Central Haemodynamics and Plasma Prostaglandin E2 in Borderline and Sustained Essential Hypertensive Patients before and after Indomethacin

Safar, Michel E.; Hornych, A; Levenson, Jaime; Simon, Alain; London, Gérard M.; Bariéty, J; Milliez, P

doi:10.1042/cs061323s

Cited by 20 publications

(10 citation statements)

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“…Indo is typically used for the management of pain and has been shown to increase BP with several weeks of use in borderline hypertensives (38) and increase total peripheral resistance in healthy adults (45). Similarly, Indo increased mean arterial pressure measured at the brachial artery in both young and older subjects in the present study.…”

Section: Discussionsupporting

confidence: 63%

“…Given these potential age-related changes, fewer vasodilatory mechanisms would be available to offset the vasoconstrictor response to COX inhibition, resulting in a greater augmentation of the reflected wave and therefore central BP. Thus, the vasoconstricting effect of Indo on the peripheral vasculature likely produces the increase in peripheral wave reflection in older adults (38,45). Additionally, Indo has been shown to induce coronary vasoconstriction and decrease myocardial blood flow in adults with coronary artery disease (12,35).…”

Section: Discussionmentioning

confidence: 99%

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Cyclooxygenase inhibition augments central blood pressure and aortic wave reflection in aging humans

Barnes

Casey

Hines

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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The augmentation index and central blood pressure increase with normal aging. Recently, cyclooxygenase (COX) inhibitors, commonly used for the treatment of pain, have been associated with transient increases in the risk of cardiovascular events. We examined the effects of the COX inhibitor indomethacin (Indo) on central arterial hemodynamics and wave reflection characteristics in young and old healthy adults. High-fidelity radial arterial pressure waveforms were measured noninvasively by applanation tonometry before (control) and after Indo treatment in young (25 Ϯ 5 yr, 7 men and 6 women) and old (64 Ϯ 6 yr, 5 men and 6 women) subjects. Aortic systolic (control: 115 Ϯ 3 mmHg vs. Indo: 125 Ϯ 5 mmHg, P Ͻ 0.05) and diastolic (control: 74 Ϯ 2 mmHg vs. Indo: 79 Ϯ 3 mmHg, P Ͻ 0.05) pressures were elevated after Indo treatment in older subjects, whereas only diastolic pressure was elevated in young subjects (control: 71 Ϯ 2 mmHg vs. Indo: 76 Ϯ 1 mmHg, P Ͻ 0.05). Mean arterial pressure increased in both young and old adults after Indo treatment (P Ͻ 0.05). The aortic augmentation index and augmented pressure were elevated after Indo treatment in older subjects (control: 30 Ϯ 5% vs. Indo 36 Ϯ 6% and control 12 Ϯ 1 mmHg vs. Indo: 18 Ϯ 2 mmHg, respectively, P Ͻ 0.05), whereas pulse pressure amplification decreased (change: 8 Ϯ 3%, P Ͻ 0.05). In addition, older subjects had a 61 Ϯ 11% increase in wasted left ventricular energy after Indo treatment (P Ͻ 0.05). In contrast, young subjects showed no significant changes in any of the variables of interest. Taken together, these results demonstrate that COX inhibition with Indo unfavorably increases central wave reflection and augments aortic pressure in old but not young subjects. Our results suggest that aging individuals have a limited ability to compensate for the acute hemodynamic changes caused by systemic COX inhibition.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Cyclooxygenase inhibition augments central blood pressure and aortic wave reflection in aging humans

Barnes

Casey

Hines

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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“…4 ' 5 . 33 ' 34 Acute administration of ASP appears to cause an acute reduction in vascular PG synthesis, thus leading to a pressor response in essential hypertension. In contrast, the dominant effect appears to be suppression of excessive renin release and a depressor response in RVH.…”

mentioning

confidence: 99%

Aspirin lowers blood pressure in patients with renovascular hypertension.

et al. 1989

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To clarify the role of renal prostanoid in hyperreninemia and high blood pressure in human renovascular hypertension, we measured prostaglandin E 2 and renin activity in renal venous and abdominal aortic plasma before and after the intravenous administration of the cyclooxygenase inhibitor, aspirin DL-lysine. Subjects were six patients with unilateral renovascular hypertension and six with essential hypertension. In patients with renovascular hypertension, prostaglandin E 2 concentration in renal venous plasma from the stenotic kidney was 9.25 ±1.48 pg/ml, which was significantly higher (/?<0.01) than the concentration in the renal venous plasma from the normal kidney (4.97±1.02 pg/ml) or in the aortic plasma (2.59±0.15 pg/ml). Plasma renin activity was also higher in the renal vein of the stenotic kidney than in the other two sites. The stenotic side/normal side ratio of the renal venous prostaglandin E 2 correlated significantly with a renin ratio greater than 1.5 (r=0.8211, p<0.05). Intravenous injection of aspirin DL-lysine (18 mg/kg) 30 minutes later markedly suppressed prostaglandin E 2 and renin levels at all sites and clearly lowered arterial blood pressure (mean: from 120±6 to 110±5 mm Hg,p<0.01). The reduction in blood pressure correlated significantly with the suppression of plasma renin activity in the aorta (/?<0.05) and in the renal vein of the stenotic kidney (/?<0.01). Conversely, in patients with essential hypertension, aspirin had little effect on renin levels and increased mean blood pressure. These data indicate that renal prostaglandin plays an important role in the augmented release of renal renin and the pathogenesis of hypertension in human renovascular hypertension. {Hypertension 1989;14:461-468)

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“…As previously described [26,27] tensive subjects are: (a) between 20 and 25 years, 5.5±0.9 pg/ml; (b) between 25 and 50 years, 6.8 ±1.3 pg/ml, indicating no significant change with age. Central venous blood PGE2 concentrations are 10.8+3.7 pg/ml for persons aged 25-50 years [26], Means, standard errors of the mean and correlation coefficients were calculated according to standard statistical methods [28], Regres sion analysis were performed usingtheleastsquares method. Difference in means were assessed by the Fisher F test and the Student's t test.…”

Section: Hemodynamic Parametersmentioning

confidence: 94%

Plasma Prostaglandins PGE<sub>2</sub> and PGF<sub>2α</sub>, Total Effective Vascular Compliance and Renal Plasma Flow in Essential Hypertension

London¹,

Hornych²,

Me³

et al. 1982

Nephron

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Plasma prostaglandins PGE₂ and PGF_2α, cardiac hemodynamics, total effective vascular compliance, plasma (PV), interstitial (IFV) and extracellular fluid volumes, and renal indices were determined in 13 men with either borderline or sustained essential hypertension. PGE₂ measured in the central venous blood was increased in borderline and in sustained hypertensives (p < 0.01), while PGF_2α remained within normal ranges. Pulmonary degradation of both prostaglandins was decreased. In the overall population, the PGE₂/PGF_2α ratio was: (i) negatively correlated with central venous pressure (r=-0.68; p <0.01), and (ii) positively correlated with total effective vascular compliance (r = 0.76; p < 0.001), the PV/IFV ratio (r = 0.63; p < 0.02) and the renal plasma flow (r = 0.79; p < 0.001). The study suggests that, in hypertensive patients, prostaglandins PGE₂ and PGF_2α play an important role on the compliance of the venous system and on the control of renal blood flow, contributing to the autoregulatory mechanisms of the hypertensive vascular disease.

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Central Haemodynamics and Plasma Prostaglandin E2 in Borderline and Sustained Essential Hypertensive Patients before and after Indomethacin

Cited by 20 publications

References 0 publications

Cyclooxygenase inhibition augments central blood pressure and aortic wave reflection in aging humans

Cyclooxygenase inhibition augments central blood pressure and aortic wave reflection in aging humans

Aspirin lowers blood pressure in patients with renovascular hypertension.

Plasma Prostaglandins PGE<sub>2</sub> and PGF<sub>2α</sub>, Total Effective Vascular Compliance and Renal Plasma Flow in Essential Hypertension

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