Circadian Variations of Urinary Dopamine, Norepinephrine, Epinephrine and Sodium in Normotensive and Hypertensive Subjects

Kawano, Yuhei; Kawasaki, Terukazu; Kawazoe, Nobuyuki; Abe, Isao; Uezono, Keiko; Ueno, Masashi; Fukiyama, Koshiro; Omae, Teruo

doi:10.1159/000185975

Cited by 33 publications

(15 citation statements)

References 19 publications

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“…No fall in the nocturnal blood pressure and the rise in the early morning in SAS patients may indicate activation of the sympathetic nervous system at night and in the early morning. In normal persons, urinary excretion of catecholamines is reported to be highest in the daytime (20), but we observed no significant difference between diurnal and nocturnal excretion rates in the SAS patients. It has been reported that the nocturnal excretion rate of catecholamines exceeds the diurnal rate in SAS patients (21).…”

Section: Resultscontrasting

confidence: 81%

The Relation between Sleep Apnea and Intra-Arterially Measured Blood Pressure in Hyperternsive Patients with Sleep Apnea Syndrome.

Arimoto¹,

Hirata²,

Kosugi³

et al. 1993

Hypertens Res

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The relationship between sleep apnea and blood pressure was examined in 7 patients with sleep apnea syndrome (SAS). In addition, whether or not SAS is a risk factor for cerebrovascular disease was assessed. Polysomnography, including measurements of arterial 02 saturation (Sa02), was performed in 7 patients during a 3-day hospitalization period; direct intra-arterial blood pressure was continuously recorded. The blood pressure data were analyzed at the beginning of apnea, the beginning of fall in Sa02, the end of apnea, the time of maximum blood pressure, and the time of Sa02 recovery. Analysis was also carried out for 30 s at 30-min intervals to assess nocturnal blood pressure variability.Two urine specimens, one accumulated from 9 a.m. to 9 p.m. and the other from 9 p.m. to 9 a.m., were collected. The pattern of blood pressure changes did not reveal the nocturnal decrease observed in normal subjects. A transient elevation of blood pressure was observed at the end of each apneic period; the mean increase in blood pressure was 28.0 mmHg in systole and 16.4 mmHg in diastole, and the maximum increase in systolic blood pressure was over 100 mmHg. There was no significant difference between diurnal and nocturnal concentrations of urinary catecholamines, suggesting that the sympathetic activity of patients with SAS is not decreased at night. Furthermore, the transient but considerable elevation of blood pressure observed at the end of each apneic period suggests that SAS may potentially trigger cerebrovascular disease. (Hypertens Res 1993;16: 209-213)

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Section: Resultscontrasting

confidence: 81%

The Relation between Sleep Apnea and Intra-Arterially Measured Blood Pressure in Hyperternsive Patients with Sleep Apnea Syndrome.

Arimoto¹,

Hirata²,

Kosugi³

et al. 1993

Hypertens Res

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“…Kawano et al 15 presented a contrasting result. Their study of 20 normotensive, 20 borderline hypertensive, and 10 mildly hypertensive middle-aged men found that all of the groups had a normal pattern of high sodium excretion during the day and low output at night.…”

Section: Diurnal Rhythm Of Sodium Excretion In Normotensive and Hypermentioning

confidence: 97%

Nocturnal Sodium Excretion, Blood Pressure Dipping, and Sodium Sensitivity

2006

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M ore than 30 years ago, Guyton 1 described pressurenatriuresis: increasing arterial blood pressure promotes sodium excretion, decreasing blood volume and lowering blood pressure, whereas when blood pressure falls, sodium excretion decreases, and blood volume and blood pressure increase. 1,2 The linchpin of the model of Guyton et al 3 is the concept of feedback gain. Gain is the degree to which a feedback system can correct a perturbation, that is, the amount of correction of a deviation divided by the residual degree of deviation. When a control system corrects a perturbation minimally, its feedback gain is near 0. When it corrects it completely, its gain is infinite. As emphasized by Guyton et al,3 in integrated systems with infinite and finite gain components, the infinite gain function ultimately dominates. There are myriad blood pressure control systems, for example, arterial baroreceptors and chemoreceptors, the central nervous system ischemic response, the renin-angiotensin system, and capillary fluid shift, but all are ultimately trumped by pressure-natriuresis. In the experiments by Guyton et al, 3 pressure-natriuresis had near infinite gain over a wide range of urinary sodium excretion, such that the set point of blood pressure regulation was not affected by sodium intake over a period of several days or a few weeks.This pressure-natriuresis model describes a steady-state relationship. At short time intervals, blood pressure and sodium excretion may not be closely linked, but the body will always eventually bring the system back into balance. In this review, we wish to draw attention to differences in the relationship of blood pressure to sodium excretion during day and night and to how nighttime pressure-natriuresis and sodium sensitivity of blood pressure interact. We will suggest that these features of pressure-natriuresis have implications both for the clinical management of hypertension and research into the genetic underpinnings of the disease. Diurnal Rhythm of Sodium Excretion in Normotensive and Hypertensive SubjectsIn healthy people, sodium excretion reaches a maximum during the day and a minimum at night during sleep, and it has long been thought that blood pressure is the primary determinant of nighttime sodium excretion. 4 -7 Centonza et al 8 performed ambulatory blood pressure monitoring over a 26-hour period in normotensive subjects for whom sodium intake was fixed at a moderate amount (170 mmol/day). All of the subjects demonstrated a nocturnal dip in blood pressure with a concomitant dip in sodium excretion. Moreover, there were significant positive correlations between blood pressure and sodium excretion during the night and over 24 hours, as well as during periods of quiet supine wakefulness and postprandial sitting. No similar relationship was apparent when subjects carried out daily activities in the standing position. The authors concluded that the pressure-natriuresis relationship is blunted during upright posture, possibly because of the activation of neurohumoral systems. 8 St...

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“…9,[13][14][15] It has been shown that diurnal changes in BP coincide with changes in heart rate and the levels of plasma and urinary catecholamines. [13][14][15][16] It also has been shown that BP is high during nighttime working hours and low during daytime sleeping hours in shift workers, although the dip in BP during sleeping hours may be attenuated at the beginning of the night shift. 17,18 These results indicate that the endogenous clock has a minor role in the generation of BP variation associated with the awake and sleep cycle.…”

Section: Diurnal Bp Variation In Relation To Mental and Physical Actimentioning

confidence: 99%

“…Urinary sodium excretion is relatively high during the daytime and low during nighttime in normotensive and hypertensive subjects. 16 This diurnal variation in sodium excretion is diminished or reversed in hypertensive nondippers. 51 Impaired sodium excretion capacity in salt-sensitive patients may result in the elevation of nocturnal BP to stimulate natriuresis in order to restore sodium balance (Table 1).…”

Section: Obesity and Sleep Apneamentioning

confidence: 99%

Diurnal blood pressure variation and related behavioral factors

Kawano

2010

Hypertens Res

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Blood pressure (BP) varies according to many internal and external factors, and behavioral factors have an important role in diurnal BP variation. BP rises sharply on waking in the morning and falls during sleep at night, although it varies throughout the day and night. These changes in BP are closely related to mental and physical activities, and the sympathetic nervous system mainly contributes to the diurnal variation in BP. Other behavioral factors, such as food consumption and obesity, dietary intake of sodium, drinking and smoking habits, consumption of coffee and tea, and bathing, also affect the diurnal variation in BP. Alterations in diurnal BP variation due to behavioral factors are frequently seen in patients with hypertension and can be classified as morning hypertension, daytime hypertension and nighttime hypertension. Appropriate lifestyle modifications may normalize or improve both the level and rhythm of BP in these patients. Hypertension Research (2011) 34, 281-285; doi:10.1038/hr.2010.241; published online 2 December 2010Keywords: ambulatory blood pressure monitoring; diurnal blood pressure variation; lifestyle; mental stress; physical activity INTRODUCTION Blood pressure (BP) varies according to many internal and external factors. There are several distinctive rhythmic variations in BP including diurnal (or circadian) variation, and behavioral factors have an important role in diurnal BP variation. BP rises sharply on waking in the morning and falls during sleep at night, although it varies with changes in mental and physical activities during daytime and nighttime. [1][2][3][4] In addition to the awake and sleep cycle, many behavioral factors, such as mental stress, exercise, food consumption, changes in body weight, dietary intake of sodium and other electrolytes, drinking and smoking habits, consumption of coffee and tea, and bathing, influence both the level and variation in BP. [5][6][7][8] Understanding the influences of those behavioral factors on diurnal BP variation is important for the management of hypertension because alterations in diurnal BP variation due to behavioral factors are observed in many hypertensive subjects. 9,10 It has been shown that ambulatory BP monitoring is useful for assessing the influence of behavioral factors as well as the effects of lifestyle modifications on the level and pattern of BP throughout the day. 11,12 In this review article, I would like to summarize the effects of behavioral factors on diurnal BP variation with respect to the pathophysiology of hypertension and the effects of lifestyle modifications on 24-h BP.

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Circadian Variations of Urinary Dopamine, Norepinephrine, Epinephrine and Sodium in Normotensive and Hypertensive Subjects

Cited by 33 publications

References 19 publications

The Relation between Sleep Apnea and Intra-Arterially Measured Blood Pressure in Hyperternsive Patients with Sleep Apnea Syndrome.

The Relation between Sleep Apnea and Intra-Arterially Measured Blood Pressure in Hyperternsive Patients with Sleep Apnea Syndrome.

Nocturnal Sodium Excretion, Blood Pressure Dipping, and Sodium Sensitivity

Diurnal blood pressure variation and related behavioral factors

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