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Borderline hypertension: relationship between age, hemodynamics and circulating catecholamines

F H Messerli, E D Frohlich, D H Suarez

    Circulation
    |October 1, 1981
    PubMed

    Insights

    Borderline hypertension presents differently with age. Young patients show high cardiac output and renal blood flow, while older patients exhibit increased peripheral resistance and normal cardiac output, influenced by catecholamines.

    Area of Science:

    • Cardiovascular Physiology
    • Hypertension Pathophysiology
    • Clinical Investigation

    Background:

    • Essential hypertension is a complex condition with varying hemodynamic profiles.
    • Age is a significant factor influencing cardiovascular regulation and disease progression.
    • Understanding the interplay of hemodynamics, catecholamines, and intravascular volume is crucial for hypertension management.

    Purpose of the Study:

    • To investigate the age-related differences in systemic and renal hemodynamics in borderline hypertension.
    • To examine the relationship between age, circulating catecholamines (norepinephrine, epinephrine, dopamine), and intravascular volumes.
    • To elucidate the shift in hemodynamic profiles from young to older patients with borderline hypertension.

    Main Methods:

    • Cross-sectional study involving 38 normotensive subjects and 77 patients with borderline essential hypertension.
    • Measurement of systemic hemodynamics (cardiac index, total peripheral resistance) and renal blood flow.
    • Analysis of circulating catecholamine levels (norepinephrine, epinephrine, dopamine) and intravascular volumes.
    • Statistical correlation analysis to assess relationships between variables and age.

    Main Results:

    • Younger borderline hypertensive patients (<30 years) exhibited higher cardiac index and renal blood flow compared to normotensive controls.
    • Older borderline hypertensive patients (>40 years) showed significantly increased total peripheral resistance but normal cardiac output.
    • Cardiac output and renal blood flow correlated inversely with age across the study population.
    • Norepinephrine levels increased with age, while epinephrine levels tended to decrease, correlating with hemodynamic shifts.

    Conclusions:

    • The hyperdynamic circulation characteristic of borderline hypertension is predominantly observed in younger individuals (<30 years).
    • Older patients (>40 years) with borderline hypertension are characterized by elevated total peripheral resistance and normal cardiac output.
    • Age-dependent alterations in catecholamine levels, particularly norepinephrine and epinephrine, may drive the transition from high-cardiac-output to high-resistance hypertension.

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