Intracranial Pressure During the Development of Renovascular Hypertension

The mechanisms by which changes in intracranial pressure (ICP) occur during hypertension are unclear. The experimental 2K1C (2-kidney, 1-clip) hypertension is a model characterized by sympathetic and renin-angiotensin system overactivation in which ICP still needs investigation. In the present study, we analyzed ICP alterations during the development of 2K1C hypertension using invasive and noninvasive ICP recording methods. We also tested the importance of AT1R (angiotensin II type 1 receptor) activation for the ICP changes and investigated the integrity of the blood-brain barrier within central cardioregulatory nuclei in 2K1C hypertensive rats. 2K1C hypertension was induced in 6-week-old male rats (150 g). In the fourth week of 2K1C hypertension induction, when mean arterial pressure reached 162±2 mm Hg, ICP significantly increased, ICP pulse waveforms changed, increasing the ratio between the two peaks (P2/P1 ratio) of the ICP waveform. In the third week of 2K1C hypertension induction, blood-brain barrier disruption was detected within the hypothalamic paraventricular nucleus, rostral ventrolateral medulla, and nucleus tractus solitarius. In the sixth week, intravenous losartan (AT1R antagonist) or the vasodilator hydralazine acutely reduced arterial pressure to normotensive levels. Losartan, but not hydralazine, partially reduced the increase of ICP and P2/P1 ratio in hypertensive rats. These results show significant changes in ICP in 2K1C hypertensive rats and suggest that AT1R activation may contribute to elevated ICP during hypertension—an effect possibly intensified by the blood-brain barrier disruption in important central cardioregulatory nuclei in renovascular hypertensive animals.

Aliskiren Reduces the Adrenal Zona Glomerulosa Apoptosis and Autophagy in Wistar Rats with 2K1C Hypertension

Hypertension is a disease classified as primary or secondary, manifested not only by elevation of blood pressure but also involved in structural and functional changes of target organs. Renal artery stenosis is a leading factor of secondary hypertension, and its progress is associated with overactivation of the renin-angiotensin-aldosterone system (RAAS). Aliskiren is a renin inhibiting drug that suppresses RAAS and culminates in decreased renin release, plasma angiotensin II concentration, and inhibition of aldosterone secretion. In this sense, the aim of the present study was to analyze the structural and ultrastructural morphophysiology of the adrenal glomerular zone, after treatment with aliskiren in Wistar rats with 2K1C hypertension. Parameters as structure and ultrastructure of the adrenal glomerular zone, cellular apoptosis, nuclear cell proliferation, and AT1 receptor expression were analyzed by immunostaining and electron microscopy. Our results showed that the hypertensive animals treated with aliskiren presented a reestablishment of AT1 receptor expression and decrease in apoptosis and autophagy. In addition, treatment with aliskiren improves the cell aspects in the adrenal glomerular zone, evidenced by ultrastructural analysis through preserved nuclei and well-developed mitochondria. Therefore, our evidence suggests that aliskiren has a beneficial effect on the adrenal glomerular zone remodeling in animals with renovascular hypertension.

Excessive dietary salt promotes aortic stiffness in murine renovascular hypertension

High dietary salt exaggerates hypertension in multiple experimental models. Here we demonstrate that a high-salt diet produces a greater increase in arterial blood pressure at 1 wk after induction of 2-kidney, 1-clip (2K1C) hypertension but not at 3 wk. Interestingly, 2K1C mice fed a high-salt diet displayed an exaggerated pulse pressure, elevated pulse wave velocity, and reduced endothelium-dependent vasodilation of the aorta but not mesenteric arteries. These findings suggest that dietary salt may interact with underlying cardiovascular disease to promote selective vascular dysfunction and aortic stiffness.

Renal sensory nerves increase sympathetic nerve activity and blood pressure in 2-kidney 1-clip hypertensive mice

Renal denervation lowers arterial blood pressure (ABP) in multiple clinical trials and some experimental models of hypertension. These antihypertensive effects have been attributed to the removal of renal afferent nerves. The purpose of the present study was to define the function, anatomy, and contribution of mouse renal sensory neurons to a renal nerve-dependent model of hypertension. First, electrical stimulation of mouse renal afferent nerves produced frequency-dependent increases in ABP that were eliminated by ganglionic blockade. Stimulus-triggered averaging revealed renal afferent stimulation significantly increased splanchnic, renal, and lumbar sympathetic nerve activity (SNA). Second, kidney injection of wheat germ agglutinin into male C57Bl6 mice (12–14 wk; Jackson Laboratories) produced ipsilateral labeling in the T11–L2 dorsal root ganglia. Next, 2-kidney 1-clip (2K1C) hypertension was produced in male C57Bl6 mice (12–14 wk; Jackson Laboratories) by placement of a 0.5-mm length of polytetrafluoroethylene tubing around the left renal artery. 2K1C mice displayed an elevated ABP measured via telemetry and a greater fall in mean ABP to ganglionic blockade at day 14 or 21 vs. day 0. Renal afferent discharge was significantly higher in 2K1C-clipped vs. 2K1C-unclipped or sham kidneys. In addition, 2K1C-clipped vs. 2K1C-unclipped or sham kidneys had lower renal mass and higher mRNA levels of several proinflammatory cytokines. Finally, both ipsilateral renal denervation (10% phenol) or selective denervation of renal afferent nerves (periaxonal application of 33 mM capsaicin) at time of clipping resulted in lower ABP of 2K1C mice at day 14 or 21. These findings suggest mouse renal sensory neurons are activated to increase SNA and ABP in 2K1C hypertension. NEW & NOTEWORTHY This study documents the function, anatomy, and contribution of mouse renal sensory nerves to neurogenic hypertension produced by renal stenosis. Activation of renal afferents increased sympathetic nerve activity and blood pressure. Renal afferent activity was elevated in hypertensive mice, and renal afferent denervation lowered blood pressure. Clinically, patients with renal stenosis have been excluded from clinical trials for renal denervation, but this study highlights the potential therapeutic efficacy to target renal nerves in these patients.

Boldine Improves Kidney Damage in the Goldblatt 2K1C Model Avoiding the Increase in TGF-β

Boldine, a major aporphine alkaloid found in Chilean boldo tree, is a potent antioxidant. Oxidative stress plays a detrimental role in the pathogenesis of kidney damage in Renovascular hypertension (RVH). The activation of the Renin-Angiotensin System (RAS) is crucial in the development and progression of hypertensive renal damage and TGF-β is closely associated with the activation of RAS. In the present study, we assessed the effect of boldine on the progression of kidney disease using the 2K1C hypertension model and identifying mediators in the RAS such as TGF-β, that could be modulated by this alkaloid. Toward this hypothesis, rats (n=5/group) were treated with boldine (50mg/kg/day, gavage) for 6 weeks after 2K1C surgery (pressure≥180mmHg). Kidney function was evaluated by measuring of proteinuria/creatininuria ratio (U prot/U Crea), oxidative stress (OS) by measuring thiobarbituric acid reactive substances (TBARS). The evolution of systolic blood pressure (SBP) was followed weekly. α-SMA and Col III were used as markers of kidney damage; ED-1 and Osteopontin (OPN) as markers of inflammation. We also explored the effect in RAS mediators, such as ACE-1 and TGF-β. Boldine treatment reduced UProt/UCrea ratio, plasma TBARS and slightly reduced SBP in 2K1C hypertensive rats, producing no effect in control animals. In 2K1C rats treated with boldine the levels of α-SMA, Col III, ED-1 and OPN were lower when compared to 2K1C rats. Boldine prevented the increase in ACE-1 and TGF-β in 2K1C rats, suggesting that boldine reduces kidney damage. These results suggest that boldine could potentially be used as a nutraceutic.

Abstract P422: Two-kidney One Clip (2k1c) Hypertension Reduces Complexity of Heart Rate Variability in Mice

Introduction: Hypertension is the most common chronic cardiovascular disease, being multifactorial in origin and an important cause of morbidity and mortality worldwide. Complex behaviors of heart rate series have been widely recognized and the loss of complexity in heart rate variability (HRV) has been shown to predict adverse cardiovascular outcomes. We hypothesized that two-kidney one clip (2K1C) hypertension reduces the HRV complexity in mice. Methods and Results: C57BL/6 mice were anesthetized with isoflurane and submitted to 2K1C hypertension by placing a silver clip (0.12 mm) around left renal artery. After 4 weeks, mice were implanted with subcutaneous electrocardiogram (ECG) electrodes and allowed to recover for 48 h. On the day of the experiment, the ECG was recorded for 30 minutes in conscious, unrestrained mice. At the end of the recording, arterial pressure (AP) was directly measured in each mouse under isoflurane anesthesia. RR interval time series were generated and the complexity of HRV was determined using detrending fluctuation analysis (DFA) and multiscale entropy (MSE). Mean AP was higher in 2K1C mice (133±2 vs 93±4 mmHg) while the HR was similar between groups. DFA scaling exponents were calculated in short (5 to 15), mid (30 to 200) and long (200 to 1500) window sizes, but only the long-term exponent was different between groups (1.27±0.09 vs 0.89±0.08 in 2K1C and sham mice, respectively). MSE was calculated up to scale 20 and averaged in short (1 to 5) and long (6 to 20) time scales. In both short (0.75±0.16 vs 1.25±0.11) and long (0.76±0.17 vs 1.22±0.09) ranges, entropy is lower in hypertensive mice. Conclusions: The complexity of HRV dynamics was found lower in renovascular hypertensive mice. Both sympathetic and vagal control of the heart seems to be involved in this process, as predictability (MSE) and fractality (DFA) is affected in various temporal scales. Nevertheless, the greatest entropy difference between groups is found at scale 6, which is closely related to respiration.