Effect of Posture, Isometric Hand-Grip Exercise, and Norepinephrine Infusion in Normal-Renin Hypertensive Patients

  • Lawrence R. Krakoff
  • Nicolas D. Vlachakis
  • Milton Mendlowitz


The role of the sympathetic nervous system in the pathogenesis of clinical hypertension has remained unsettled and controversial. Development of methods for accurate and sensitive measurement of plasma catecholamine concentration offer promise in defining the role of noradrenergic and adre- nomedullary function in this regard. Since the sympathetic nervous system plays a prominent role in rapid adjustment of the circulation to such perturbations as upright posture (1) or exercise (1, 2), quantification of the role of this system requires correlation between cardiovascular events and biochemical parameters. In comparing hypertensive to normotensive subjects, interpretation of the significance of levels of endogenous plasma catecholamines must be made in light of considerable evidence for vascular hyperresponsiveness to infused catecholamines in many hypertensive subjects (3, 4).


Arterial Pressure Plasma Norepinephrine Hypertensive Subject Plasma Catecholamine Quiet Standing 
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  1. 1.
    Ziegler MG, Lake CR, Kopin IJ (1976) Deficient sympathetic nervous response in familial dysautonia. New Engl J Med 294: 630–633PubMedCrossRefGoogle Scholar
  2. 2.
    Kozlowski S, Brezinska Z, Nazar L, Kowalski W, Franczyk M (1973) Plasma catecholamines during sustained isometric exercise. Clin Sci Mol Med 45: 723–731PubMedGoogle Scholar
  3. 3.
    Goldenberg M, Pines KL, Baldwin EF, et al (1948) Hemodynamic response of man to norepinephrine and epinephrine and its relation to the problem of hypertension. Am J Med 5: 792PubMedCrossRefGoogle Scholar
  4. 4.
    Mendlowitz M, Naftchi N (1958) Work of digital vasoconstriction produced by infused norepinephrine in primary hypertension. J App Physiol 13: 247Google Scholar
  5. 5.
    Vlachakis ND, Ribeiro AB, Krakoff LR (1978) Effect of saralasin upon plasma catecholamines in hypertensive patients. Am Heart J 95: 78–80PubMedCrossRefGoogle Scholar
  6. 6.
    Krakoff LR (1973) Plasma renin substrate: Measurement by radioimmunoassay of angiotensin I concentration in syndromes associated with steroid excess. J Clin Endocrinol Metab 37: 110–118PubMedCrossRefGoogle Scholar
  7. 7.
    Kodish ME, Katz FH (1974) Plasma renin concentration: Comparison of angiotensinase inhibitors and correlation with plasma renin activity and aldosterone. J Lab Clin Med 83: 705–715PubMedGoogle Scholar
  8. 8.
    Snedecor GW, Cochran WG (1967) Statistical methods. Iowa State University Press, Ames, IaGoogle Scholar
  9. 9.
    Engelman K, Portnoy B (1970) A sensitive double isotope derivative assay for norepinephrine and epinephrine. Circ Res 26: 53–57PubMedGoogle Scholar
  10. 10.
    DeQuattro V, Chan S (1972) Raised plasma catecholamines in some patients with primary hypertension. Lancet 1: 806–809CrossRefGoogle Scholar
  11. 11.
    de Champlain J, de Farley L, Cousineau D, van Ameringen MR (1976) Circulating catecholamine levels in human and experimental hypertension. Circ Res 38: 108–114Google Scholar
  12. 12.
    Esler M, Julius S, Zweifler A, et al (1977) Mild high-renin essential hypertension: Neurogenic human hypertension? New Engl J Med 296: 405–411PubMedCrossRefGoogle Scholar
  13. 13.
    Cousineau D, Lapointe L, de Champlain J (1978) Circulating catecholamines and systolic time intervals in normotensive and hypertensive patients with and without left ventricular hypertrophy. Am Heart J 96: 227–234PubMedCrossRefGoogle Scholar
  14. 14.
    Lake CR, Ziegler MG, Coleman MD, Kopin IJ (1977) Age-adjusted plasma norepinephrine levels are similar in normotensive and hypertensive subjects. New Engl J Med 296: 208–209PubMedCrossRefGoogle Scholar
  15. 15.
    Christensen MS, Christensen NJ (1972) Plasma catecholamines in hypertension. Scand J Lab Clin Invest 30: 169–173CrossRefGoogle Scholar
  16. 16.
    Louis WJ, Doyle AE, Anavekar S (1973) Plasma norepinephrine levels in essential hypertension. New Engl J Med 288: 599–601PubMedCrossRefGoogle Scholar
  17. 17.
    Sever PS, Birch M, Osikowska B, Tunbridge RDG (1977) Plasmanoradrenaline in essential hypertension. Lancet 1: 1078–1081PubMedGoogle Scholar
  18. 18.
    Axelrod J, Weinshilboum R (1972) Catecholamines. New Engl J Med 287: 237–242PubMedCrossRefGoogle Scholar
  19. 19.
    Sjoerdsma A (1961) Relationships between alterations in amine metabolism and blood pressure. Circ Res 9: 734–743Google Scholar
  20. 20.
    Wolf RL, Mendlowitz M, Roboz J, Gitlow SE (1975) Simultaneous urinary assays for the combined metanephrines and 3-methoxy,4-hydroxy phenylglycol in patients with pheochromocytoma and primary hypertension. New Engl J Med 237: 1459–1463Google Scholar
  21. 21.
    Krakoff, LR, Ginsburg SM (1973) Effect of chemical sympathectomy on pressor responses to norepinephrine, angiotensin and tyramine. Experientia 29: 995–997PubMedCrossRefGoogle Scholar
  22. 22.
    Wilcox CS, Aminoff MJ (1976) Blood pressure responses to noradrenaline and dopamine infusions in Parkinson’s disease and the Shy-Drager syndrome. Br J Clin Pharmacol 3: 207–214PubMedGoogle Scholar
  23. 23.
    Folkow B (1977) The haemodynamic consequences of adaptive structural changes of the resistance vessels in hypertension. Clin Sci 41: 1–12Google Scholar
  24. 24.
    Berecek K, Bohr D (1977) Structural and functional changes in vascular resistance and reactivity in the deoycorticosterone acetate (DOCA) hypertensive pig Circ Res 40 (Suppl I): 146–152Google Scholar
  25. 25.
    Silverberg AB, Suresh DS, Haymond MW, Cryer PE (1978) Norepinephrine: Hormone and neurotransmitter in man. Am J Physiol 234 (3): E252–E256PubMedGoogle Scholar
  26. 26.
    DeQuattro V, Margolin A, Stocks LO (1970) Pseudo-pheochromocytoma-adrenomedullary response to venography. J Clin Endocrinol Metab 30: 138–140CrossRefGoogle Scholar
  27. 27.
    Esler M, Randall O, Bennett B, et al (1976) Suppression of sympathetic nervous function in low renin essential hypertension. Lancet 2: 115–118PubMedCrossRefGoogle Scholar
  28. 28.
    Graham RM, Pettinger WA (1979) Prazosin. New Engl J Med 300: 232–236PubMedCrossRefGoogle Scholar
  29. 29.
    Vlachakis MD, Mendlowitz M (1976) An approach to the treatment of essential hypertension. Am Heart J 92: 750–757PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1981

Authors and Affiliations

  • Lawrence R. Krakoff
  • Nicolas D. Vlachakis
  • Milton Mendlowitz

There are no affiliations available

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