Urinary Norepinephrine Excretion Research Articles

Norepinephrine and epinephrine responses to postural stimulus in orthostatic hypotension due to brainstem ischemic lesions

Norepinephrine (NE) and epinephrine (E) responses to upright posture were investigated in 25 patients with orthostatic hypotension due to brainstem ischemic lesions and in 25 control subjects. In controls the postural stimulus induced constantly a rise in NE urinary excretion and a reduction in E excretion, while in patients with orthostatic hypotension it caused a depression in NE urinary excretion and a rise in E urinary excretion; the last alteration was noticed in all but one patient. The E discharge induced by posture in patients with orthostatic hypotension may be involved in the reduction of vascular peripheral resistance and then in postural fall of blood pressure displayed by such patients.

Obesity, blood pressure, and the sympathetic nervous system.

Obesity has long been recognized as a major risk factor for the development of hypertension. Recently, insulin level has been shown to correlate with blood pressure in clinical and population-based studies. Since insulin is a major signal in the relationship between dietary intake and sympathetic nervous system activity, the possibility that insulin-mediated sympathetic stimulation is involved in the pathogenesis of hypertension in the obese has been raised. This hypothesis, developed on the basis of studies in laboratory rodents and normal human subjects, is currently being tested in the Normative Aging Study in Boston. Utilizing epidemiologic techniques applied to this defined population, evidence in support of this hypothesis has been accumulated. The preliminary results indicate that in this population, the abdominal form of obesity is associated with higher insulin levels and increased 24-hour urinary norepinephrine excretion (an index of sympathetic activity).

Renal and Hemodynamic Effects of Atrial Natriuretic Peptide Infusion Are not Mediated by Peripheral Dopaminergic Mechanisms

The possible involvement of peripheral dopaminergic mechanisms in the action of atrial natriuretic peptides was investigated in 10 subjects by administering 200 micrograms h-ANP 99-126 intravenously for 30 min during treatment with 50 mg carbidopa, a peripheral inhibitor of dopamine synthesis, every 8 h, or during placebo. Atrial natriuretic peptide (ANP) infusion during placebo was associated with a significant increase of diuresis, natriuresis, kaliuresis, urinary noradrenaline, and dopamine excretion. Plasma aldosterone significantly decreased. Blood pressure was slightly reduced. The administration of carbidopa significantly reduced urinary dopamine excretion but did not modify natriuresis, diuresis, indexes of adrenergic and renin-aldosterone system activity, blood pressure, or heart rate, both in basal conditions and in response to ANP infusion. We conclude that the effects of exogenous ANP administration are independent from dopaminergic mechanisms that involve the synthesis of dopamine outside the central nervous system, particularly in the kidney.

Effects of calcium supplementation and deoxycorticosterone on plasma atrial natriuretic peptide and electrolyte excretion in spontaneously hypertensive rats

The effects of calcium and the mineralocorticoid deoxycorticosterone (DOC) on blood pressure were studied in four groups of spontaneously hypertensive rats (SHR): (1) control; (2) calcium; (3) deoxycorticosterone and; (4) deoxycorticosterone + calcium. Calcium was given as 1.5% calcium chloride in drinking fluid and deoxycorticosterone by weekly subcutaneous injections (25 mg kg-1). During the nine weeks of treatment the increase in systolic blood pressure was enhanced in the deoxycorticosterone and attenuated in the calcium group, whereas the deoxycorticosterone + calcium group did not deviate from control. Total plasma calcium was elevated in the calcium group. Plasma concentrations of sodium and atrial natriuretic peptide (ANP) were increased by deoxycorticosterone while neither of the calcium-treated groups differed from control in these respects. Urinary excretions of calcium and sodium were increased in both groups receiving calcium, and also the deoxycorticosterone group excreted more calcium into urine than the control. Adrenergic nerve density in a section of the mesenteric artery and the urinary excretion of noradrenaline and adrenaline were similar in all study groups. The results indicate that calcium supplementation can attenuate the development of hypertension and prevent the deoxycorticosterone-induced blood pressure rise in SHR, possibly by influencing sodium metabolism as seen in increased natriuresis, and by preventing the actions of deoxycorticosterone on sodium balance.

Morphine responders with unexplained pain after cholecystectomy may have sympathetic overactivity

In patients with unexplained pain after cholecystectomy, morphine often induces pain and may increase plasma aspartate aminotransferase activity because of exaggerated or prolonged rises in pressure within the biliary system. Previous studies have demonstrated that patients showing increases in aspartate aminotransferase have increases in plasma concentrations of noradrenaline and dopamine prior to and soon after induction of pain. The purpose of this study was to assess sympathetic activity under basal conditions in patients with (responders) and without (non-responders) increases in aspartate aminotransferase after challenge with morphine. When compared to non-responders, morphine responders had higher plasma concentrations of noradrenaline (p = 0.0001) and dopamine (p = 0.02) and higher urinary excretion of noradrenaline over 24 h (p = 0.03). Plasma and urinary levels of adrenaline were similar in the two groups. These observations indicate higher basal levels of sympathetic activity in the subgroup of patients showing increases in aspartate aminotransferase after challenge with morphine.

Gender differences in the systolic blood pressure response to exercise

Previous work has shown a gender difference in the normal cardiac response to exercise. Men had significantly higher absolute systolic blood pressure responses at 50%, 75%, and 100% peak heart rate on all modalities (p < 0.05). This difference is absent when systolic blood pressure is adjusted for body surface area, is reduced when adjusted for body weights, and is reversed when systolic blood pressure is adjusted for lean body mass. The influence of gender on the systolic blood pressure response to dynamic exercise was independent of exercise modality. Men had a higher systolic blood pressure in spite of the fact that they had similar sympathetic nervous system response as indicated by urinary norepinephrine excretion. Gender differences in systolic blood pressure responses were altered when adjusted for body weight, body surface area, and lean body mass.

Hypothyroidism increases serotonin turnover and sympathetic activity in the adult rat

Adult, male Sprague-Dawley rats underwent surgical thyroidectomy (Tx) or sham surgery. In all three experiments from which data are reported, a 3-week recovery period was allowed. In experiments I and II, baseline measurements of colonic temperature (Tc) and urinary norepinephrine excretion (NE) were obtained, and both variables were monitored daily for the duration of the studies. After baseline measurements, half of each surgical group was given either triiodothyronine (T3) or vehicle injections subcutaneously; in experiment I replacements continued for 1.5 days, while in experiment II T3 replacement continued for 3.5 days. Rats were decapitated at the end of each experiment and serotonin (5-HT) turnover was measured in brainstem. Serotonin turnover in rostral and caudal brainstem was increased with Tx (p less than 0.05). Increased turnover in caudal brainstem was normalized by T3 only in experiment II. Similarly, decreased Tc and elevated NE with Tx were normalized in experiment II but not in experiment I. In experiment III, NE measurements normalized on a creatinine excretion basis indicated that increased NE is evident with Tx, irrespective of normalization procedure. Significant correlations between 5-HT in caudal brainstem and metabolic correlates of sympathetic function, concurrent normalization of NE and 5-HT in caudal brainstem, plus work from other laboratories describing sympathoexcitatory serotonergic neurons located in the caudal brainstem suggest that the central and peripheral changes in the hypothyroid rat are causally related.

Chronic effects of methylmercury on the urinary excretion of catecholamines and their responses to hypoglycemic stress

Five male Wistar rats were treated with methylmercury chloride (MMC) and compared with five age-matched control rats. A dose of 10 mg/kg was given three times. The chronic effects of the MMC administration on the urinary output of catecholamines [norepinephrine (NE), epinephrine (E) and dopamine (DA)] were measured for 50 days. On the 69th day after MMC administration, the rats were examined for insulin-induced hypoglycemic stress. On the 90th day, the animals were decapitated and various organs were weighed and serum thyroid hormones [thyroid stimulating hormone (TSH) and total and free thyroxine (T4)] were measured. Decreases in DA excretion and DA response to stress were observed in the MMC-treated group. Inflammation of the kidney was also found, suggesting MMC-induced damage to the renal tubular region, the apparent site of renal DA synthesis. The MMC group and the control group showed differential NE and E response patterns. The lowered baseline excretion of NE appeared to continue even 70 days after MMC administration, while the difference in E excretion between the two groups disappeared 1 month after MMC administration. Both NE and E showed normal responsiveness to hypoglycemic stress induced by insulin. All serum TSH and total and free T4 baseline levels showed slight increases, and the thyroid gland weights in the MMC group were slightly heavier. These findings suggest a rather hyperthyroid state after the initial acute phase suppression, as suggested by the previous examinations. Thus, these findings suggest long-lasting effects of methylmercury administration, especially on renal DA synthesis. Baseline urinary excretion of NE and thyroid function could also be affected for a long time.

Compression of Body by Clothing. Increase in urinary norepinephrine excretion caused by foundation garments.

The urinary excretions of norepinephrine (NE) and epinephrine (EP) were measured to investigate the physiological effects of girdles worn by women to look attractive. 1) The urinary excretion of NE was remarkably increased by the wearing of a girdle in all the subjects examined, whether living conditions and stimulations were changed or remained unchanged. 2) The urinary excretion of NE was increased by wearing a girdle, regardless of the type of girdle or its intensity of compression. 3) The urinary excretion of NE tended to increase more by the wearing of a bodysuit having a large area of body compression than by the wearing of a girdle having a narrow area of compression. 4) The urinary excretion of NE showed no specific pattern of change, even when the subjects were accustomed to the use of a girdle. These findings may indicate that a girdle of even the best-fitting size exerts a kind of stress on the human body.

Hypertension and sympathetic hyperactivity induced in rats by high-fat or glucose diets

Male Sprague-Dawley rats fed either a high-fat diet or a glucose-enriched diet developed higher blood pressure (BP) than rats fed a control diet. After 8 wk of diet treatment systolic BP was 11% higher (P less than 0.01) in fat-fed rats and 7% higher (P less than 0.05) in glucose-fed rats when compared with rats fed the control diet. Rats fed the high-fat diet developed hypertension only when they were allowed to overeat and become obese and hyperinsulinemic. But when their feeding was restricted to prevent obesity and hyperinsulinemia, they remained normotensive. In contrast, elevated BP developed in rats consuming the glucose diet in the absence of obesity or hyperinsulinemia. After 7 wk of diet treatment, urinary norepinephrine excretion was 1.9 +/- 0.1, 1.9 +/- 0.1, and 1.5 +/- 0.1 micrograms/day in rats fed the high-fat, glucose, and control diets, respectively (P less than 0.05 vs. control). Higher norepinephrine excretion in hypertensive rats suggests that increased sympathetic nervous system (SNS) activity might participate in mediating the effects of dietary fat or glucose on BP. In addition, insulin may contribute to raising BP in rats fed the high-fat diet, either directly or indirectly through its stimulatory effect on the SNS. We conclude that chronic feeding of diets high in fat or glucose increases BP and enhances SNS activity in rats.

Chronic intracerebroventricular infusions of endothelin elevate arterial pressure in rats

We investigated the effects of intracerebroventricular infusions of endothelin on cardiovascular and endocrinological responses using conscious, unrestrained rats. Chronic intracerebroventricular infusions of endothelin, 10 pmol/h for 7 days, elevated arterial pressure significantly on days 5, 6 and 7 of the infusion, compared with intracerebroventricular infusions of the vehicle. Heart rate decreased from day 1 of the infusion of endothelin until the end of the experiment. The urinary excretion of norepinephrine increased on day 3 and epinephrine increased on days 3, 4 and 5 of endothelin infusion. The urinary excretion of arginine vasopressin increased on day 5, 6 and 7 of the infusion. These findings suggest that chronic intracerebroventricular infusions of endothelin elicit elevations in arterial pressure and that the initiation of blood pressure rises can be related to sympathetic activation although the actual role for the pressor responses has been played by the released arginine vasopressin.

Chronic intracerebroventricular infusions of endothelin elevate arterial pressure in rats

We investigated the effects of intracerebroventricular infusions of endothelin on cardiovascular and endocrinological responses using conscious, unrestrained rats. Chronic intracerebroventricular infusions of endothelin, 10 pmol/h for 7 days, elevated arterial pressure significantly on days 5, 6 and 7 of the infusion, compared with intracerebroventricular infusions of the vehicle. Heart rate decreased from day 1 of the infusion of endothelin until the end of the experiment. The urinary excretion of norepinephrine increased on day 3 and epinephrine increased on days 3, 4 and 5 of endothelin infusion. The urinary excretion of arginine vasopressin increased on day 5, 6 and 7 of the infusion. These findings suggest that chronic intracerebroventricular infusions of endothelin elicit elevations in arterial pressure and that the initiation of blood pressure rises can be related to sympathetic activation although the actual role for the pressor responses has been played by the released arginine vasopressin.

Comparison of Clinic and Home Blood Pressure Levels and the Role of the Sympathetic Nervous System in Clinic –3 Home Differences

Plasma and urine norepinephrine, epinephrine and home blood pressure were measured in 48 young hypertensive men (mean age, 21 years) and 25 matched normotensive controls. Plasma samples were drawn following 30 min rest in the clinic and 24 h urine samples were collected at home. Twenty-one hypertensive patients were given a single dose of clonidine (150 micrograms orally). Changes in blood pressure, heart rate and plasma norepinephrine were assessed. Twenty-five of the hypertensive patients were found to have a normal home blood pressure (defined from records of the normotensive subjects). The other group of patients maintained a high home blood pressure. In comparison to normal subjects, patients with a high home blood pressure were characterized by higher urinary norepinephrine and epinephrine excretion and higher plasma epinephrine. Patients with a normal home blood pressure had normal heart rate at home, normal plasma and urinary catecholamines. However, the two groups of hypertensives could not be distinguished on the basis of clinic blood pressure, plasma or urinary catecholamines due to considerable overlap. At 90 min after oral clonidine administration, the plasma norepinephrine and blood pressure levels were decreased in both groups of hypertensives to a similar extent. The changes in heart rate were significantly smaller in patients with a high home blood pressure than in those with a normal home blood pressure. These results suggest that the patients with a high home blood pressure tended to have a high sympathetic nerve activity. However, the two groups of hypertensives could not be separated on the basis of plasma or urinary catecholamine measurements.

Altered responses to environmental stress in streptozotocin-diabetic rats

Metabolic and biochemical adaptations were compared in streptozotocin-diabetic and nondiabetic control rats exposed for 24 hours to a cold environment (4°C) or hypobaric hypoxia (simulated altitude=12,000 ft). In the cold, diabetic rats had greater reductions in adrenal norepinephrine (NE) and greater elevations in urinary NE and epinephrine excretion. However, diabetics did not increase food intake, whereas cold-exposed nondiabetic rats did. 5-HT turnover was reduced in hypothalamus and elevated in brain stem in both diabetics and nondiabetics. Responses to hypoxia were different. Both diabetics and nondiabetics reduced food and water intake and had elevated plasma glucose concentrations. Diabetic had elevated urinary NE excretion. Hypothalamic NE concentration and dopamine turnover were significantly reduced by hypoxia. Brain stem 5-HT turnover was also reduced in nondiabetics but not in diabetics. Thus, diabetics had a different response profile to the environmental stressors than nondiabetics. In addition, the two stressors elicited different responses. Some stressors may be more debilitating in diabetics. The greater reactivity of the sympathetic nervous system in diabetics suggests a mechanism by which stress leads to increased risk of metabolic complications in diabetes mellitus.

Neural-Renal Interactions in the Hypertension Induced by Papillary Necrosis: Role of Dietary Salt Intake

The effects of high salt intake (1.0% NaCl in the drinking water) on rats made hypertensive by 2-bromoethylamine hydrobromide (BEA) treatment (200 mg/kg, i.p.) were examined. BEA-induced medullary necrosis resulted in a mild hypertension (146 +/- 5 mm Hg) that was exacerbated by 4 weeks of high salt intake (163 +/- 6 mmHg). BEA-treated rats had significant salt-induced increases in urinary norepinephrine excretion and hypothalamic and brainstem norepinephrine content, that were not present in BEA-treated rats drinking tap water or control rats drinking saline. BEA treatment in combination with increased salt intake produced a decrease (p less than 0.05) in renal dopamine content and adrenal norepinephrine stores relative to BEA treatment alone. BEA treatment also significantly decreased renal norepinephrine stores and dopamine binding sites irrespective of salt intake. Renal alpha 2-adrenergic receptors and central nervous system stores of dopamine and serotonin were unaffected by BEA treatment. Renal function was well preserved as indicated by normal creatinine, glucose and protein excretion; however, significant (p less than 0.05) disruption of the urinary concentrating mechanism was present. These studies suggest that BEA-induced hypertension has a neural component that is exacerbated by high salt intake. The primary defect in BEA hypertension appears to be the lack of circulating antihypertensive lipids that attenuate the ability of salt loads to simulate sympathetic nervous system activity.

Cardiovascular Reactivity to and Renal Impact of Stress and Exercise

The orthosympathetic nervous system is involved in the pathogenesis of essential hypertension. In this study, we carried out tests of sympathetic stimulation using successfully an isometric exercise and a psychological stress. The efficacy of the two tests in 10 normotensive patients (NTs) was assessed by a significant increase in blood pressure and heart rate and a significant increase in metanephrine urinary excretion. These tests, repeated 2 months later, were perfectly reproducible in NTs. The cardiovascular response during exercise and stress was significantly higher in 10 hypertensive patients (HTs) than in NTs. At rest, urinary norepinephrine excretion was significantly higher in HTs. In contrast to NTs, stress in HTs significantly increased urinary excretion of epinephrine and norepinephrine, whereas exercise failed to increase urinary catecholamine excretion in both groups. In HTs, both tests induced an increase in microalbuminuria. Among functional renal parameters, only proximal sodium reabsorption (measured by lithium clearance) was significantly lower in HTs than in NTs, compensated by a higher distal reabsorption. In HTs, 2 months of treatment with bisoprolol reduced rest and peak heart rate and blood pressure, but failed to reduce blood pressure reactivity to the orthosympathetic stimulation. Proximal sodium reabsorption at rest was normalized by the treatment. Bisoprolol was also able to reduce microalbuminuria during the 24 h and in the rest period preceding the test, but the same percent increase was observed during tests.

Cardiovascular Reactivity to and Renal Impact of Stress and Exercise

The orthosympathetic nervous system is involved in the pathogenesis of essential hypertension. In this study, we carried out tests of sympathetic stimulation using successfully an isometric exercise and a psychological stress. The efficacy of the two tests in 10 normotensive patients (NTs) was assessed by a significant increase in blood pressure and heart rate and a significant increase in metanephrine urinary excretion. These tests, repeated 2 months later, were perfectly reproducible in NTs. The cardiovascular response during exercise and stress was significantly higher in 10 hypertensive patients (HTs) than in NTs. At rest, urinary norepinephrine excretion was significantly higher in HTs. In contrast to NTs, stress in HTs significantly increased urinary excretion of epinephrine and norepinephrine, whereas exercise failed to increase urinary catecholamine excretion in both groups. In HTs, both tests induced an increase in microalbuminuria. Among functional renal parameters, only proximal sodium reabsorption (measured by lithium clearance) was significantly lower in HTs than in NTs, compensated by a higher distal reabsorption. In HTs, 2 months of treatment with bisoprolol reduced rest and peak heart rate and blood pressure, but failed to reduce blood pressure reactivity to the orthosympathetic stimulation. Proximal sodium reabsorption at rest was normalized by the treatment. Bisoprolol was also able to reduce microalbuminuria during the 24 h and in the rest period preceding the test, but the same percent increase was observed during tests.

Differential rates of urinary noradrenalin excretion in affective disorders: Utility of a short time sampling procedure

Levels of morning urinary noradrenalin (NA) excretion were compared in 61 patients with unipolar major depression (MDR), 25 patients with minor depression (mDE), 39 patients with anxiety disorder (AD), and 21 healthy control subjects (C). The following differences in the level of urinary NA excretion rate were found: MDE > mDE = AD > C. In addition, a significant positive correlation was found in the MDE group between severity of illness, expressed as total Hamilton depression score, in diagnostic subclasses from the Research Diagnostic Criteria, and urinary NA excretion rates (first episode, MDE total group, recurrent, with psychotic features). These data support the utility of a short time urine sampling procedure to measure NA excretion as a peripheral marker monitoring sympathetic activity in inpatient as well as outpatient conditions.

Acute cyclosporine renal dysfunction reversed by dopamine infusion in healthy subjects

Up to now, no studies have been performed in normal humans to investigate the role of renal hemodynamic abnormalities in relation to acute-cyclosporin A (CsA) renal dysfunction and to verify whether the specific renal vasodilator, dopamine, can counteract these abnormalities. Eight normal subjects were examined both (A) after oral CsA (12 mg/kg body wt) and (B) after oral CsA + dopamine infusion (2 mg/kg body wt/min), under water diuresis. Both in protocols A and in B, four basal renal clearances were performed before CsA and every twenty minutes for four hours after CsA administration. In protocol A, after CsA, inulin (GFR) and PAH clearance (RPF) fell by up to 27% and to 41%, respectively, so that filtration fraction (FF) increased (P less than 0.01). A slight (not significant) hypertension occurred while renal resistances were markedly raised (P less than 0.001). Fractional urine and Na+ excretion as well as CH2O decreased, while UOsm increased (P less than 0.01). In protocol B, dopamine was infused from 120 to 180 minutes after CsA (that is, when the maximal adverse effects of CsA on renal hemodynamics had been observed in A). Dopamine infusion could reverse completely the effects of CsA on RPF, GFR, fractional urine output and CH2O; only UOsm remained higher than normal in conclusion with an increased fractional excretion of sodium (P less than 0.01). No changes were observed in plasma renin activity, aldosterone and in urinary epinephrine and norepinephrine excretion both in protocols.(ABSTRACT TRUNCATED AT 250 WORDS)

Sympathetic and metabolic correlates of hypoxic moderation of spontaneous hypertension in the rat.

Exposure to hypobaric hypoxia (H; simulated altitude = 3658 m) was initiated in 5-week-old, male spontaneously hypertensive (SHR) and Wistar-Kyoto (WKy) normotensive rats while normoxic controls (N) for both groups were maintained under laboratory conditions. Significant attenuation of systolic arterial blood pressure was evident in SHR-H relative to SHR-N (125 +/- 6 vs 145 +/- 5 mm Hg; P less than 0.05) but not in WKy-H relative to WKy-N (WKy-H, 116 +/- 2 vs WKy-N, 117 +/- 5 mm Hg). Hypoxia significantly decreased metabolic efficiency in both normotensive and hypertensive rats, although being both more severe and accompanied by significantly impaired growth rate in SHR-H. Urinary excretion of norepinephrine in the SHR was elevated relative to WKy, irrespective of altitude treatment, while hypoxia elicited similar increases in urinary excretion of norepinephrine in both SHR and WKy. Myocardial and adrenal contents of norepinephrine were significantly reduced following 3 days of simulated altitude exposure in both strains of rats. Tissue contents of norepinephrine in hypoxic rats returned to normoxic levels by 21 days of simulated altitude. Both urine and tissue indices provided consistent indirect evidence that changes in sympathetic neuronal activity in response to hypoxia were similar in normotensive and hypertensive rats. These findings suggest that prior reports of reduced alpha-adrenergic responsiveness in vasculature from hypoxia-exposed SHR reflect a postsynaptic event that is regulated independently of norepinephrine release from sympathetic nerve terminals.