Abstract

The surge in arterial pressure during arousal in the waking period is thought to be largely due to activation of the sympathetic nervous system. In this study we compared in SHR the effects of chronic administration of the centrally acting sympatholytic agent rilmenidine with an angiotensin converting enzyme inhibitor perindopril on the rate of rise and power of the surge in mean arterial pressure (MAP) that occurs with arousal associated with the onset of night. Recordings were made using radiotelemetry in 17 adult SHR before and after treatment with rilmenidine (2mg/kg/day), perindopril (1mg/kg/day) or vehicle in the drinking water for 2 weeks. Rilmenidine reduced MAP by 7.2 ± 1.7mmHg while perindopril reduced MAP by 19 ± 3mmHg. Double logistic curve fit analysis showed that the rate and power of increase in systolic pressure during the transition from light to dark was reduced by 50% and 65%, respectively, but had no effect on diastolic pressure. Rilmenidine also reduced blood pressure variability in the autonomic frequency in the active period as assessed by spectral analysis which is consistent with reduction in sympathetic nervous system activity. Perindopril had no effect on the rate or power of the arousal surge in either systolic or diastolic pressure. These results suggest that the arousal induced surge in blood pressure can largely be reduced by an antihypertensive agent that inhibits the sympathetic nervous system and that angiotensin converting enzyme inhibition, while effective in reducing blood pressure, does not alter the rate or power of the surge associated with arousal.

Highlights

  • Hypertension is an important risk factor for predicting cardiovascular disease but it is the morning period that is the period of greatest risk of stroke and myocardial infarcts [1,2,3,4,5,6]

  • Chronic treatment with rilmenidine was less effective at lowering systolic arterial pressure (SAP) in spontaneously hypertensive rats (SHR) (P = 0.04) but no difference in the diastolic arterial pressure (DAP) was observed between perindopril and rilmenidine treated SHR (P = 0.09)

  • Rilmenidine had no effect on variability of blood pressure (BP) in the Low frequency (LF) or high frequency (HF) bands which are not thought to be related to sympathetic activity [32]

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Summary

Introduction

Hypertension is an important risk factor for predicting cardiovascular disease but it is the morning period that is the period of greatest risk of stroke and myocardial infarcts [1,2,3,4,5,6]. During the morning period there is a gradual increase in blood pressure (BP) associated with the normal circadian pattern in humans as BP moves towards its higher daytime level. Earlier studies compared the frequency of cardiac synchronised sympathetic bursts in the perineal nerve and did not show a difference between the morning and evening period, suggesting that there was no difference between sympathetic activity in these periods [11] It is the amplitude of the burst that we found is related to the morning surge in blood pressure and not the frequency of firing [10]. We recently confirmed that individual sympathetic units did not increase firing rate in hypertension [13] Taken together, these findings suggest that the morning surge in blood pressure that occurs during arousal is characterised by activation of new sympathetic fibres

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