Renal effects of hyperinsulinaemia in subjects with two hypertensive parents

1999 ◽  
Vol 97 (6) ◽  
pp. 681-687
Author(s):  
Ulrik B. ANDERSEN ◽  
Peter SKØTT ◽  
Niels E. BRUUN ◽  
Harriet DIGE-PETERSEN ◽  
Hans IBSEN
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Genetic Predisposition ◽  
Sensitivity Index ◽  
Renal Metabolism ◽  
Sodium Potassium ◽  
The Family ◽  
Normotensive Subjects ◽  
Sodium Clearance ◽  
Sodium And Potassium

The aim of this investigation was to study the effects of isoglycaemic hyperinsulinaemia on the renal metabolism of electrolytes and water in subjects with a strong genetic predisposition to essential hypertension, compared with that in non-predisposed subjects. We studied 25 normotensive subjects aged 18–35 years whose parents both had essential hypertension, and 22 age- and sex-matched subjects whose parents were both normotensive. Diabetes or morbid obesity in any subject or parent excluded the family. The 24-h blood pressure was measured. The subjects received an isocaloric diet with a fixed content of sodium and potassium for 4 days before the study. An isoglycaemic, hyperinsulinaemic clamp with infusion of insulin (40 munits·min-1·m-2) was performed. We measured the renal clearance of diethylenetriaminepenta-acetic acid, sodium, potassium and lithium both under basal conditions and during hyperinsulinaemia. In response to hyperinsulinaemia, renal sodium clearance decreased to a significantly greater extent in the hypertension-prone subjects [0.57 (0.74, 0.36) ml·min-1·1.73 m2 (median and quartiles)] than in the controls [0.34 (0.56, 0.18) ml·min-1·1.73 m2] (P = 0.04). Compared with the controls, the subjects predisposed to hypertension had a higher 24-h diastolic blood pressure [78 (70, 82) mmHg, compared with 73 (68, 77) mmHg], but a similar insulin sensitivity index {107×[313 (225, 427)] compared with 107×[354 (218, 435)] l2·min-1·pmol-1·kg-1}. Thus the sodium-retaining effect of insulin was more pronounced in subjects with a strong genetic predisposition to essential hypertension than in subjects with normotensive parents. This effect may contribute to the development of hypertension in subjects with a genetic predisposition to hypertension.

Solitary Kidney and Ageing as Causes of Low Renin and Aldosterone Concentrations: Relevance to ‘Low-Renin’ Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 177s-180s ◽  
Author(s):  
R. Gordon ◽  
Freda Doran ◽  
M. Thomas ◽  
Frances Thomas ◽  
P. Cheras
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Normotensive Subjects ◽  
The Mean

1. As experimental models of reduced nephron population in man, (a) twelve men aged 15–32 years who had one kidney removed 1–13 years previously and (b) fourteen normotensive men aged 70–90 years were studied. Results were compared with those in eighteen normotensive men aged 18–28 years and eleven men aged 19–33 years with essential hypertension. 2. While the subjects followed a routine of normal diet and daily activity, measurements were made, after overnight recumbency and in the fasting state, of plasma volume and renin activity on one occasion in hospital and of blood pressure on five to fourteen occasions in the home. Blood pressure was also measured after standing for 2 min and plasma renin activity after 1 h standing, sitting or walking. Twenty-four hour urinary aldosterone excretion was also measured. 3. The measurements were repeated in the normotensive subjects and subjects in (a) and (b) above after 10 days of sodium-restricted diet (40 mmol of sodium/day). 4. The mean plasma renin activity (recumbent) in essential hypertensive subjects was higher than in normotensive subjects. In subjects of (a) and (b) above, it was lower than normotensive subjects, and was not increased by dietary sodium restriction in subjects of (a). 5. The mean aldosterone excretion level was lower in old normotensive subjects than in the other groups, and increased in each group after dietary sodium restriction. 6. Mean plasma volume/surface area was not different between the four groups and in normotensive, essential hypertensive and nephrectomized subjects but not subjects aged 70–90 years was negatively correlated with standing diastolic blood pressure.

Abstract P053: Sodium and Potassium Intake and Blood Pressure and Risk of Hypertension Among U.S. Adults - Results From NHANES 2003-2008

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Zefeng Zhang ◽  
Mary Cogswell ◽  
Cathleen Gillespie ◽  
Jing Fang ◽  
Shifan Dai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Sodium Potassium ◽  
Potassium Intake ◽  
Undiagnosed Hypertension ◽  
Unit Increase ◽  
Nationally Representative ◽  
Prevention Of Hypertension ◽  
Sodium And Potassium

Introduction: Evidence from randomized controlled trials demonstrates higher sodium and/or lower potassium intake increase blood pressure and the risk of hypertension. However, the relationship between sodium, potassium and blood pressure has not been examined using nationally representative sample and estimated usual intakes of these nutrients. Hypothesis: We hypothesized that usual sodium and potassium intake have opposing effects on blood pressure and a higher sodium-to-potassium ratio is associated with elevated blood pressure and hypertension. Methods: We analyzed data on 12,854 participants aged 20 years and older from the 2003-2008 National Health and Nutrition Examination Surveys. We estimated the usual intakes of sodium and potassium from the diet accounting for measurement error. Mean blood pressure was calculated from up to three readings on each subject and hypertension included both diagnosed and undiagnosed hypertension. We used multivariable linear regression to examine the associations between intakes of sodium, potassium and their ratio with systolic and diastolic blood pressure, and logistic regression for associations with hypertension. Results: The average estimated usual intakes of sodium and potassium were 3465 and 2741 mg/d, respectively. The average sodium-to-potassium ratio was 1.39; higher ratios were observed among males, younger and non-Hispanic black participants. After adjustment for potential confounders, usual intakes of sodium, potassium and their ratio were significantly associated with systolic blood pressure, with an increase of 1.08 mm Hg (95% confidence interval (CI): 0.30 – 1.86) and a decrease of 1.47 mmHg (95% CI: -2.31, -0.63) for every 1000 mg/d increase in sodium and potassium intake, respectively, and an increase of 2.80 mmHg (95% CI: 0.90 - 4.70) for every unit increase in sodium-to-potassium ratio. No association was found for diastolic blood pressure. The adjusted odds ratio (OR) comparing the highest and lowest quartiles of usual sodium or potassium intakes were 1.63 (95% CI: 1.14 - 2.34) and 0.61 (95% CI: 0.45 - 0.82), respectively, for risk of hypertension. For sodium-to-potassium ratio, the adjusted OR was 1.49 (95% CI: 1.17 - 1.89). The patterns of association were largely consistent across age, gender, race/ethnicity, body mass index, and education subgroups. Conclusions: In conclusion, our results indicated higher sodium and lower potassium intakes were associated with increased systolic blood pressure and risk for hypertension. The combined effect of sodium and potassium might play a central role in the pathogenesis of hypertension. The results further confirm that reducing sodium and increasing potassium intakes concurrently may have important implications in the prevention of hypertension, and hence, of cardiovascular disease.

Relation of Plasma Noradrenaline to Blood Pressure, Age, Sex and Sodium Balance in Patients with Stable Essential Hypertension and in Normotensive Subjects

1978 ◽  
Vol 55 (s4) ◽  
pp. 81s-83s ◽  
Author(s):  
H. M. Brecht ◽  
W. Schoeppe
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Essential Hypertension ◽  
Diastolic Blood Pressure ◽  
Plasma Noradrenaline ◽  
Sodium Balance ◽  
Creatinine Ratio ◽  
Control Subjects ◽  
Normotensive Subjects ◽  
Normotensive Control

1. Plasma noradrenaline was measured in 125 patients with stable essential hypertension (WHO I—II) and in 107 normotensive control subjects lying and standing. 2. In normotensive subjects and in patients with essential hypertension no sex-related differences of plasma noradrenaline were found between age-matched groups. 3. Plasma noradrenaline was not related to sodium balance indexed by urinary sodium/creatinine ratio. 4. In patients with essential hypertension plasma noradrenaline increases with age. 5. Mean plasma noradrenaline concentrations are significantly higher in patients with essential hypertension compared with age-matched normotensive subjects both lying and standing. 6. In patients with essential hypertension diastolic blood pressure and heart rate correlated significantly with supine plasma noradrenaline concentrations.

Plasma Noradrenaline Concentration and α-Adrenoceptor-Mediated Vasoconstriction in Normotensive and Hypertensive Man

1981 ◽  
Vol 60 (5) ◽  
pp. 483-489 ◽  
Author(s):  
W. Kiowski ◽  
F. R. Bühler ◽  
P. Vanbrummelen ◽  
F. W. Amann
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Vascular Resistance ◽  
Sympathetic Activity ◽  
Plasma Noradrenaline ◽  
Arterial Infusion ◽  
Hypertensive Patients ◽  
Noradrenaline Concentration ◽  
Normotensive Subjects ◽  
Control Plasma

1. Plasma noradrenaline concentrations and blood pressure were measured in 45 patients with essential hypertension and 34 matched normotensive subjects. Plasma noradrenaline was similar in both groups, but in the hypertensive patients plasma noradrenaline correlated with blood pressure. 2. The increase in forearm flow in response to an intra-arterial infusion of phentolamine was determined in 12 of the hypertensive and 14 of the normotensive subjects to assess the α-adrenoceptor-mediated component of vascular resistance. Although the dilator response to phentolamine was similar in both groups, in the hypertensive patients it was correlated with the control plasma noradrenaline (r = 0.83, P<0.01) as well as the height of mean blood pressure (r = 0.73, P<0.01). 3. These results suggest that in hypertensive patients plasma noradrenaline can be a marker for both sympathetic activity and the α-adrenoceptor-mediated component of vascular resistance.

The Urinary Excretion of Catecholamines and Their Derivatives in Primary Hypertension in Man

1977 ◽  
Vol 52 (3) ◽  
pp. 319-323 ◽  
Author(s):  
R. F. Bing ◽  
J. Harlow ◽  
A. J. Smith ◽  
M. M. Townshend
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Urinary Excretion ◽  
High Plasma ◽  
Plasma Catecholamine ◽  
Elevated Blood ◽  
Hypertensive Patients ◽  
Catecholamine Excretion ◽  
Normotensive Subjects ◽  
Plasma Catecholamine Concentrations

1. The 24 h urinary excretion of adrenaline, noradrenaline, normetadrenaline, metadrenaline and vanilloylmandelic acid has been compared in 17 male normotensive subjects and 25 age-matched male hypertensive patients studied under similar in-patient conditions. 2. 24 h urinary metadrenaline was significantly lower in the hypertensive patients. With this exception, no significant differences were found between the two groups when the total 24 h excretion of free catecholamines and their metabolites was analysed. 3. Diurnal variation in free catecholamine excretion was found in both normotensive and hypertensive subjects. There was no corresponding variation in metabolite excretion. 4. No correlation could be established between systolic or diastolic blood pressure and the amounts of the catecholamines or their metabolites in the urine of either group. 5. The results are considered in the light of recent work demonstrating high plasma catecholamine concentrations in hypertension. They lend no support to the concept that excessive circulating catecholamines are responsible for the elevated blood pressure in essential hypertension.

Significance of Increase in Labelled Albumin Disappearance Rate in Arterial Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 211s-213s
Author(s):  
M. Ulrych ◽  
Z. Ulrych
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Volume ◽  
Plasma Renin ◽  
Disappearance Rate ◽  
Reference Standard ◽  
Hypertensive Patients ◽  
Volume Blood ◽  
Normotensive Subjects ◽  
Normotensive Control

1. Relationships between labelled albumin disappearance rate (LADR), plasma volume, blood volume, plasma renin activity (PRA) and blood pressure (BP) were studied in normotensive control subjects and patients with hypertension of different aetiology and severity. In essential hypertensive patients without complications an inverse linear relationship was found between blood pressure and plasma or blood volume. 2. Very close inverse correlations were found between LADR and PRA in both normotensive subjects and patients with uncomplicated essential hypertension. LADR appears to be an excellent reference standard for PRA. 3. It is postulated that LADR mainly reflects the relation between circulating fluid and vascular capacitance tone. LADR is increased in hypertension and blood volume may still be inappropriately high.

scholarly journals Secrecy and the Pathogenesis of Hypertension

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Randi Ettner ◽  
Frederic Ettner ◽  
Tonya White
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Cardiovascular Reactivity ◽  
Emotional Disclosure ◽  
Emotional Expressiveness ◽  
General Medical Practice ◽  
Gender Nonconforming ◽  
Medicine Physician ◽  
The Family ◽  
Regulation Of Blood Pressure

Literature supporting a relationship between emotions and regulation of blood pressure dates back to the early 1900s. Theoretical explanations of the pathophysiology of the correlation have centered on several possible trajectories, the most likely being cardiovascular reactivity to stress. Prospective studies have demonstrated that chronic stress and enduring traits such as defensiveness and anxiety, impacts the development of hypertension. An analysis of 195 genetic males seeking contrary hormones for treatment of gender dysphoria revealed a significantly increased prevalence of hypertension in this cohort. The authors attribute this increased prevalence to the known effects of emotional disclosure on health and conclude that the inhibition of emotional expressiveness is significant in the etiology and maintenance of essential hypertension in this population. As hypertension is associated with morbidity and mortality, the implications for the family medicine physician treating gender nonconforming individuals and other patients in the context of a general medical practice will be discussed.

The Antihypertensive and Renal Activities of Potassium Canrenoate are Associated with Increased Renal Prostaglandin Excretion

1989 ◽  
Vol 77 (2) ◽  
pp. 217-222 ◽  
Author(s):  
Sergio Castellani ◽  
Luca Scarti ◽  
Ji Lin Chen ◽  
Attilio Del Rosso ◽  
Marino Carnovali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Prostaglandin E2 ◽  
Prostaglandin F2α ◽  
Prostaglandin Synthesis ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Control Subjects ◽  
Potassium Canrenoate ◽  
Normotensive Subjects

1. In a double-blind, randomized, cross-over study the effects of potassium canrenoate administration (100 mg twice daily for 10 days orally) on renal prostaglandin synthesis (prostaglandin E2 and prostaglandin F2α) were evaluated in 10 normotensive females and in 10 females with essential hypertension. 2. When compared with normotensive subjects, hypertensive patients in baseline conditions showed a reduced excretion of urinary prostaglandin E2 associated with an excessive prostaglandin F2α production. 3. Potassium canrenoate significantly reduced mean blood pressure in hypertensive patients [from 118.9 ± 8.7 mmHg (1.62 ± 0.12 kPa) to a peak minimum value of 104.7 ± 9.8 mmHg (1.42 ± 0.13 kPa) on the seventh day of treatment; P < 0.01 for the whole period] but not in control subjects [from 88 ± 9.4 mmHg (1.20 ± 0.13 kPa) to 84.3 ± 8.3 mmHg (1.15 ± 0.11 kPa) on the eighth day, NS] even though potassium canrenoate significantly increased sodium excretion in both groups. Renal prostaglandin excretion was affected differently in the two groups: in control subjects excretion of both prostaglandin E2 and prostaglandin F2α was increased after drug administration, whereas in hypertensive patients only prostaglandin E2 excretion was enhanced.

Elevated Plasma Adrenaline Reflects Sympathetic Overactivity and Enhanced α-Adrenoceptor-Mediated Vasoconstriction in Essential Hypertension

1981 ◽  
Vol 61 (s7) ◽  
pp. 161s-164s ◽  
Author(s):  
P. Bolli ◽  
F. W. Amann ◽  
L. Hulthén ◽  
W. Kiowski ◽  
F. R. Bühler
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Essential Hypertension ◽  
Forearm Blood Flow ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Plasma Adrenaline ◽  
Pressor Test ◽  
Normotensive Subjects

1. Stressful sympathetic stimulation (cold pressor test) was applied to 18 patients with essential hypertension and 15 normotensive subjects. Intra-arterial blood pressure, heart rate, plasma adrenaline and noradrenaline concentrations as well as forearm blood flow were measured before and during the cold pressor test; tests were repeated after regional postsynaptic α1-adrenoceptor blockade with prazosin. 2. Under basal conditions mean blood pressure (P &lt; 0.001), heart rate (P &lt; 0.01), forearm blood flow (P &lt; 0.001) as well as adrenaline concentration (P &lt; 0.01), but not noradrenaline, was higher in patients with essential hypertension. 3. During the cold pressor test, mean blood pressure, heart rate, plasma adrenaline and noradrenaline concentrations increased and forearm flow decreased (all P &lt; 0.001). 4. Stress-stimulated plasma adrenaline was higher in essential hypertensive patients than in normotensive subjects (P &lt; 0.01). In the former the stress-induced increase in plasma adrenaline correlated with the increase in mean blood pressure (r = 0.514; P &lt; 0.05). 5. Prazosin increased forearm blood flow more in essential hypertension (P &lt; 0.001). This increase correlated with the resting plasma adrenaline in the hypertensive (r = 0.710; P &lt; 0.001), but not in normotensive, subjects. 6. When the cold pressor test was repeated during postsynaptic α1-adrenoceptor blockade forearm blood flow did not decrease; instead it increased further in both groups (P &lt; 0.05). 7. Thus in essential hypertension elevated plasma adrenaline concentration reflects sympathetic overactivity as also expressed by enhanced α-adrenoceptor-mediated vasoconstriction.

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