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A long-term study of plasma catecholamine levels and plasma renin activity in borderline hypertension
R O Böhm1, M A van Baak, M E van Hooff
1Department of Pharmacology, University of Limburg, Maastricht, The Netherlands.
Insights
Borderline hypertension may progress to definite hypertension in individuals with elevated resting plasma noradrenaline. Enhanced sympathetic activity is suggested in those developing sustained high blood pressure.
Area of Science:
- Cardiology
- Endocrinology
- Hypertension Research
Background:
- Borderline hypertension is a precursor state to sustained hypertension.
- Sympathetic nervous system activity plays a role in blood pressure regulation.
Purpose of the Study:
- To investigate the relationship between plasma catecholamine levels and the progression of borderline hypertension over 7 years.
- To identify predictors of developing definite hypertension from a borderline hypertensive state.
Main Methods:
- Longitudinal follow-up of 26 borderline hypertensive and 24 normotensive subjects for 7 years.
- Measurement of blood pressure and plasma catecholamine (noradrenaline and adrenaline) levels at rest and during exercise.
Main Results:
- Five borderline hypertensive subjects progressed to definite hypertension.
- Subjects who developed definite hypertension exhibited consistently high resting plasma noradrenaline levels.
- No significant differences were observed in plasma adrenaline or exercise-induced noradrenaline levels.
Conclusions:
- Consistently high resting plasma noradrenaline may indicate enhanced sympathetic activity.
- Enhanced sympathetic activity in borderline hypertensive individuals could predict the development of definite hypertension.
Abstract:
Blood pressure and plasma catecholamine levels were followed up for a total of 7 years in 26 subjects with borderline hypertension and in 24 normotensive subjects. During the observation period, five subjects from the borderline hypertensive group became definitely hypertensive, 10 remained in the borderline hypertensive range and in 10, blood pressure fell below borderline hypertensive levels. Of the original 24 normotensive subjects, 15 remained in the normotensive range. In seven, blood pressure rose, but did not reach borderline hypertensive levels. Three subjects were lost to follow-up. In contrast with the subjects who remained normotensive and borderline hypertensive, those who became definitely hypertensive had consistently high plasma noradrenaline concentrations at rest. Plasma adrenaline levels and plasma noradrenaline concentrations during exercise did not differ, however. The study suggests that borderline hypertensive subjects who develop definite hypertension within a few years have consistently enhanced sympathetic activity.