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Garg P, Mendiratta A, Banga A, Bucharles A, Victoria P, Kamaraj B, Qasba RK, Bansal V, Thimmapuram J, Pargament R, Kashyap R. Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200232. [PMID: 38179185 PMCID: PMC10765252 DOI: 10.1016/j.ijcrp.2023.200232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/20/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
Background Breathing exercises have been reported to have positive physiological effects on the body. The incidence of hypertension has become a major risk factor for cardiac complications leading to higher morbidity and mortality. Our aim was to conduct a systematic review and meta-analysis to study the effect of breathing exercises on blood pressure (BP) and heart rate (HR). Methods A systematic review and meta-analysis analyzing randomized clinical trials (RCTs) about the effect of breathing exercises on blood pressure was conducted (PROSPERO Registration ID: CRD42022316413). PubMed, ScienceDirect, WebofScience, and Cochrane Library databases were screened for RCTs from January 2017 to September 2022. The main search terms included "breathing exercise", "Pranayam", "Bhramari", "alternate nostril breathing", "deep breathing", "slow breathing", "hypertension", and "high blood pressure". The primary outcome was the value of the systolic blood pressure and diastolic blood pressure after the intervention. The effect on heart rate was also analyzed as a secondary outcome. Results A total of 15 studies were included in the meta-analysis. Breathing exercises have a modest but significant effect on decreasing systolic blood pressure (-7.06 [-10.20, -3.92], P = <0.01) and diastolic blood pressure (-3.43 [-4.89, -1.97], P = <0.01) mm Hg. Additionally, breathing exercises were also observed to cause a significant decrease in the heart rate (-2.41 [-4.53, -0.30], P = 0.03) beats/minute. Conclusion In a comprehensive systematic review and meta-analysis of breathing exercises and its effect on BP and HR, there is a moderate but significant positive effect. The studies are not deprived of bias.
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Affiliation(s)
- Piyush Garg
- Medanta-The Medicity, Gurgaon, HR, India
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
| | - Ayushi Mendiratta
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Parkview Health System, USA
| | - Akshat Banga
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Sawai Man Singh Medical College, Jaipur, RJ, India
| | - Anna Bucharles
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Universidade Positivo, Curitiba, Brazil
| | - Piccoli Victoria
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Universidade Positivo, Curitiba, Brazil
| | - Balakrishnan Kamaraj
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Madurai Medical College, Madurai, TN, India
| | - Rakhtan K. Qasba
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Green Life Medical College and Hospital, Dhaka, Bangladesh
| | - Vikas Bansal
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Rahul Kashyap
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
- Medical Director, Research, WellSpan Health, York, PA, USA
- GCSRT, Harvard Medical School, Boston, MA, USA
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Verzicco I, Tedeschi S, Graiani G, Bongrani A, Carnevali ML, Dancelli S, Zappa J, Mattei S, Bovino A, Cavazzini S, Rocco R, Calvi A, Palladini B, Volpi R, Cannone V, Coghi P, Borghetti A, Cabassi A. Evidence for a Prehypertensive Water Dysregulation Affecting the Development of Hypertension: Results of Very Early Treatment of Vasopressin V1 and V2 Antagonism in Spontaneously Hypertensive Rats. Front Cardiovasc Med 2022; 9:897244. [PMID: 35722114 PMCID: PMC9198251 DOI: 10.3389/fcvm.2022.897244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/29/2022] [Indexed: 12/01/2022] Open
Abstract
In addition to long-term regulation of blood pressure (BP), in the kidney resides the initial trigger for hypertension development due to an altered capacity to excrete sodium and water. Betaine is one of the major organic osmolytes, and its betaine/gamma-aminobutyric acid transporter (BGT-1) expression in the renal medulla relates to interstitial tonicity and urinary osmolality and volume. This study investigated altered water and sodium balance as well as changes in antidiuretic hormone (ADH) activity in female spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats from their 3–5 weeks of age (prehypertensive phase) to SHR’s 28–30 weeks of age (established hypertension-organ damage). Young prehypertensive SHRs showed a reduced daily urine output, an elevated urine osmolarity, and higher immunostaining of tubule BGT-1, alpha-1-Na-K ATPase in the outer medulla vs. age-matched WKY. ADH circulating levels were not different between young prehypertensive SHR and WKY, but the urine aquaporin2 (AQP2)/creatinine ratio and labeling of AQP2 in the collecting duct were increased. At 28–30 weeks, hypertensive SHR with moderate renal failure did not show any difference in urinary osmolarity, urine AQP2/creatinine ratio, tubule BGT-1, and alpha-1-Na-K ATPase as compared with WKY. These results suggest an increased sensitivity to ADH in prehypertensive female SHR. On this basis, a second series of experiments were set to study the role of ADH V1 and V2 receptors in the development of hypertension, and a group of female prehypertensive SHRs were treated from the 25th to 49th day of age with either V1 (OPC21268) or V2 (OPC 41061) receptor antagonists to evaluate the BP time course. OPC 41061-treated SHRs had a delayed development of hypertension for 5 weeks without effect in OPC 21268-treated SHRs. In prehypertensive female SHR, an increased renal ADH sensitivity is crucial for the development of hypertension by favoring a positive water balance. Early treatment with selective V2 antagonism delays future hypertension development in young SHRs.
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Affiliation(s)
- Ignazio Verzicco
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Stefano Tedeschi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Gallia Graiani
- Histology and Histopathology Unit and Molecular Biology Laboratory, Dental School Parma, University of Parma, Parma, Italy
| | - Alice Bongrani
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Maria Luisa Carnevali
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Simona Dancelli
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Jessica Zappa
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Silvia Mattei
- Nefrologia e Dialisi, Azienda USL – Istituto di Ricerca a Carattere Scientifico IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Achiropita Bovino
- Internal Medicine Unit, Ospedale Fidenza, Azienda USL Parma, Parma, Italy
| | - Stefania Cavazzini
- Laboratory of Industrial Toxicology, DIMEC, University of Parma, Parma, Italy
| | - Rossana Rocco
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Anna Calvi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Barbara Palladini
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Riccardo Volpi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Valentina Cannone
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Pietro Coghi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Alberico Borghetti
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Aderville Cabassi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
- *Correspondence: Aderville Cabassi,
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Calvi A, Fischetti I, Verzicco I, Belvederi Murri M, Zanetidou S, Volpi R, Coghi P, Tedeschi S, Amore M, Cabassi A. Antidepressant Drugs Effects on Blood Pressure. Front Cardiovasc Med 2021; 8:704281. [PMID: 34414219 PMCID: PMC8370473 DOI: 10.3389/fcvm.2021.704281] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
Individuals suffering from depressive disorders display a greater incidence of hypertension compared with the general population, despite reports of the association between depression and hypotension. This phenomenon may depend, at least in part, on the use of antidepressant drugs, which may influence blood pressure through different effects on adrenergic and serotoninergic pathways, as well as on histaminergic, dopaminergic, and cholinergic systems. This review summarizes extant literature on the effect of antidepressant drugs on blood pressure. Selective serotonin reuptake inhibitors are characterized by limited effects on autonomic system activity and a lower impact on blood pressure. Thus, they represent the safest class-particularly among elderly and cardiovascular patients. Serotonin-norepinephrine reuptake inhibitors, particularly venlafaxine, carry a greater risk of hypertension, possibly related to greater effects on the sympathetic nervous system. The norepinephrine reuptake inhibitor reboxetine is considered a safe option because of its neutral effects on blood pressure in long-term studies, even if both hypotensive and hypertensive effects are reported. The dopamine-norepinephrine reuptake inhibitor bupropion can lead to blood pressure increases, usually at high doses, but may also cause orthostatic hypotension, especially in patients with cardiovascular diseases. The norepinephrine-serotonin modulators, mirtazapine and mianserin, have minimal effects on blood pressure but may rarely lead to orthostatic hypotension and falls. These adverse effects are also observed with the serotonin-reuptake modulators, nefazodone and trazodone, but seldomly with vortioxetine and vilazodone. Agomelatine, the only melatonergic antidepressant drug, may also have limited effects on blood pressure. Tricyclic antidepressants have been associated with increases in blood pressure, as well as orthostatic hypotension, particularly imipramine. Oral monoamine-oxidase inhibitors, less frequently skin patch formulations, have been associated with orthostatic hypotension or, conversely, with hypertensive crisis due to ingestion of tyramine-containing food (i.e., cheese reaction). Lastly, a hypertensive crisis may complicate antidepressant treatment as a part of the serotonin syndrome, also including neuromuscular, cognitive, and autonomic dysfunctions. Clinicians treating depressive patients should carefully consider their blood pressure status and cardiovascular comorbidities because of the effects of antidepressant drugs on blood pressure profiles and potential interactions with antihypertensive treatments.
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Affiliation(s)
- Anna Calvi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Ilaria Fischetti
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Ignazio Verzicco
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Stamatula Zanetidou
- Research Group on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Riccardo Volpi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Pietro Coghi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Stefano Tedeschi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Aderville Cabassi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
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4
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Negro A, Verzicco I, Tedeschi S, Campanini N, Zanelli M, Negri E, Farnetti E, Nicoli D, Palladini B, Santi R, Cunzi D, Calvi A, Coghi P, Gerra L, Volpi R, Graiani G, Cabassi A. Case Report: Irreversible Watery Diarrhea, Severe Metabolic Acidosis, Hypokalemia and Achloridria Syndrome Related to Vasoactive Intestinal Peptide Secreting Malignant Pheochromocytoma. Front Endocrinol (Lausanne) 2021; 12:652045. [PMID: 33815297 PMCID: PMC8010837 DOI: 10.3389/fendo.2021.652045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pheochromocytoma (PHEO) clinical manifestations generally mirror excessive catecholamines secretion; rarely the clinical picture may reflect secretion of other hormones. Watery diarrhea, hypokalemia and achlorhydria (WDHA) is a rare syndrome related to excessive secretion of vasoactive intestinal peptide (VIP). CLINICAL CASE A 73-year-old hypotensive man affected by adrenal PHEO presented with weight loss and watery diarrhea associated with hypokalemia, hyperchloremic metabolic acidosis (anion gap 15 mmol/l) and a negative urinary anion gap. Abdominal computed tomography scan showed a right adrenal PHEO, 8.1 cm in maximum diameter, with tracer uptake on 68GaDOTA-octreotate positron emission tomography. Metastasis in lumbar region and lung were present. Both chromogranin A and VIP levels were high (more than10 times the normal value) with slightly elevated urine normetanephrine and metanephrine excretion. Right adrenalectomy was performed and a somatostatin analogue therapy with lanreotide started. Immunostaining showed chromogranin A and VIP co-expression, with weak somatostatin-receptor-2A positivity. In two months, patient clinical conditions deteriorated with severe WDHA and multiple liver and lung metastasis. Metabolic acidosis and hypokalemia worsened, leading to hemodynamic shock and exitus. CONCLUSIONS A rare case of WDHA syndrome caused by malignant VIP-secreting PHEO was diagnosed. High levels of circulating VIP were responsible of the rapidly evolving clinical picture with massive dehydration and weight loss along with severe hyperchloremic metabolic acidosis and hypokalemia due to the profuse untreatable diarrhea. The rescue treatment with lanreotide was unsuccessful because of the paucity of somatostatin-receptor-2A on VIP-secreting PHEO chromaffin cells.
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Affiliation(s)
- Aurelio Negro
- Internal Medicine and Secondary Hypertension Center, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ignazio Verzicco
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Stefano Tedeschi
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Nicoletta Campanini
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Magda Zanelli
- Pathology Unit, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Emanuele Negri
- High Care Internal Medicine Unit, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Enrico Farnetti
- Molecular Biology Laboratory, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Nicoli
- Molecular Biology Laboratory, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Barbara Palladini
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Rosaria Santi
- Internal Medicine and Secondary Hypertension Center, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
- High Care Internal Medicine Unit, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Cunzi
- Internal Medicine and Secondary Hypertension Center, Ospedale Sant’Anna di Castelnovo Ne’ Monti, Azienda Unità sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Anna Calvi
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Pietro Coghi
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Luigi Gerra
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Riccardo Volpi
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
| | - Gallia Graiani
- Histology and Histopathology Unit, Dental School, University of Parma, Parma, Italy
| | - Aderville Cabassi
- Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy
- *Correspondence: Aderville Cabassi,
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Thiel S, Haile SR, Peitzsch M, Schwarz EI, Sievi NA, Kurth S, Beuschlein F, Kohler M, Gaisl T. Endocrine responses during CPAP withdrawal in obstructive sleep apnoea: data from two randomised controlled trials. Thorax 2019; 74:1102-1105. [PMID: 31467191 DOI: 10.1136/thoraxjnl-2019-213522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 11/03/2022]
Abstract
The aim of this investigation was to elucidate the effect of CPAP withdrawal on neurometabolic and cardiometabolic markers in patients with obstructive sleep apnoea. We evaluated 70 patients (mean age 61±10 years, 82% men) treated with CPAP in two 2-week, parallel, randomised controlled trials. CPAP withdrawal resulted in elevated 3,4-dihydroxyphenylglycol, norepinephrine and cortisol after 2 weeks of CPAP withdrawal; however, no statistically significant changes of the renin-angiotensin-aldosterone system (RAAS) determinants were documented. In summary, CPAP withdrawal may be more prominently linked to short-term increases in sympathetic activation than hypothalamic-pituitary-adrenal axis or RAAS activation. ClinicalTrials.gov Identifier: NCT02493673 and NCT02050425.
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Affiliation(s)
- Sira Thiel
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
| | - Sarah R Haile
- Department of Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Mirko Peitzsch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Esther I Schwarz
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
| | - Salome Kurth
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Nutrition, University Hospital Zurich, Zurich, Switzerland.,Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Malcolm Kohler
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland.,Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Thomas Gaisl
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
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Briant LJB, O'Callaghan EL, Champneys AR, Paton JFR. Respiratory modulated sympathetic activity: a putative mechanism for developing vascular resistance? J Physiol 2015; 593:5341-60. [PMID: 26507780 DOI: 10.1113/jp271253] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/23/2015] [Indexed: 12/29/2022] Open
Abstract
KEY POINTS Sympathetic activity exhibits respiratory modulation that is amplified in hypertensive rats. Respiratory modulated sympathetic activity produces greater changes in vascular resistance than tonic stimulation of the same stimulus magnitude in normotensive but not hypertensive rats. Mathematical modelling demonstrates that respiratory modulated sympathetic activity may fail to produce greater vascular resistance changes in hypertensive rats because the system is saturated as a consequence of a dysfunctional noradrenaline reuptake mechanism. Respiratory modulated sympathetic activity is an efficient mechanism to raise vascular resistance promptly, corroborating its involvement in the ontogenesis of hypertension. ABSTRACT Sympathetic nerve activity (SNA) exhibits respiratory modulation. This component of SNA is important - being recruited under cardiorespiratory reflex conditions and elevated in the spontaneously hypertensive (SH) rat - and yet the exact influence of this modulation on vascular tone is not understood, even in normotensive conditions. We constructed a mathematical model of the sympathetic innervation of an arteriole, and used it to test the hypothesis that respiratory modulation of SNA preferentially increases vasoconstriction compared to a frequency-matched tonic pattern. Simulations supported the hypothesis, where respiratory modulated increases in vasoconstriction were mediated by a noradrenergic mechanism. These predictions were tested in vivo in adult Wistar rats. Stimulation of the sympathetic chain (L3) with respiratory modulated bursting patterns, revealed that bursting increases vascular resistance (VR) more than tonic stimulation (57.8 ± 3.3% vs. 44.8 ± 4.2%; P < 0.001; n = 8). The onset of the VR response was also quicker for bursting stimulation (rise time constant = 1.98 ± 0.09 s vs. 2.35 ± 0.20 s; P < 0.01). In adult SH rats (n = 8), the VR response to bursting (44.6 ± 3.9%) was not different to tonic (37.4 ± 3.5%; P = 0.57). Using both mathematical modelling and in vivo techniques, we have shown that VR depends critically on respiratory modulation and revealed that this pattern dependency in Wistar rats is due to a noradrenergic mechanism. This respiratory component may therefore contribute to the ontogenesis of hypertension in the pre-hypertensive SH rat - raising VR and driving vascular remodelling. Why adult SH rats do not exhibit a pattern-dependent response is not known, but further modelling revealed that this may be due to dysfunctional noradrenaline reuptake.
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Affiliation(s)
- Linford J B Briant
- School of Physiology & Pharmacology, Medical Sciences Building, University Walk, University of Bristol, Bristol, BS81TD, UK.,Department of Engineering Mathematics, Merchant Venturers Building, Woodland Road, University of Bristol, Bristol, BS8 1UB, UK
| | - Erin L O'Callaghan
- School of Physiology & Pharmacology, Medical Sciences Building, University Walk, University of Bristol, Bristol, BS81TD, UK
| | - Alan R Champneys
- Department of Engineering Mathematics, Merchant Venturers Building, Woodland Road, University of Bristol, Bristol, BS8 1UB, UK
| | - Julian F R Paton
- School of Physiology & Pharmacology, Medical Sciences Building, University Walk, University of Bristol, Bristol, BS81TD, UK
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7
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Alves-Wagner AB, Mori RC, Sabino-Silva R, Fatima LA, da Silva Alves A, Britto LR, D'Agord Schaan B, Machado UF. Beta-adrenergic blockade increases GLUT4 and improves glycemic control in insulin-treated diabetic Wistar rats. Auton Neurosci 2015; 193:108-16. [DOI: 10.1016/j.autneu.2015.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/25/2015] [Accepted: 10/27/2015] [Indexed: 12/20/2022]
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8
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Shanks J, Herring N. Peripheral cardiac sympathetic hyperactivity in cardiovascular disease: role of neuropeptides. Am J Physiol Regul Integr Comp Physiol 2013; 305:R1411-20. [PMID: 24005254 PMCID: PMC3882692 DOI: 10.1152/ajpregu.00118.2013] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/20/2013] [Indexed: 02/08/2023]
Abstract
High levels of sympathetic drive in several cardiovascular diseases including postmyocardial infarction, chronic congestive heart failure and hypertension are reinforced through dysregulation of afferent input and central integration of autonomic balance. However, recent evidence suggests that a significant component of sympathetic hyperactivity may also reside peripherally at the level of the postganglionic neuron. This has been studied in depth using the spontaneously hypertensive rat, an animal model of genetic essential hypertension, where larger neuronal calcium transients, increased release and impaired reuptake of norepinephrine in neurons of the stellate ganglia lead to a significant tachycardia even before hypertension has developed. The release of additional sympathetic cotransmitters during high levels of sympathetic drive can also have deleterious consequences for peripheral cardiac parasympathetic neurotransmission even in the presence of β-adrenergic blockade. Stimulation of the cardiac vagus reduces heart rate, lowers myocardial oxygen demand, improves coronary blood flow, and independently raises ventricular fibrillation threshold. Recent data demonstrates a direct action of the sympathetic cotransmitters neuropeptide Y (NPY) and galanin on the ability of the vagus to release acetylcholine and control heart rate. Moreover, there is as a strong correlation between plasma NPY levels and coronary microvascular function in patients with ST-elevation myocardial infarction being treated with primary percutaneous coronary intervention. Antagonists of the NPY receptors Y1 and Y2 may be therapeutically beneficial both acutely during myocardial infarction and also during chronic heart failure and hypertension. Such medications would be expected to act synergistically with β-blockers and implantable vagus nerve stimulators to improve patient outcome.
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Affiliation(s)
- Julia Shanks
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
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Loria AS, Brands MW, Pollock DM, Pollock JS. Early life stress sensitizes the renal and systemic sympathetic system in rats. Am J Physiol Renal Physiol 2013; 305:F390-5. [PMID: 23678041 PMCID: PMC3742864 DOI: 10.1152/ajprenal.00008.2013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 05/09/2013] [Indexed: 01/16/2023] Open
Abstract
We hypothesized that maternal separation (MS), an early life stress model, induces a sensitization of the sympathetic system. To test this hypothesis, we evaluated the renal and systemic sympathetic system in 12- to 14-wk-old male control or MS rats with the following parameters: 1) effect of renal denervation on conscious renal filtration capacity, 2) norepinephrine (NE) content in key organs involved in blood pressure control, and 3) acute systemic pressor responses to adrenergic stimulation or ganglion blockade. MS was performed by separating pups from their mothers for 3 h/day from day 2 to 14; controls were nonhandled littermates. Glomerular filtration rate (GFR) was examined in renal denervated (DnX; within 2 wk) or sham rats using I¹²⁵-iothalamate plasma clearance. MS-DnX rats showed significantly increased GFR compared with MS-SHAM rats (3.8 ± 0.4 vs. 2.4 ± 0.2 ml/min, respectively, P < 0.05), whereas DnX had no effect in controls, indicating that renal nerves regulate GFR in MS rats. NE content was significantly increased in organ tissues from MS rats (P < 0.05, n = 6-8), suggesting a sensitization of the renal and systemic sympathetic system. Conscious MS rats displayed a significantly greater increase in mean arterial pressure (MAP) in response to NE (2 μg/kg ip) and a greater reduction in MAP in response to mecamylamine (2 mg/kg ip, P < 0.05, n = 4) monitored by telemetry, indicating that MS rats exhibit exaggerated responses to sympathetic stimulation. In conclusion, these data indicate that MS sensitizes the renal and systemic sympathetic system ultimately impairing blood pressure regulation.
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Affiliation(s)
- Analia S Loria
- Section of Experimental Medicine, CB 2200, 1459 Laney Walker Blvd., Dept. of Medicine, Georgia Regents University, Augusta, GA 30912, USA.
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Limberg JK, Morgan BJ, Schrage WG, Dempsey JA. Respiratory influences on muscle sympathetic nerve activity and vascular conductance in the steady state. Am J Physiol Heart Circ Physiol 2013; 304:H1615-23. [PMID: 23585141 DOI: 10.1152/ajpheart.00112.2013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In patients with hypertension, volitional slowing of the respiratory rate has been purported to reduce arterial pressure via withdrawal of sympathetic tone. We examined the effects of paced breathing at 7, 14, and 21 breaths/min, with reciprocal changes in tidal volume, on muscle sympathetic nerve activity, forearm blood flow, forearm vascular conductance, and blood pressure in 21 men and women, 8 of whom had modest elevations in systemic arterial pressure. These alterations in breathing frequency and volume did not affect steady-state levels of sympathetic activity, blood flow, vascular conductance, or blood pressure (all P > 0.05), even though they had the expected effect on sympathetic activity within breaths (i.e., increased modulation during low-frequency/high-tidal volume breathing) (P < 0.001). These findings were consistent across subjects with widely varied baseline levels of sympathetic activity (4-fold), mean arterial pressure (78-110 mmHg), and vascular conductance (15-fold), and those who became hypocapnic during paced breathing vs. those who maintained normocapnia. These findings challenge the notion that slow, deep breathing lowers arterial pressure by suppressing steady-state sympathetic outflow.
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Affiliation(s)
- Jacqueline K Limberg
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, School of Education, University of Wisconsin, Madison, WI, USA
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11
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Shanks J, Mane S, Ryan R, Paterson DJ. Ganglion-specific impairment of the norepinephrine transporter in the hypertensive rat. Hypertension 2012; 61:187-93. [PMID: 23172922 DOI: 10.1161/hypertensionaha.112.202184] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hypertension is associated with enhanced cardiac sympathetic transmission, although the exact mechanisms underlying this are still unknown. We hypothesized that defective function of the norepinephrine uptake transporter (NET) may contribute to the sympathetic phenotype of the spontaneously hypertensive rat, and that this may occur before the development of hypertension itself. The dynamic kinetics of NET were monitored temporally using a novel fluorescent assay of the transporter in cultured postganglionic sympathetic neurons from the cardiac stellate ganglion, the superior cervical ganglion, the celiac ganglia/superior mesenteric ganglia, and the renal sympathetic chain. All NET activity was blocked by desipramine. NET rate was significantly impaired in cardiac stellate sympathetic neurons from the prehypertensive spontaneously hypertensive rat compared with age-matched normotensive Wistar-Kyoto rats. A similar response was seen in hypertensive spontaneously hypertensive rats stellate sympathetic neurons. However, no reduction in transporter rate was observed at either age in the other major noncardiac sympathetic ganglia. Depolarization of cardiac stellate neurons by electrical field stimulation further potentiated the difference in transporter rate observed between the hypertensive and normotensive rats at both developmental ages. In conclusion, dysregulation of the norepinephrine transporter in the hypertensive rat is ganglion-specific, where NET impairment in the stellate neurons may contribute to the increased cardiac norepinephrine spillover seen in hypertension.
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Affiliation(s)
- Julia Shanks
- Department of Physiology, Anatomy, and Genetics, Burdon Sanderson Cardiac Science Centre, BHF Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
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12
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Miyazaki M, Schroder E, Edelmann SE, Hughes ME, Kornacker K, Balke CW, Esser KA. Age-associated disruption of molecular clock expression in skeletal muscle of the spontaneously hypertensive rat. PLoS One 2011; 6:e27168. [PMID: 22076133 PMCID: PMC3208587 DOI: 10.1371/journal.pone.0027168] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 10/11/2011] [Indexed: 12/17/2022] Open
Abstract
It is well known that spontaneously hypertensive rats (SHR) develop muscle pathologies with hypertension and heart failure, though the mechanism remains poorly understood. Woon et al. (2007) linked the circadian clock gene Bmal1 to hypertension and metabolic dysfunction in the SHR. Building on these findings, we compared the expression pattern of several core-clock genes in the gastrocnemius muscle of aged SHR (80 weeks; overt heart failure) compared to aged-matched control WKY strain. Heart failure was associated with marked effects on the expression of Bmal1, Clock and Rora in addition to several non-circadian genes important in regulating skeletal muscle phenotype including Mck, Ttn and Mef2c. We next performed circadian time-course collections at a young age (8 weeks; pre-hypertensive) and adult age (22 weeks; hypertensive) to determine if clock gene expression was disrupted in gastrocnemius, heart and liver tissues prior to or after the rats became hypertensive. We found that hypertensive/hypertrophic SHR showed a dampening of peak Bmal1 and Rev-erb expression in the liver, and the clock-controlled gene Pgc1α in the gastrocnemius. In addition, the core-clock gene Clock and the muscle-specific, clock-controlled gene Myod1, no longer maintained a circadian pattern of expression in gastrocnemius from the hypertensive SHR. These findings provide a framework to suggest a mechanism whereby chronic heart failure leads to skeletal muscle pathologies; prolonged dysregulation of the molecular clock in skeletal muscle results in altered Clock, Pgc1α and Myod1 expression which in turn leads to the mis-regulation of target genes important for mechanical and metabolic function of skeletal muscle.
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MESH Headings
- Age Factors
- Animals
- Blotting, Western
- CLOCK Proteins/genetics
- CLOCK Proteins/metabolism
- Circadian Clocks/physiology
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Gene Expression Regulation, Developmental
- Heart/physiopathology
- Hypertension/physiopathology
- Liver/metabolism
- Liver/pathology
- Male
- Muscle, Skeletal/metabolism
- Muscle, Skeletal/pathology
- MyoD Protein/genetics
- MyoD Protein/metabolism
- Nuclear Receptor Subfamily 1, Group D, Member 1/genetics
- Nuclear Receptor Subfamily 1, Group D, Member 1/metabolism
- Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha
- RNA, Messenger/genetics
- RNA-Binding Proteins/genetics
- RNA-Binding Proteins/metabolism
- Rats
- Rats, Inbred SHR
- Rats, Inbred WKY
- Real-Time Polymerase Chain Reaction
- Transcription Factors/genetics
- Transcription Factors/metabolism
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Affiliation(s)
- Mitsunori Miyazaki
- Department of Physiology, Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States of America
| | - Elizabeth Schroder
- Department of Physiology, Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States of America
- * E-mail:
| | - Stephanie E. Edelmann
- Department of Physiology, Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States of America
| | - Michael E. Hughes
- Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Karl Kornacker
- Division of Sensory Biophysics, Ohio State University, Columbus, Ohio, United States of America
| | - C. William Balke
- Clinical and Translational Science Institute and the Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Karyn A. Esser
- Department of Physiology, Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States of America
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Abstract
AIM The transient receptor potential vanilloid type 1 (TRPV1) channels have been implicated to play a role in blood pressure regulation. However, contribution of tissue specific TRPV1 to blood pressure regulation is largely unknown. Here, we test the hypothesis that TRPV1 expressed in dorsal root ganglia (DRG) of lower thoracic and upper lumbar segments (T8-L3) of the spinal cord and their central and peripheral terminals constitutes a counter regulatory mechanism preventing the increases in blood pressure. METHODS The expression of TRPV1 was knocked down by intrathecal injection of TRPV1 short-hairpin RNA (shRNA) in rats. Systolic blood pressure and mean arterial pressure (MAP) were recorded. The level of TRPV1 and tyrosine hydroxylase (TH) was measured by Western blot. RESULTS Intrathecal injection of TRPV1 shRNA (6 μg kg(-1) day(-1) ) for 3 days increased systolic blood pressure and MAP when compared to rats that received control shRNA (control shRNA: 112 ± 2 vs. TRPV1 shRNA: 123 ± 2 mmHg). TRPV1 expression was suppressed in T8-L3 segments of dorsal horn and DRG as well as mesenteric arteries of rats given TRPV1 shRNA. Contents of TH, a marker of sympathetic nerves, were increased in mesenteric arteries of rats treated with TRPV1 shRNA. Pretreatment with the α1-adrenoceptor blocker, prazosin (1 mg kg(-1) day(-1) , p.o.), abolished the TRPV1 shRNA-induced pressor effects. CONCLUSION Our data show that selective knockdown of TRPV1 expressed in DRG of T8-L3 segments of the spinal cord and their central and peripheral terminals increases blood pressure, suggesting that neuronal TRPV1 in these segments possesses a tonic anti-hypertensive effect possibly via suppression of the sympathetic nerve activity.
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Affiliation(s)
- S-Q Yu
- Department of Medicine, Michigan State University, East Lansing, USA
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15
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Carey RM. Pathophysiology of Primary Hypertension. Microcirculation 2008. [DOI: 10.1016/b978-0-12-374530-9.00020-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wang SC, Shih HH, Rossi DT, Campbell W. Determination of highly polar catecholamine with liquid chromatography–tandem mass spectrometry using weak cation-exchange stationary phase to increase retention time. Microchem J 2007. [DOI: 10.1016/j.microc.2007.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cabassi A, Dancelli S, Pattoneri P, Tirabassi G, Quartieri F, Moschini L, Cavazzini S, Maestri R, Lagrasta C, Graiani G, Corradi D, Parenti E, Tedeschi S, Cremaschi E, Coghi P, Vinci S, Fiaccadori E, Borghetti A. Characterization of myocardial hypertrophy in prehypertensive spontaneously hypertensive rats: interaction between adrenergic and nitrosative pathways. J Hypertens 2007; 25:1719-30. [PMID: 17620971 DOI: 10.1097/hjh.0b013e3281de72f0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE AND METHODS Left ventricular hypertrophy in human and experimental hypertension is not always associated with pressure overload but seems to precede an increase in blood pressure. In this study, performed in male 5-week-old prehypertensive spontaneously hypertensive rats (SHR; n = 65) and age-matched Wistar-Kyoto rats (n = 56), the relationship between myocardial structure and activation of the adrenergic and nitric oxide systems was evaluated. RESULTS Body weight, blood pressure and heart rate were similar in both groups. A higher left ventricle/body weight ratio was found in SHR, as a result of greater mononuclear (+47%) and binuclear (+43%) myocyte volumes, without changes in interstitial collagen. Both adrenergic and nitric oxide pathways were activated in SHR, as expressed by higher myocardial norepinephrine content, tyrosine hydroxylase activity, myocardial nitric oxide synthase 3 expression and protein nitration, indicating greater peroxynitrite (ONOO) generation from nitric oxide and superoxide. No difference was measured in nitric oxide synthase 1 expression, whereas nitric oxide synthase 2 was undetectable. A positive correlation between myocardial tyrosine hydroxylase activity and protein nitration was observed in SHR (r = 0.328; P < 0.01). Early treatment with a superoxide dismutase mimetic, 4-hydroxy-2,2,6,6-tetramethyl piperidinoxyl, from the third to the fifth week of age, reduced ONOO generation, protein nitration and sympathetic activation in SHR without changes in myocardial structure. CONCLUSION In prehypertensive SHR, left ventricular hypertrophy is associated with adrenergic and nitrosative imbalance. Early superoxide dismutase mimetic treatment in SHR effectively reduces higher myocardial ONOO generation, sympathetic activation, and heart rate without affecting the development of myocardial hypertrophy.
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Affiliation(s)
- Aderville Cabassi
- Laboratory of Hypertension, Department of Internal Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy.
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Kuroko Y, Tokunaga N, Yamazaki T, Akiyama T, Ishino K, Sano S, Mori H. Effect of sustained limb ischemia on norepinephrine release from skeletal muscle sympathetic nerve endings. Neurochem Int 2006; 49:448-53. [PMID: 16632086 DOI: 10.1016/j.neuint.2006.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2005] [Accepted: 03/02/2006] [Indexed: 11/21/2022]
Abstract
Acute ischemia has been reported to impair sympathetic outflow distal to the ischemic area in various organs, whereas relatively little is known about this phenomenon in skeletal muscle. We examined how acute ischemia affects norepinephrine (NE) release at skeletal muscle sympathetic nerve endings. We implanted a dialysis probe into the adductor muscle in anesthetized rabbits and measured dialysate NE levels as an index of skeletal muscle interstitial NE levels. Regional ischemia was introduced by microsphere injection and ligation of the common iliac artery. The time courses of dialysate NE levels were examined during prolonged ischemia. Ischemia induced a decrease in the dialysate NE level (from 19+/-4 to 2.0+/-0 pg/ml, mean+/-S.E.), and then a progressive increase in the dialysate NE level. The increment in the dialysate NE level was examined with local administration of desipramine (DMI, a membrane NE transport inhibitor), omega-conotoxin GVIA (CTX, an N-type Ca(2+) channel blocker), or TMB-8 (an intracellular Ca(2+) antagonist). At 4h ischemia, the increment in the dialysate NE level (vehicle group, 143+/-30 pg/ml) was suppressed by TMB-8 (25+/-5 pg/ml) but not by DMI (128+/-10 pg/ml) or CTX (122+/-18 pg/ml). At 6h ischemia, the increment in the dialysate NE level was not suppressed by the pretreatment. Ischemia induced biphasic responses in the skeletal muscle. Initial reduction of NE release may be mediated by an impairment of axonal conduction and/or NE release function, while in the later phase, the skeletal muscle ischemia-induced NE release was partly attributable to exocytosis via intracellular Ca(2+) overload rather than opening of calcium channels or carrier mediated outward transport of NE.
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Affiliation(s)
- Yosuke Kuroko
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
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Quadrilatero J, Rush JWE. Increased DNA fragmentation and altered apoptotic protein levels in skeletal muscle of spontaneously hypertensive rats. J Appl Physiol (1985) 2006; 101:1149-61. [PMID: 16778006 DOI: 10.1152/japplphysiol.00194.2006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Apoptosis is a highly conserved process that plays an important role in controlling tissue development, homeostasis, and architecture. Dysregulation of apoptosis is a hallmark of numerous human pathologies including hypertension. In the present work we studied the effect of hypertension on apoptosis and the expression of several apoptotic signaling and/or regulatory proteins in four functionally and metabolically distinct muscles. Specifically, we examined these markers in soleus, red gastrocnemius, white gastrocnemius, and left ventricle (LV) of 20-wk-old normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). Compared with WKY rats SHR had a significantly greater heart weight, LV weight, and mean arterial pressure. In general, SHR skeletal muscle had increased Bax protein, procaspase-3 protein, caspase-3 activity, cleaved poly(ADP-ribose) polymerase protein, and DNA fragmentation as well as decreased Bcl-2 protein and a lower Bcl-2-to-Bax ratio. Subcellular distribution studies demonstrated increased levels of apoptosis-inducing factor protein in cytosolic or nuclear extracts as well as elevated nuclear Bax protein in SHR skeletal muscle. Moreover, heat shock protein 70 in red gastrocnemius and soleus was significantly correlated to several apoptotic factors. With the exception of lower heat shock protein 90 levels in SHR no additional differences in any apoptotic markers were observed in LV between groups. Collectively, this report provides the first evidence that apoptotic signaling is altered in skeletal muscle of hypertensive animals, an effect that may be mediated by both caspase-dependent and -independent mechanisms. This proapoptotic state may provide some understanding for the morphological and functional abnormalities observed in skeletal muscle of hypertensive animals.
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Affiliation(s)
- Joe Quadrilatero
- Department of Kinesiology, University of Waterloo, 200 University Ave. W., Waterloo, Ontario, Canada N2L3G1
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López-Hernández FJ, López-Novoa JM. The lord of the ring: mandatory role of the kidney in drug therapy of hypertension. Pharmacol Ther 2005; 111:53-80. [PMID: 16154201 DOI: 10.1016/j.pharmthera.2005.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 08/01/2005] [Indexed: 12/21/2022]
Abstract
Strong evidence supports the idea that total peripheral resistance (TPR) is increased in all forms of human and experimental hypertension. Although the etiological participation of TPR in the origin and long-term maintenance of hypertension has been extensively debated, it now seems clear that the renal, nonadaptive, infinite gain-working, pressure-sensitive natriuresis and diuresis is the main mechanism of blood pressure control in the long term. The tissue, cellular, biochemical, and genetic sensors and executors of this process have not been fully identified yet, but the role of the renal medulla has gained growing attention as the physiopathological scenario in which the key regulatory elements reside. Specifically, the functionality of the renomedullary vasculature seems to be highly responsible for blood pressure control. The vasculature of the renal medulla becomes a new and more specific target for the therapeutic intervention of hypertension. Recent data on the effect of baroreceptor-controlled renal sympathetic activity on the long-term regulation of blood pressure are integrated. The renomedullary effects of the main antihypertensive drugs are discussed, and new perspectives for the therapeutic intervention of hypertension are outlined. Comparison of the genetic program of the renal medulla before and after the development of hypertension in spontaneously hypertensive and experimentally induced animal models might provide a mechanism for identifying the key genes that become activated or suppressed in the development of high blood pressure. These genes, their encoded proteins, or other elements related to their signalling and genetic pathways might serve as new and more specific targets for the pharmacological treatment of abnormally elevated blood pressure. Besides, proteins specifically located to the luminal side of the renomedullary vascular endothelium may serve as potential targets for site-directed drug and gene therapy.
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Affiliation(s)
- Francisco J López-Hernández
- Unidad de Investigación, Hospital Universitario de Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain.
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Julien C, Bayat S, Sam B, Lévy P, Patrick L. Vascular reactivity to norepinephrine and acetylcholine after chronic intermittent hypoxia in mice. Respir Physiol Neurobiol 2003; 139:21-32. [PMID: 14637307 DOI: 10.1016/j.resp.2003.09.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study assessed the early vascular reactivity changes in mice after exposure to 14 days intermittent hypoxia (IH) with active or inactive sympathetic nervous system (SNS). Hindquarters of mice exposed to 14 days of IH, sham exposed mice or unhandled mice were perfused at constant flow with Krebs-Albumin (5%). Changes in perfusion pressure were assessed after injection of several doses of norepinephrine in anaesthetized mice (active SNS) or in euthanized mice (inactive SNS). Response to several doses of acetylcholine was recorded after precontraction of hindquarter vascular bed by methoxamine in euthanized mice. Vasoconstrictor response was increased after IH for high dose of NE (50 microg) in euthanized mice and for all doses of NE (2-10-50 microg) in anaesthetized mice, but no change in vasodilatation was observed. These findings suggest that 14 days of IH altered vascular reactivity of mice hindquarter in an early pattern. Vasoconstriction was enhanced, particularly with active SNS, while there was no dysfunction of endothelium-relaxation.
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Affiliation(s)
- C Julien
- Laboratoire Hypoxie: Physiopathologie, Faculté de Médecine, 38700 Grenoble, France.
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Tokunaga N, Yamazaki T, Akiyama T, Sano S, Mori H. In vivo monitoring of norepinephrine and its metabolites in skeletal muscle. Neurochem Int 2003; 43:573-80. [PMID: 12820986 DOI: 10.1016/s0197-0186(03)00064-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although skeletal muscle sympathetic nerve activity plays an important role in the regulation of vascular tone and glucose metabolism, relatively little is known about regional norepinephrine (NE) kinetics in the skeletal muscle. With use of the dialysis technique, we implanted dialysis probes in the adductor muscle of anesthetized rabbits and examined whether dialysate NE and its metabolites were influenced by local administration of pharmacological agents through the dialysis probes. Dialysate dihydroxyphenylglycol (DHPG) and 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured as two major metabolites of NE. The skeletal muscle dialysate NE, DHPG and MHPG were 11.7+/-1.2, 38.1+/-3.2, and 266.1+/-28.7 pg/ml, respectively. Basal dialysate NE levels were suppressed by tetrodotoxin (Na(+) channel blocker, 10 microM) (5.1+/-0.6 pg/ml), and augmented by desipramine (NE uptake blocker, 100 microM) (25.8+/-3.2 pg/ml). Basal dialysate DHPG levels were suppressed by pargyline (monoamine oxidase blocker, 1mM) (24.3+/-4.6 pg/ml) and augmented by reserpine (vesicle NE transport blocker, 10 microM) (75.8+/-2.7 pg/ml). Basal dialysate MHPG levels were not affected by pargyline, reserpine, or desipramine. Addition of tyramine (sympathomimetic amine, 600 microM), KCl (100 mM), and ouabain (Na(+)-K(+) ATPase blocker, 100 microM) caused brisk increases in dialysate NE levels (200.9+/-14.2, 90.6+/-25.7, 285.3+/-46.8 pg/ml, respectively). Furthermore, increases in basal dialysate NE levels were correlated with locally administered desipramine (10, 100 microM). Thus, dialysate NE and its metabolite were affected by local administration of pharmacological agents that modified sympathetic nerve endings function in the skeletal muscle. Skeletal muscle microdialysis with local administration of a pharmacological agent provides information about NE release, uptake, vesicle uptake and degradation at skeletal muscle sympathetic nerve endings.
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Affiliation(s)
- Noriyuki Tokunaga
- Department of Cardiac Physiology, National Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, 565-8565, Osaka, Japan
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Bailey MA, Haton C, Orea V, Sassard J, Bailly C, Unwin RJ, Imbert-Teboul M. ETA receptor-mediated Ca2+ signaling in thin descending limbs of Henle's loop: impairment in genetic hypertension. Kidney Int 2003; 63:1276-84. [PMID: 12631344 DOI: 10.1046/j.1523-1755.2003.00880.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Endothelins (ET) have diuretic and natriuretic actions via ETB receptors that are found in most renal tubular segments, although the thin limbs have not been studied. Data also suggest that dysfunction of the renal ET system may be important in the pathogenesis of hypertension. The present study was aimed at determining the presence and nature of ET receptors in the thin limbs of Henle's loop and their ability to activate a Ca2+-dependent signaling pathway, as well as whether ET-induced Ca2+ signals are altered in hypertension. METHODS Reverse transcription-polymerase chain reaction (RT-PCR) and Fura 2 fluoreselected strains of Lyon rats with low-normal (LL), normal (LN), and high (LH) blood pressure. RESULTS In SD rats, ET induced Ca2+ signals in DTL of long-looped nephrons, but not in DTL of short loops, or in ascending thin limbs. Ca2+ increases were abolished by BQ123, an antagonist of the ETA receptor, but not by BQ788, an antagonist of the ETB subtype. Endothelin-3 and sarafotoxin 6c, two ETB receptor agonists, were both inactive. RT-PCR showed the presence of both ETA and ETB receptor mRNA. Ca2+ signals measured scence measurements of [Ca2+]i were made to characterize ET receptors in descending thin limbs (DTL) of Sprague-Dawley rats, spontaneously hypertensive (SH) rats, and control Wistar-Kyoto (WKY) rats, and the three in DTL of WKY LL and LN rats were similar to those in Sprague-Dawley rats, but were significantly diminished (LH) or abolished (SH) in hypertensive rats. CONCLUSION A functional ETA receptor activating a Ca2+-dependent pathway is expressed in DTL. This ETA-induced calcium signaling is impaired in two strains of genetically hypertensive rats.
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Affiliation(s)
- Matthew A Bailey
- Centre for Nephrology and Department of Physiology, Royal Free and University College Medical School, University College London, UK
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Tanno AP, Bianchi FJ, Costa Sampaio Moura MJ, Marcondes FK. Atrial supersensitivity to noradrenaline in stressed female rats. Life Sci 2002; 71:2973-981. [PMID: 12384181 DOI: 10.1016/s0024-3205(02)02145-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Stress can change the responses to catecholamines in many tissues. The aim of this study was to investigate the influence of the estrous cycle on the sensitivity of right atria to noradrenaline in female rats subjected to acute swimming stress. Female Wistar rats in proestrus, estrus, metestrus or diestrus were submitted to a 50 min-swimming session. Immediately after the exercise, the rats were killed and their right atria were mounted for isometric recording of the spontaneous beating rate. Concentration-effect curves to noradrenaline were obtained before and after the inhibition of neuronal uptake with phenoxybenzamine (10 microM) and of extraneuronal uptake with estradiol (5 microM). Acute swimming stress did not change the right atrial sensitivity to noradrenaline in rats in estrus, metestrus and diestrus. However, swimming stress produced supersensitivity to noradrenaline in proestrus (pD(2) control: 7.14 +/- 0.03 vs. pD(2) swimming: 7.55 +/- 0.04; p<0.05). This supersensitivity was still observed after uptake inhibition. When catecholamine uptake was inhibited, the concentration-effect curve to noradrenaline was shifted to the left 2.5-fold in the proestrus control group and 1.7-fold in the proestrus stress group (p<0.05). In conclusion, the estrous cycle influenced the acute stress-induced atrial supersensitivity to noradrenaline.
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Affiliation(s)
- Ana Paula Tanno
- Departamento de Ciências Fisiológicas, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Av. Limeira 901, 13414-903, Piracicaba, SP, Brazil
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Abstract
Long-term control of arterial pressure has been attributed to the kidney by virtue of its ability to couple the regulation of blood volume to the maintenance of sodium and water balance by the mechanisms of pressure natriuresis and diuresis. In the presence of a defect in renal excretory function, hypertension arises as the consequence of the need for an increase in arterial pressure to offset the abnormal pressure natriuresis and diuresis mechanisms, and to maintain sodium and water balance. There is growing evidence that an important cause of the defect in renal excretory function in hypertension is an increase in renal sympathetic nerve activity (RSNA). First, increased RSNA is found in animal models of hypertension and hypertensive humans. Second, renal denervation prevents or alleviates hypertension in virtually all animal models of hypertension. Finally, increased RSNA results in reduced renal excretory function by virtue of effects on the renal vasculature, the tubules, and the juxtaglomerular granular cells. The increase in RSNA is of central nervous system origin, with one of the stimuli being the action of angiotensin II, probably of central origin. By acting on brain stem nuclei that are important in the control of peripheral sympathetic vasomotor tone (e.g. rostral ventrolateral medulla), angiotensin II increases the basal level of RSNA and impairs its arterial baroreflex regulation. Therefore, the renal sympathetic nerves may serve as the link between central sympathetic nervous system regulatory sites and the kidney in contributing to the renal excretory defect in the development of hypertension.
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Affiliation(s)
- Gerald F DiBona
- Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
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