Age-Adjusted Plasma Norepinephrine Levels Are Similar in Normotensive and Hypertensive Subjects

Lake, C. Raymond; Mg, Ziegler; Coleman,; Ij, Kopin

doi:10.1056/nejm197701272960408

Cited by 317 publications

(88 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This field of research is complex in human subjects and the theory is derived mainly from animal models (Durnin & Lean, 1992). In the elderly, resting circulating catecholamine concentrations are elevated (Lake et al 1977), and the responsiveness to catecholamines may decline with age, as is the case in experimental animals (Rothwell & Stock, 1983). However, Poehlman (1993) examined the evidence with regard to human subjects on the thermic effect of ingestion of a meal and ageing and reported that the thermic response to ingestion of a meal appears to be influenced by age, physical activity and body composition.…”

Section: Thermogenesismentioning

confidence: 99%

Nutrition, ageing and ill health

1998

View full text Add to dashboard Cite

There are physical, mental, social and environmental changes which take place with ageing; for example, decreased physical activity, increase in body fat, decrease in lean body mass and consequently decreased energy intake may be associated with physiological functions that affect metabolism, nutrient intake, physical activity and risk of disease. There are now many studies which have found that undernutrition is prevalent and often unrecognized in patients admitted to hospitals and institutions. There is also evidence which links protein-energy undernutrition or its markers with clinical outcomes in acute and non-acute hospital settings and that nutritional supplements can improve outcomes in some of these settings. However, most clinically-available nutrition screening instruments lack sensitivity and specificity, and abnormal nutritional indicators may simply reflect effects of age, functional disability, or severe underlying disease. Thus, causal relationship cannot be assumed without a sufficiently powerful intervention study which adequately adjusts for the effects of non-nutritional factors, such as the number and severity of co-morbid conditions on clinical outcome.

show abstract

Section: Thermogenesismentioning

confidence: 99%

Nutrition, ageing and ill health

1998

View full text Add to dashboard Cite

show abstract

“…Lake, et al 22 have suggested that systematic differences in group mean age introduced artifactual effects in prior positive studies, because plasma norepinephrine varied with age and because hypertensives were older than normotensives. Across the 27 studies that listed mean group ages between 20 and 50 years, mean group norepinephrine levels did correlate significantly with mean group age for the normotensives (r = 0.42, p < 0.05) but not the hypertensives (r = 0.28).…”

Section: Patient Agementioning

confidence: 99%

“…Franco-Morselli et al 12 Franco-Morselli et al 13 Geffen et al 14 Henry et al 15 Hjemdahl and Eliasson" Hofman et al 17 Jones et al 18 Kafka et al 19 Kiowski et al 80 Kobayashi et al 21 Lake et al 22 Lake 23 Louis et al 2 * Miura et al 26 Miura et al 26 Pedersen and Christensen 27 Philipp et al 28 Robertson et al 29 Sever et al 30 Sever et al 3 '…”

mentioning

confidence: 99%

Plasma norepinephrine in essential hypertension. A study of the studies.

Goldstein¹

1981

Hypertension

190

View full text Add to dashboard Cite

SUMMARY Of 32 studies comparing plasma norepinephrine concentrations in hypertensive and normotensive groups, 28 (88%) reported higher levels in the hypertensive group. However, only 13 (41%) of the studies reported statistically significant hypertensive-nonnotensive differences in norepinephrine, leading the present attempt to identify factors differentiating "positive" studies (those reporting significant hypertensivenormotensive differences) from "negative" studies (those reporting nonsignificant differences). Hypertensive norepinephrine levels were similar in positive and negative studies (281 vs 288 pg/ml), but normotensive levels were lower in the positive studies (177 vs 269 pg/ml). When compared with the fluorimetric technique, the radioenzymatic type of assay was associated both with a lower frequency of positive results (25% vs 100%) and greater intrastudy standard deviations (152 vs 72 pg/ml). Hypertensive-normotensive differences varied inversely with age (> = -0.37). Resolution of the persisting controversy about norepinephrine levels in essential hypertension will require more attention to the causes of variability associated with the assay technique, to the sources, characteristics, and treatment of the normotensive controls, and to the age of the patient population. (Hypertension 3: 48-52, 1981) KEY WORDS • norepinephrine • catecholamines • hypertensionT HE introduction about a decade ago of sensitive techniques for measuring plasma norepinephrine,'• a and indications that those levels reflect sympathetic neural activity,' promised to help answer a perennial question in hypertension research: Does sympathetic hyperactivity cause essential hypertension? Despite the subsequent publication of more than 30 comparative studies in hypertensives and normotensive controls,*"" controversy persists about whether patients with hypertension exhibit elevated levels of norepinephrine. This report reexamines these studies in an attempt to identify the causes of the inconsistencies in results. MethodsThe studies considered in this review satisfied the following criteria: 1) they were published since 1973, in English; 2) they were not merely abstracts, but were

show abstract

“…Conflicting results are still being reported: whether in essential hypertension plasma catecholamines are raised 1 " 9 or not, 10 " 18 whether they correlate with plasma renin activity 14 ' 1B or not, 9 whether they correlate with blood pressure 5 ' 9 or not, 4 ' 6 and whether they increase with age 10 -1J or not. 4 ' 5 In all studies performed, patients with essential hypertension have been compared with normotensive controls, ignoring the possibility that the raised blood pressure per se could have an influence on the activity of the sympathetic nervous system and on plasma catecholamines.…”

mentioning

confidence: 99%

Plasma epinephrine and norepinephrine concentrations in primary and secondary human hypertension.

Skrabal¹,

Auböck²,

Hörtnagl³

et al. 1981

Hypertension

View full text Add to dashboard Cite

SUMMARY Supine plasma concentrations of epinephrine and norepinephrine were measured by a radioenzymatic method in 69 patients with essential hypertension and were compared with the levels found in 40 patients with hypertension resulting from chronic parenchymatous renal disease and in 18 normotensive controls. Mean plasma levels of epinephrine and norepinephrine were not statistically different in primary and secondary hypertension and comparable to levels in normotenstve controls. If the upper confidence limit is taken to be 0.4 ng/ml of plasma norepinephrine in renal hypertension, only three of 69 patients with essential hypertension (4%) had a slightly raised plasma norepinephrine and, with an upper confidence limit of 0 3 ng/ml in normal subjects, only four of 69 patients (6%) had a definitely raised plasma norepinephrine. Plasma norepinephrine was significantly higher in high-renin as compared to low-renin essential hypertension; it correlated neither with age nor blood pressure. Plasma epinephrine was suppressed in about 30% of the patients with primary and secondary hypertension and correlated significantly with heart rate and pulse pressure. On the basis of the present results, differences in the sympathetic tone in primary hypertension and secondary hypertension of renal origin are not obvious. Supine plasma catecbolamine levels do not add any new evidence to the concept that increased activity of the sympathetic nervous system is involved in the pathogeoesis of essential hypertension. In fact, plasma epinephrine is suppressed in a substantial number of patients with primary and secondary hypertension. Furthermore, since plasma reoin correlated with plasma norepinephrine only in essential but not in renal hypertension, it appears that the sympathetic nervous system contributes to basal renin release only in primary hypertension. In secondary hypertension resulting from chronic renal disease, basal renin release is probably maintained by the renal baroreceptors of the diseased kidneys. (Hypertension 3: 373-379, 1981 Received March 11, 1980; revision accepted October 17, 1980. sympathetic nervous system and on plasma catecholamines. A comparison of plasma levels of catecholamines in patients with essential hypertension and those with secondary hypertension of renal origin has to our knowledge not yet been performed. The purpose of the present investigation is to compare the plasma levels of epinephrine, norepinephrine, and renin in primary hypertension and secondary hypertension of renal origin. Material and MethodsWe investigated 69 patients (24 females) with essential hypertension, 40 patients (22 females) with hypertension associated with well-established chronic parenchymatous renal disease, and 19 normal control subjects (all male). In patients with essential hypertension, we used routine clinical procedures including urinanalysis, rapid sequence urography, and determination of urinary catecholamines to exclude secondary forms of hypertension. The diagnoses in patients with renal hypertension wer...

show abstract

Age-Adjusted Plasma Norepinephrine Levels Are Similar in Normotensive and Hypertensive Subjects

Cited by 317 publications

References 11 publications

Nutrition, ageing and ill health

Nutrition, ageing and ill health

Plasma norepinephrine in essential hypertension. A study of the studies.

Plasma epinephrine and norepinephrine concentrations in primary and secondary human hypertension.

Contact Info

Product

Resources

About