Enhanced 24-hour norepinephrine and renin secretion in young patients with essential hypertension: relation with the circadian pattern of arterial blood pressure |
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| Authors: | M L Tuck N Stern J R Sowers |
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| Affiliation: | 1. From the UCLA School of Medicine, Los Angeles, California, U.S.A.;2. From the Veterans Administration Medical Center, Sepulveda, California, U.S.A.;1. Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo 162-8480, Japan;2. Department of Psychiatry, Tokyo Women''s Medical University, School of Medicine, Shinjuku-ku, Tokyo 162-8666, Japan;1. Department of Cardiology, Second Affiliated and Yuying Children''s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China;2. Department of Nephrology, Second Affiliated and Yuying Children''s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China;3. Department of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian 350122, China;1. Department of Medicine and Biological Science, Graduate School of Medicine, Gunma University School of Medicine, Gunma, Japan;2. Gunma Prefectural Cardiovascular Center, Gunma, Japan |
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| Abstract: | This study examines the possibility that 24-hour differences in blood pressure (BP) regulation between hypertensive and normotensive subjects is related to changes in 24-hour secretory patterns in circulating pressor hormones. Nine young subjects with normal BP and 9 patients with essential hypertension (EH) were studied during 24-hour recumbency. Every 20 minutes samples were taken to determine plasma norepinephrine (NE) levels and plasma renin activity (PRA). BP was measured every 20 minutes by automatic recording. A distinct circadian rhythm was demonstrated for mean BP, NE and PRA in both groups. Nocturnal reductions in mean BP, NE and PRA related best to the sleep-wakefulness cycle in both groups. Circadian changes in mean BP correlated with NE levels in both normal subjects and patients with EH. The most striking difference between the 2 groups was the absolute levels of mean BP, NE and PRA, which were higher in the EH group at most time points in the 24-cycle. Differences in levels of NE and PRA between the 2 groups were most accentuated during sleep. Thus, young persons with EH show evidence of enhanced sympathetic nervous activity throughout the 24-hour cycle, which is most pronounced during sleep. The multiple sampling approach offers a more sensitive indicator of the role of pressor hormones in BP maintenance. |
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