Prenatal dexamethasone 'programmes' hypotension, but stress-induced hypertension in adult offspring

David O'Regan1, Christopher J Kenyon, Jonathan R Seckl

  • 1Endocrinology Unit, Queen's Medical Research Institute, Centre for Cardiovascular Science, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.

Insights

Prenatal exposure to dexamethasone (DEX) in rats programs low birth weight and stress-induced hypertension in adulthood. Altered sympathetic responses to vasoconstrictors mediate this programmed hypertension.

Area of Science:

  • Endocrinology
  • Developmental Biology
  • Cardiovascular Physiology

Background:

  • Low birth weight is linked to adult hypertension.
  • Fetal glucocorticoid overexposure is a potential mechanism.
  • Prenatal dexamethasone (DEX) exposure in rats lowers birth weight and programs adult hypertension.

Purpose of the Study:

  • Investigate the nature of DEX-induced programmed hypertension.
  • Elucidate the origins of this programmed hypertension.
  • Assess the role of sympathetic responses in DEX-programmed hypertension.

Main Methods:

  • Radiotelemetry to measure blood pressure (BP) in adult offspring.
  • Assessed BP response to mild and severe stressors.
  • Administered amphetamine to promote catecholamine release.
  • Evaluated mesenteric vasculature sensitivity to noradrenaline.

Main Results:

  • Prenatal DEX resulted in 14% lower birth weight and lower basal adult BP.
  • DEX-exposed offspring exhibited stress-induced hypertension (up to 30 mmHg higher).
  • DEX offspring showed a greater BP rise (77%) after amphetamine.
  • Mesenteric vasculature of DEX offspring was more sensitive to vasoconstrictors.

Conclusions:

  • Prenatal DEX programming leads to stress-induced, not basal, hypertension.
  • Altered sympathetic responses to vasoconstrictors mediate DEX-programmed hypertension.
  • This study elucidates the mechanisms of low birth weight-associated hypertension.

Related Concept Videos

Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Hormonal Regulation01:33

Hormonal Regulation

The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hormonal Regulation of Blood Pressure01:17

Hormonal Regulation of Blood Pressure

Endocrinal or hormonal intervention in the cardiovascular system is predominantly exerted by the catecholamines - epinephrine and norepinephrine, as well as a slew of hormones that interact with renal function to modulate blood volume.
Epinephrine and Norepinephrine
The adrenal medulla releases epinephrine and norepinephrine, catecholamines that enhance and extend the sympathetic or "fight or flight" physiological response. These hormones escalate heart rate and the force of contraction while...