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Regional norepinephrine turnover in human hypertension
M Esler1, G Lambert, G Jennings
1Baker Medical Research Institute, Prahran, Australia.
Summary
Sympathetic nervous system activity is elevated in young patients with primary hypertension, particularly affecting the kidneys and heart. This increased norepinephrine overflow contributes to the early development of hypertension.
Area of Science:
- Cardiovascular Physiology
- Renal Physiology
- Neuroendocrinology
Background:
- Human hypertension involves complex pathophysiology.
- The role of the sympathetic nervous system in hypertension requires further elucidation.
Purpose of the Study:
- To investigate sympathetic nervous system pathophysiology in primary hypertension.
- To assess norepinephrine overflow in hypertensive patients compared to healthy controls.
Main Methods:
- Measured overall and regional norepinephrine overflow to plasma.
- Analyzed plasma renin activity and renal renin release.
- Compared 55 untreated primary hypertension patients with 40 healthy subjects.
Main Results:
- Increased total norepinephrine spillover was observed in primary hypertension.
- Younger patients (<40 years) showed significantly higher renal and cardiac norepinephrine overflow.
- Elevated renal renin release and plasma renin activity correlated with increased renal sympathetic activity in younger patients.
Conclusions:
- A selective increase in sympathetic nervous outflow to the heart and kidneys is common in young primary hypertension patients.
- This heightened sympathetic activity likely contributes to the early pathogenesis of hypertension.
- Sympathetic activity and norepinephrine release were generally normal in older hypertensive patients.