Effect of angiotensin II receptor blockade on autonomic nervous system function in patients with essential hypertension
| العنوان: | Effect of angiotensin II receptor blockade on autonomic nervous system function in patients with essential hypertension |
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| المؤلفون: | Emma Windebank, Elisabeth Lambert, Henry Krum, Duncan J. Campbell, Murray D. Esler |
| المصدر: | American Journal of Physiology-Heart and Circulatory Physiology. 290:H1706-H1712 |
| بيانات النشر: | American Physiological Society, 2006. |
| سنة النشر: | 2006 |
| مصطلحات موضوعية: | Adult, Male, Angiotensin receptor, medicine.medical_specialty, Sympathetic nervous system, Sympathetic Nervous System, Adolescent, Physiology, Thiophenes, Baroreflex, Losartan, Renin-Angiotensin System, Angiotensin Receptor Antagonists, Norepinephrine, Physiology (medical), Internal medicine, Renin–angiotensin system, medicine, Humans, Antihypertensive Agents, Aged, Cross-Over Studies, business.industry, Imidazoles, Middle Aged, Autonomic nervous system, Endocrinology, medicine.anatomical_structure, Acrylates, Hypertension, Female, Cardiology and Cardiovascular Medicine, business, Angiotensin II Type 1 Receptor Blockers, medicine.drug |
| الوصف: | It has long been proposed that the renin-angiotensin system exerts a stimulatory influence on the sympathetic nervous system, including augmentation of central sympathetic outflow and presynaptic facilitation of norepinephrine release from sympathetic nerves. We tested this proposition in 19 patients with essential hypertension, evaluating whether the angiotensin receptor blockers (ARBs) eprosartan and losartan had identifiable antiadrenergic properties. This was done in a prospective, randomized, three-way placebo-controlled study of crossover design. Patients were randomized to 600 mg of eprosartan daily, 50 mg of losartan daily, or placebo. The treatment period was 4 wk, with 2-wk washout periods. Multiunit firing rates in efferent sympathetic nerves distributed to skeletal muscle vasculature (muscle sympathetic nerve activity, MSNA) were measured with microneurography, testing whether ARBs inhibit central sympathetic outflow. In parallel, isotope dilution methodology was used to measure whole body norepinephrine spillover to plasma. Mean blood pressure on placebo was 151/98 mmHg, with both ARBs causing reductions of approximately 11 mmHg systolic and 6 mmHg diastolic pressure, placebo corrected. Both MSNA [35 +/- 12 bursts/min (mean +/- SD) on placebo] and whole body norepinephrine spillover [366 +/- 247 ng/min] were unchanged by ARB administration, indicating that the ARBs did not materially inhibit central sympathetic outflow or act presynaptically to reduce norepinephrine release at existing rates of nerve firing. These findings contrast with the easily demonstrable reduction in sympathetic nervous activity produced by antihypertensive drugs of the imidazoline-binding class, which are known to act within the brain to inhibit sympathetic nervous outflow. We conclude that sympathetic nervous inhibition is not a major component of the blood pressure-lowering action of ARBs in essential hypertension. |
| تدمد: | 1522-1539 0363-6135 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6a405a3ba05e8dbb23824fdb4f3f43aaTest https://doi.org/10.1152/ajpheart.00885.2005Test |
| رقم الانضمام: | edsair.doi.dedup.....6a405a3ba05e8dbb23824fdb4f3f43aa |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15221539 03636135 |
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