BIOMAT Database Logo BIOMAT Database Logo

The sympathetic nervous system in hypertension: assessment by blood pressure variability and ganglionic blockade. 2003

André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
Autonomic Dysfunction Center, Vanderbilt University, Nashville, TN 37232-2195, USA.

OBJECTIVE To determine if the contribution of the sympathetic nervous system to blood pressure could be evidenced by low-frequency oscillations of systolic blood pressure (LF(SBP)), reflecting vascular sympathetic modulation, or by the decrease in blood pressure after autonomic blockade. METHODS We studied multiple system atrophy (MSA) patients, in whom supine hypertension is maintained by residual sympathetic tone ('positive controls'); pure autonomic failure (PAF) patients, in whom supine hypertension is largely independent of sympathetic tone ('negative controls'); essential hypertensive patients (HTN) and normotensive subjects (NTN). RESULTS Supine systolic blood pressure (SBP) was 204 +/- 8, 185 +/- 6, 177 +/- 9 and 130 +/- 4 mmHg in MSA, PAF, HTN and NTN, respectively. LF(SBP) was higher in MSA and HTN (5.7 +/- 1.5 and 5.8 +/- 1.4 mmHg(2) compared to NTN and PAF (3.3 +/- 0.5 and 1.1 +/- 0.5 mmHg(2). Trimethaphan 2-4 mg/min induced complete autonomic blockade and lowered SBP below 125 mmHg in all NTN and all but one MSA (to 111 +/- 3 and 97 +/- 9 mmHg). SBP remained elevated in PAF (164 +/- 7 mmHg). Responses in HTN were variable; SBP decreased below 125 mmHg in three and remained elevated in four patients. The decrease in LF(SBP) correlated with the reduction in SBP, with a steeper slope in MSA and HTN compared to NTN (29.0 +/- 5.5, 8.4 +/- 1.6 and 3.6 +/- 1.2 mmHg/mmH (2), respectively). CONCLUSIONS Ganglionic blockade, alone or coupled to LF(SBP), discriminated between human models of sympathetic-dependent (MSA) and independent (PAF) hypertension. This approach may aid in assessing the contribution of the sympathetic nervous system in essential hypertension, in which sympathetic dependence is variably expressed.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D008297 Male Males
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D005730 Ganglionic Blockers Agents having as their major action the interruption of neural transmission at nicotinic receptors on postganglionic autonomic neurons. Because their actions are so broad, including blocking of sympathetic and parasympathetic systems, their therapeutic use has been largely supplanted by more specific drugs. They may still be used in the control of blood pressure in patients with acute dissecting aortic aneurysm and for the induction of hypotension in surgery. Ganglionic Blocking Agents,Ganglioplegic Agents,Blocking Agents, Ganglionic,Ganglionic Blockaders,Agents, Ganglionic Blocking,Agents, Ganglioplegic,Blockaders, Ganglionic,Blockers, Ganglionic
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001342 Autonomic Nervous System Diseases Diseases of the AUTONOMIC NERVOUS SYSTEM, including sympathetic, parasympathetic, and enteric nervous systems. Autonomic Disorders,Central Autonomic Nervous System Diseases,Disorders of the Autonomic Nervous System,Dysautonomia,Nervous System Diseases, Autonomic,Nervous System Diseases, Parasympathetic,Nervous System Diseases, Sympathetic,Non-Familial Dysautonomia,Parasympathetic Nervous System Diseases,Peripheral Autonomic Nervous System Diseases,Sympathetic Nervous System Diseases,ANS (Autonomic Nervous System) Diseases,ANS Diseases,Autonomic Central Nervous System Diseases,Autonomic Diseases,Autonomic Nervous System Disorders,Autonomic Peripheral Nervous System Diseases,Segmental Autonomic Dysfunction,ANS Disease,Autonomic Disease,Autonomic Disorder,Autonomic Dysfunction, Segmental,Autonomic Dysfunctions, Segmental,Disorder, Autonomic,Dysautonomia, Non-Familial,Dysautonomias,Non Familial Dysautonomia,Non-Familial Dysautonomias,Segmental Autonomic Dysfunctions

Related Publications

André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
The sympathetic nervous system in hypertension: assessment by blood pressure variability and ganglionic blockade.
September 2003, Journal of hypertension,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
Sympathetic nervous system and blood-pressure control in essential hypertension.
November 1978, Lancet (London, England),
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
[System analysis of blood pressure regulation; the sympathetic nervous system and hypertension].
June 1979, Nederlands tijdschrift voor geneeskunde,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
The sympathetic nervous system and blood pressure in humans: implications for hypertension.
August 2012, Journal of human hypertension,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
Obesity, blood pressure, and the sympathetic nervous system.
May 1991, Annals of epidemiology,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
The sympathetic nervous system's role in regulating blood pressure variability.
January 2001, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
[Sympathetic nervous factors, pressure variability and organ damage in arterial hypertension].
January 1997, Annali italiani di medicina interna : organo ufficiale della Societa italiana di medicina interna,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
[Ganglionic tumors of the intrathoracic sympathetic nervous system].
January 1955, Archivio italiano di chirurgia,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
Electrophysiology of ganglionic transmission in the sympathetic nervous system.
January 1989, International anesthesiology clinics,
André Diedrich, and Jens Jordan, and Jens Tank, and John R Shannon, and Rosemarie Robertson, and Friedrich C Luft, and David Robertson, and Italo Biaggioni
Effective reduction in blood pressure without ganglionic blockade.
July 1959, Virginia medical monthly,
Copied contents to your clipboard!