neurones in renal hypertension in rabbits

Desensitization of postjunctional alpha 1- and alpha 2-adrenergic receptor-mediated vasopressor responses in rat harboring pheochromocytoma

Prolonged stimulation of tissues by adrenergic agonists may lead to diminished responsiveness of the tissues to subsequent activation by catecholamines; this phenomenon has been termed desensitization or tachyphylaxis. We have examined the in vivo consequences of prolonged stimulation of vascular alpha-adrenergic receptors in rats harboring pheochromocytoma, a tumor that secretes catecholamines. In both early (3-4 weeks after implantation) and late (6-7 weeks after implantation) stages of tumor development, New England Deaconess Hospital rats with transplanted pheochromocytomas developed hypertension and tachycardia and had plasma dopamine and norepinephrine concentrations markedly greater than controls. In both these stages of pheochromocytoma, pressor responses to several vasoconstrictors were examined after pithing. Rats with the tumor were found to become progressively subsensitive to alpha-adrenergic agonists. In the early phase of pheochromocytoma, loss in sensitivity was found for both alpha 1- and alpha 2-adrenergic agonists, whereas responsiveness to the nonadrenergic vasoconstrictors Arg-vasopressin and angiotensin-II was intact (homologous desensitization). However, in the later stage of pheochromocytoma, pressor responses to all these vasoconstrictive agents and also to stimulation of the complex sympathetic outflow were found to be subsensitive (heterologous desensitization). In plasma membranes prepared from mesenteric arteries of early stage tumor-bearing rats, [3H]prazosin binding sites were significantly decreased to 150 +/- 12 fmol/mg vs. 234 +/- 19 fmol/mg in controls. [3H]Yohimbine binding sites were not significantly altered. Our results show that both postjunctional alpha 1- and alpha 2-adrenergic receptor-mediated vasopressor responses can be specifically attenuated in the presence of chronically elevated endogenous catecholamine levels produced by pheochromocytoma and that each alpha-receptor subtype may be differently regulated in the development of desensitization.

Cerebrospinal fluid changes in experimental cardiac arrest (maximal stress)

Cardiac arrest produces a prompt and maximal increase of plasma catecholamines, with associated elevations of the hormones involved in the endocrine response to stress. To investigate the participation of the central nervous system (CNS) in the generation of the endocrine response, the catecholamines epinephrine and norepinephrine in cerebrospinal fluid (CSF) were measured before, during, and after cardiac arrest accompanied by cardiopulmonary resuscitation (CPR) in adrenalectomized (ADX) and sham-operated (SHAM) dogs. We also determined the activity of acetylcholine esterase (AChE), an intracellular enzyme released into the CSF after hypothalamic or caudate stimulation. During CPR, plasma epinephrine increased significantly in SHAM but not ADX dogs, increasing from (mean +/- SE) 480 +/- 171 to 29,800 +/- 14,200 pg/ml (P less than 0.05). Prearrest CSF norepinephrine was higher in ADX than SHAM dogs and increased in both groups with cardiac arrest, but the increase was significant only in SHAM animals; CSF epinephrine remained unchanged during or after cardiac arrest. CSF AChE activity increased during and after defibrillation; the difference with basal levels became significant when the peak postarrest values were considered (P less than 0.05). These results document biochemical changes occurring in the CNS during maximal stress represented by cardiac arrest. It is suggested that CSF norepinephrine and AChE activity elevations are markers for hypothalamic activation from the stress of cardiac arrest.

Effects of propranolol, clonidine and hydrochlorothiazide treatment and abrupt discontinuation on central and peripheral noradrenergic activity in essential hypertension

This study was undertaken to investigate further the CNS actions of commonly employed antihypertensive drugs. Measurements of cerebrospinal fluid (CSF) and plasma catecholamines (CA) were made in an attempt to estimate the activity of central and peripheral noradrenergic neurons during treatment with or after abrupt discontinuation of treatment with clonidine (CLO), propranolol (PRO), hydrochlorothiazide (HCTZ) or placebo, in patients with essential hypertension. A randomized, parallel, placebo-controlled, single-blind design was employed. BP reductions equal to or greater than 10 mmHg were observed with CLO (0.36 +/- 0.07 mg daily), PRO (160 mg +/- 0 mg daily) or HCTZ (70 +/- 12 mg daily). CLO reduced plasma norepinephrine (NE) by 64% and PRO increased it by 25%. Neither HCTZ nor placebo modified plasma NE. Plasma renin activity (PRA) was reduced by PRO (51%, P less than 0.01) and CLO (35%, P less than 0.05). CSF-NE levels (pg/ml) were significantly lower in the CLO group (CLO: 175 +/- 23; PRO: 278 +/- 35; HCTZ: 255 +/- 34; placebo: 203 +/- 7).

Renal hypertensive hypertrophy in the rat: a substrate for arrhythmogenicity

We investigated the ability of ouabain to produce lethal arrhythmias in rats with myocardial hypertrophy resulting from chronic renal hypertension. A gradual pressure overload was produced in female Wistar rats by left renal artery stenosis (two kidney, one clip, Goldblatt hypertension). Hypertension (systolic blood pressure greater than 150 mm Hg) developed within three weeks after clipping of the left renal artery and blood pressure continued to increase for the next five weeks. At ten weeks after the onset of hypertension animals were anesthetized with sodium pentobarbital (40 mg/kg) and artificially ventilated with room air while ECG was continually monitored and recorded. Continuous infusion of ouabain was maintained (0.7 mg/kg/min) through the inferior vena cava. Body weight and heart rate of control animals (C) was not significantly different from hypertensive (H) values, while systolic blood pressure in animals hypertensive for ten weeks was considerably greater (187 +/- 8.4 mm Hg) than their age-matched normotensive counterparts (123 +/- 6.0 mm Hg). Heart weight in hypertensive animals was elevated by 69% +/- 2.5 by time of study. Serological evaluation of both groups of animals revealed no significant differences in electrolytes and blood gases while significant differences were noted in glucose, BUN and creatinine. The average time to the first premature ventricular contraction was significantly shorter in H animals (3.5 +/- 0.2 min) when compared to C rats (6.0 +/- 0.2 min). The average time to ventricular tachycardia, ventricular fibrillation and death were also significantly shorter in H rats when compared to C animals (7.5 +/- 0.6 vs. 13.5 +/- 0.3; 13.5 +/- 0.5 vs. 21.0 +/- 0.5; 15.6 +/- 0.4 vs. 24.0 +/- 0.6 min). Thus, the hypertensive hypertrophied myocardium displays an increased propensity for lethal cardiac arrhythmias due to ouabain.

Clonidine reduces elevated cerebrospinal fluid catecholamine levels in patients with essential hypertension

Cerebrospinal fluid (CSF) catecholamines were measured in normotensive patients and in patients with mild to moderate essential hypertension. CSF-norepinephrine (NE) concentrations were 50% lower in the normotensive individuals (127 +/- 28 vs. 240 +/- 23 pg/ml) (P less than 0.01). In hypertensive patients, CSF-NE was inversely related to age (r = -0.68; P less than 0.01) and directly related to plasma NE (r = 0.61; P less than 0.05). Clonidine (450 mcg/day for 2 weeks) significantly reduced CSF-NE (-40%) in hypertensive patients. In addition, it decreased blood pressure, plasma and urinary NE. Urinary VMA was not affected by clonidine. No correlation was observed between clonidine effects on BP and on plasma or CSF catecholamines. This study indicates that patients with essential hypertension have elevated levels of CSF-NE which are reduced after treatment with clonidine. The elevation of CSF-NE suggests that central (spinal?) noradrenergic activity may be increased in patients with mild to moderate essential hypertension, and that can be reduced by treatment with clonidine.

Baroreflex control of myocardial contractility in conscious normotensive and renal hypertensive rabbits

We have assessed resting myocardial contractility and its baroreflex control in normotensive and hypertensive conscious rabbits. Hypertension was induced by bilateral cellophane wrapping of the kidneys with experiments performed 6 weeks later during the established phase of hypertension. The peak rate of change of left ventricular pressure (peak LV dP/dt) was used as the index of myocardial contractility. Baroreflex control of contractility and heart period (HP) was assessed by constructing stimulus response curves relating change in mean arterial pressure (MAP), induced by balloon occluders around the abdominal aorta and inferior vena cava, to change in peak LV dP/dt and HP. These stimulus response curves were obtained in normotensive rabbits with and without cardiac pacing, and in both normotensive and hypertensive animals after cardiac beta sympathetic blockade with propranolol, vagal blockade with methylscopolamine, and combined cardiac autonomic blockade with propranolol and scopolamine, as well as in rabbits with intact autonomic effectors. Resting MAP was significantly higher in the hypertensive rabbits (119 +/- 2 mm Hg) compared to normotensive controls (76 +/- 1 mm Hg). Resting peak LV dP/dt was also greater by 51% in the hypertensive animals (7054 +/- 287 mm Hg sec-1) compared to controls (4690 +/- 223 mm Hg sec-1). There was no significant difference in the resting heart period or resting left ventricular end diastolic pressure. Transient changes in MAP induced by occlusion of the aortic or venous balloons produced significant alterations in peak LV dP/dt in normotensive animals with and without pacing and in hypertensive control animals. In animals with cardiac sympathetic block, the range and slope or sensitivity of the stimulus response curves were not significantly changed but in animals with vagal blockade the sensitivity was reduced by 90% and the range at 30 mm Hg by 88%. After propranolol and methylscopolamine were administered together, the stimulus no longer evoked a response. These experiments demonstrate that myocardial contractility is under baroreflex control and suggest that this is mediated principally via parasympathetic nerves to the heart. There was no significant difference between the sensitivity of baroreflex control of myocardial contractility in the normotensive (-84 +/- 14 mm Hg sec-1 per mm Hg) and the hypertensive (-110 +/- 14 mm Hg sec-1 per mm Hg) rabbits, unlike the baroreflex control of heart period where sensitivity was markedly impaired in the hypertensive (sensitivity 3.8 +/- 0.8 msec/mm Hg) compared to the normotensive (6.9 +/- 1.0 msec/mm Hg) animals.

Alpha adrenoceptors and autonomic mechanisms in perinephritis hypertension in the rabbit

Increased pressor responses to norepinephrine and other pressor agents have been reported to occur in human essential hypertension and in several animal models of experimental hypertension. These increased responses might be related to the development of hypertension or could be a secondary consequence of the elevation in blood pressure. We have examined pressor responses to alpha-adrenoceptor agonists and to angiotensin II in male New Zealand White rabbits with perinephritic hypertension. Increased pressor responses were observed for the alpha 1 adrenoceptor agonist phenylephrine and the mixed alpha 1/alpha 2-adrenoceptor agonist norepinephrine but not for the alpha 2 adrenoceptor selective agonist guanabenz or angiotensin II. The increase occurred within 7 days of surgery and in some animals was observed when mean arterial pressure was not significantly elevated. It could not readily be attributed to intimal thickening or hypertrophy of the arterial wall, altered basal levels of norepinephrine or epinephrine, changes in norepinephrine clearance, beta-adrenoceptor interactions, or decreased baroreceptor sensitivity. However, the possibility that vascular hypertrophy and decreased baroreflex sensitivity may contribute to the increase at later times cannot be excluded. In all tissues examined, specific prazosin binding was decreased in the older animals and specific clonidine binding was decreased in forebrain. However, these changes were observed in both hypertensive and sham-operated animals and were probably age-related. We believe the increased response to alpha 1-adrenoceptor agonists may be related to changes at a postreceptor site in the coupling of receptor activation to smooth muscle contraction.

Effects of neurochemical lesions restricted to spinal cord monoaminergic neurons on blood pressure and sympathetic activity of spontaneously hypertensive rats

Intraspinal (i.s.) injection of 6-hydroxydopamine or 5,7-dihydroxytryptamine in newborn spontaneously hypertensive rats (SHR) resulted, in the adult animal (30-week-old), in a marked decrease of spinal cord noradrenaline (NA) or 5-hydroxytryptamine (5-HT) levels, respectively. Since both neurotoxin- and vehicle-injected rats developed full hypertension and had similar plasma catecholamine concentrations, it is concluded that in SHR neither spinal cord NA nor 5-HT play a major role in development and maintenance of hypertension.

Increased cerebrospinal fluid norepinephrine in essential hypertension

Studies in man and animals suggest increased central noradrenergic activity in hypertension. We can now measure norepinephrine (NE) in cerebrospinal fluid (CSF) accurately and this should provide an index of central noradrenergic activity. NE in CSF is very labile and altered by anxiety, stress, drugs, sodium balance and other factors. When these factors are controlled, NE in CSF appears elevated in essential hypertensives, particularly among young patients. Neurologic diseases that alter NE in CSF cause parallel alterations in blood pressure. Increased central noradrenergic activity is reflected in CSF NE levels and may cause some forms of hypertension.

Central dopaminergic neurons during development of genetic and DOCA-salt hypertension in the rat

The in vivo binding of [3H]spiroperidol was measured in discrete areas of the brain in 7-, 9- and 16-week-old spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto (WKY) controls. An increase in the [3H]spiroperidol binding in the striatum, tuberculum olfactorium and frontal cortex but not in the cerebellum was detected at all ages in SHR. The increase was more pronounced in 7- than in 9- or 16-week-old SHR. In vitro data indicated an increase in Bmax but no variation in Kd in the striatum of 7-week-old SHR. Moreover no difference was detectable in the dopaminergic cell bodies (A9, A10). This increase was specific to [3H]spiroperidol binding sites since no difference was observed in the in vivo binding of [3H]QNB and [3H]LSD in the same brain regions. No variation in dopamine level or dopamine utilization, as estimated by measuring the disappearance of the amine induced by alpha-methyl-p-tyrosine, was observed. The DOPA accumulation after injection of the DOPA decarboxylase inhibitor NSD 1015 was greater in the tuberculum olfactorium from 7-week-old SHR. An increase in [3H]spiroperidol binding sites was also observed in the striatum and tuberculum olfactorium after 7 weeks of DOCA-salt treatment. These results suggest that dopaminergic neurons might be implicated in the onset of hypertension in the rat.

Neurophysiology and neuropharmacology of cardiovascular regulation and stress

Evidence has accumulated over the past several years indicating that environmental factors can have a substantial influence on cardiovascular dynamics. It has been hypothesized by many investigators that through these influence environmental stressors may be important to the etiology and maintenance of cardiovascular diseases. Since the nervous system is intimately involved in the regulation of cardiovascular function it may be assumed that environmental influences on cardiovascular dynamics are to a large extent mediated by the nervous system. This assumption is supported by the literature reviewed which indicates that there are many nervous system nuclei and neurotransmitter systems involved in the regulation of cardiovascular dynamics which are also involved in an organisms adjustment to environmental stressors. The conclusion is reached that further multidisciplinary research will reveal underlying neurophysiological and neuropharmacological mechanisms responsible for stress induced cardiovascular disease and lead to new methods of treatment.

Relationship between cerebrospinal fluid norepinephrine and blood pressure in neurologic patients

In 126 patients hospitalized for various diseases norepinephrine in cerebrospinal fluid correlated with blood pressure (r = 0.41, p < 0.0001). Plasma and cerebrospinal fluid norepinephrine levels correlated with heart rate. Central noradrenergic nerves help control blood pressure and may be involved in human hypertension.

Cardiovascular and behavioral effects of intracisternal 6-hydroxydopamine in the rabbit

Acute effects of 6-hydroxydopamine (6-OHDA, 400--900 microgram kg-1 intracisternally, i.c.i.) consisted of bradycardia and hypertension, maximal 2--3 h after injection and preceded after some doses by a phase of hypotension. This pattern was obtained in completely conscious rabbits and after propanidid and sodium pentobarbitone anesthesia. After 600 microgram kg-1 i.c.i. 6-OHDA the peak rise in blood pressure (25 +/- 3.8 mm Hg) was due to a rise in peripheral resistance involving particularly renal and intestinal beds. Suprapontine mechanisms contributed to both hypertension and bradycardia. Giving pontine rabbits 6-OHDA elicited a short-latency fall in blood pressure, resembling the hypotensive phase in intact animals. Chronic effects 7 days after 600 microgram kg-1 included a rapid loss of 10% of body weight associated with reduction in food and water intake. To avoid secondary circulatory effects the rabbits were artificially fed, halving the weight loss. At 7 days blood pressure had fallen by 7.4 +/- 2.3 mm Hg probably owing to this residual weight loss. From experiments involving administration of phenotolamine and clonidine in intact rabbits and the responses of pontine animals it is likely that both descending and ascending catecholaminergic pathways have inhibitory effects on blood pressure, though some of the pathways may also be excitatory. Absence of specific chronic circulatory changes may be due to compensation through parallel pathways involving other transmitters.

Interruption of the maintenance phase of established hypertension by ablation of the anteroventral third ventricle (AV3V) in rats

Ablation of tissue surrounding anteroventral third ventricle (AV3V) was studied in three models of hypertensive rats. Lesions were placed in the AV3V at one and six weeks following the initiation of one kidney Grollman renal hypertension. At one week the rise in blood pressure was arrested and water intake was reduced; at six weeks arterial pressure returned to prehypertensive levels in animals surviving the post-lesion hydrational crisis. In two kidney (one clip) Goldblatt animals lesioned two weeks post-clip, arterial pressure was significantly reduced but did not become fully normotensive. Finally, the AV3V was also lesioned in spontaneously hypertensive rats (SHR-Okamoto strain) with established hypertension. The lesion did not reduce arterial pressure in adult SHR although characteristic initial adipsia and weight loss occurred. Ablation of the AV3V thus altered the course of maintenance of renal hypertension; however, the arterial pressure of SHR was not affected.

Central and peripheral noradrenaline in the two kidney model of renovascular hypertension in the rat

1 Plasma noradrenaline concentrations were similar in rats following unilateral renal arterial constriction (two kidney Goldblatt model) and in sham-operated control rats. 2 The development of hypertension was not affected by pretreatment with intracisternal injections of 6-hydroxydopamine. 3 These data suggest that sympathetic mechanisms do not contribute to the development of hypertension in this model.

Brain and vascular monoamine oxidase activity in the deoxycorticosterone-salt hypertensive rat

1 The role of monoamine oxidase (MAO) in the maintenance of deoxycorticosterone-sodium chloride (DOCA-salt) hypertension was investigated by assaying the MAO activity both in central as well as peripheral blood vessels and in brain tissue. 2 The results suggest that the activity of MAO in the DOCA-salt hypertensive rat is similar to the activity present in the normotensive rat.

The cardiovascular effects of intraventricular 5,6-dihydroxytryptamine in conscious hypertensive rats

1. Conscious experimental hypertensive rats injected intraventricularly with 5,6-dihydroxytryptamine (50 microgram) responded with a rapid and long-lasting (4 days) fall in blood pressure and this was accompanied by a bradycardia of similar duration. 2. The acute actions of 5,6-dihydroxytryptamine on the cardiovascular system were not modified by pretreatment with bromolysergide (0.5 mg/kg, i.p.), methysergide (2.5 mg/kg, i.p.) or intraventricular phentolamine (200 microgram). 3. The results suggest that central serotonergic neurones play an important role in the regulation of blood pressure. However, the site of action remains to be investigated.

Central and peripheral adrenergic mechanisms in the development of deoxycorticosterone-saline hypertension in rats

The role of the sympathetic nervous system in the development of deoxycorticosterone-sodium chloride (DOCA-saline) hypertension was investigated by measuring plasma levels of norepinephrine, total catecholamines, and dopamine-beta-hydroxylase activity at intervals after the initiation of the DOCA-saline regimen. Plasma norepinephrine was significantly higher in DOCA-saline-treated rats at 4 and 7 weeks and in rats treated with saline alone at 4 weeks compared with that in untreated controls. Total plasma catecholamine levels (epinephrine and norepinephrine) and dopamine-beta-hydroxylase activity were similar in hypertensive rats, untreated controls, and rats that received either DOCA or saline alone. The increases in plasma norepinephrine levels may have resulted from centrally mediated increases in peripheral sympathetic neuronal activity, since the destruction of central catecholaminergic neurons with intracerebroventricularly administered 6-hydroxydopamine (6-OHDA) prevented both the DOCA-saline-induced rise in blood pressure and the increases in plasma norepinephrine. Rats treated with 6-OHDA consistently drank less water or saline than did vehicle-treated controls. The actions of centrally administered 6-OHDA on blood pressure and plasma norepinephrine levels were not secondary to a reduction in salt intake, however, since intact rats given a similar reduced saline intake became hypertensive and demonstrated elevated plasma norepinephrine concentrations. Chronic salt loading may cause a centrally mediated increase in peripheral sympathetic neuronal activity with raised plasma concentrations of norepinephrine. The increased adrenergic activity in the presence of mineralocorticoid-induced sodium retention leads to the development of hypertension.

Effects of intraventricularly injected 6-hydroxydopamine on carotid sinus baroreceptor reflex in rabbits

Effects of 6-hydroxydopamine (6-OH-DA) injected into the lateral brain ventricle on the carotid sinus baroreceptor reflex were studied in rabbits anesthetized with alpha-chloralose and urethane. As short term effects, injection of 500 mug/kg of 6-OH-DA caused a fall in blood pressure and heart rate, enhanced the depressor and bradycardia responses to electrical stimulation of the carotid sinus nerve (CSN), and inhibited the pressor response to carotid occlusion. These effects reached the maximum with 2 hrs and disappeared by the 4th hr. Intraventricular injection of noradrenaline (NA) could mimic most of these effects. At 4.5 hrs after injection of 6-OH-DA, NA content of the brain was definitely reduced: 21% of control in the hypothalamus and 14% in the pons-medulla. Rabbits treated with 6-OH-DA under penthobarbital anesthesia 24 hrs before showed a slight fall in resting blood pressure and almost normal baroreceptor function. Intraventricular application of phentolamine abolished the responses to CSN stimulation in 6-OH-DA pretreated as well as normal animals. These results suggest that the acute effects of 6-OH-DA are based on the increased release of NA from the affected nerve terminals and that noradrenergic neurons are involved in the central pathway of baroreceptor reflex. Moreover, the relfex may be functionally maintained by a small portion of brain NA content, even when noradrenergic neurons are greatly affected by 6-OH-DA.