Contribution of endogenous vasopressin to regional hemodynamics in borderline-hypertensive Hiroshima rats

Pharmacology of vasopressin antagonists

Congestive heart failure (CHF) is characterized by fluid and water retention, which frequently is a therapeutic challenge. Most conventional diuretics act primarily as saluretics, i.e. they inhibit renal tubular electrolyte reabsorption, which due to osmotic pressure promotes excretion of isotonic fluid. Arginine vasopressin (AVP) via the V(1A) receptor vasoconstricts and via the V(2) receptor promotes water reabsorption in the renal collecting duct by inserting aquaporin-2 water channels into the luminal membrane. Novel V(2) receptor antagonists act as powerful aquaretics, i.e. they excrete free water. We review the pharmacology of non-selective V(1A)/V(2) receptor antagonists and selective V(2) receptor antagonists currently in clinical development.

Associations between sympathetic activity, plasma concentrations of renin, aldosterone, and parathyroid hormone, and the degree of intractability of blood pressure control in modialysis patients

This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, beta2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.

Are sodium-dependent V1 receptors and sympathetic nerve activations involved in regulation of blood pressure in borderline-hypertensive Hiroshima rats?

Sympathetic nerve activity (SNA) was estimated by the magnitude of depressor response after ganglionic blockade with hexamethonium bromide (C6; 25 mg/kg weight). The depressor effects of C6 were significantly less in borderline-hypertensive Hiroshima rats (BHR) than in deoxycorticosterone acetate (DOCA)-salt hypertensive rats (DOCA rats) or in spontaneously hypertensive rats (SHR), but they were not different in BHR and normotensive control Wistar rats (NCR). After sympatho-inhibition, the depressor effects of a selective vasopressin V1 receptor antagonist (V1A; 10 microg/kg: [d(CH2)5(1), O-Me-Tyr2, Arg8]-vasopressin) were significantly greater in BHR than in DOCA rats, SHR or NCR. In a previous study, we reported that the depressor effects of C6 were significantly less in BHR than in SHR, but after sympatho-inhibition, the depressor effects of V1A were significantly greater in BHR than in SHR (Hypertens Res 2002; 25: 241-248). After high-salt diet loading in the present study (8% salt-containing diet for 10 weeks), the magnitudes of increase in mean arterial pressure in BHR and NCR were almost the same. There was almost no difference in the depressor effects of V1A after sympatho-inhibition between BHR with high-salt intake and BHR without high-salt intake. The depressor effects of an angiotensin-converting enzyme inhibitor, captopril (1 mg/kg), were almost the same between BHR and NCR both before and after sympatho-inhibition. However, these effects were completely inhibited after the high-salt diet. The results show that SNA was within the normal range in BHR and that no further accelerated responsiveness of endogenous vasopressin was observed in BHR after high-salt intake.