Effects of selective angiotensin II receptor blockade on sympathetic nerve activity in primary hypertensive subjects

Struck, J.; Muck, Philip; Trübger, D.; Handrock, Renate; Weidinger, Gottfried; Dendorfer, Andreas; Dodt, Christoph

doi:10.1097/00004872-200206000-00026

Cited by 71 publications

(49 citation statements)

References 31 publications

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“…On the other hand, whereas azelnidipine slightly decreased PR, amlodipine had the opposite effect. Other studies have also indicated that amlodipine's effect on PR ranged from no change to a significant increase (12,13). Eguchi et al (14) showed that amlodipine is effective at lowering BP in older hypertensives, although it may increase ventricular ectopic beats, especially when given at high dose.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Azelnidipine on Home Blood Pressure and Pulse Rate in Patients with Essential Hypertension: Comparison with Amlodipine

Yamagishi

2006

Hypertens Res

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Section: Discussionmentioning

confidence: 99%

Efficacy of Azelnidipine on Home Blood Pressure and Pulse Rate in Patients with Essential Hypertension: Comparison with Amlodipine

Yamagishi

2006

Hypertens Res

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“…51 Indeed, our findings and the previously reported association between the sympathetic activation of hypertension and its cardiovascular complications 5,7,8 make it possible to argue that the choice of anti-hypertensive agents could be influenced by gender when sympathetic activation is of relevance. Some of these agents have been reported to have no effect on sympathetic activity [52][53][54][55][56] or increase it, 52,54 whereas others either curtail sympathetic activation 57 or block sympathetic effects. [54][55][56] In conclusion, hypertension in women was associated with a lower level of central sympathetic hyperactivity than in men.…”

Section: For Hypertensive Women (F-eht) and Men (M-eht) Normotensivementioning

confidence: 99%

“…Some of these agents have been reported to have no effect on sympathetic activity [52][53][54][55][56] or increase it, 52,54 whereas others either curtail sympathetic activation 57 or block sympathetic effects. [54][55][56] In conclusion, hypertension in women was associated with a lower level of central sympathetic hyperactivity than in men. It is suggested that this may at least partly explain the observed lower hypertension-related cardiovascular events in women than in men.…”

Section: For Hypertensive Women (F-eht) and Men (M-eht) Normotensivementioning

confidence: 99%

The effect of gender on the sympathetic nerve hyperactivity of essential hypertension

2006

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We planned to determine whether or not there is a difference in the level of muscle sympathetic nerve activity (MSNA) between hypertensive women and hypertensive men. Sympathetic activation of essential hypertension (EHT) has been associated with increased cardiovascular events, which are known to be less likely to occur in women than in men. Normal women have been reported to have less sympathetic nerve activity than men, but no reported data are available regarding gender differences in sympathetic activity in hypertensive subjects. We examined 36 patients with untreated and uncomplicated EHT comprising 18 women and 18 men, and 36 normal controls comprising 18 women and 18 men. MSNA was quantified as the mean frequency of single units and as multiunit bursts using the technique of microneurography. The hypertensive groups had greater sympathetic nerve activity than the control groups. Female hypertensives had lower (Po0.001) single unit hyperactivity (5671.7 impulses/100 cardiac beats) than male hypertensives (7271.7 impulses/100 cardiac beats). Normotensive females had lower (Po0.01) single unit activity (4273.6 impulses/100 cardiac beats) than normotensive males (5674.6 impulses/100 cardiac beats). Similar results were obtained for the frequency of multiunit burst activity. Hypertension in women is associated with a lower level of central sympathetic hyperactivity than in men. It is suggested that this may at least partly explain the observed lower hypertension-related cardiovascular events in women than in men. In addition, the findings may have implications for gender-specific management of hypertension.

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“…Amlodipine never decreases heart rate, and even increases it by activation of the baroreflex arch resulting in an increased sympathetic outflow to the vascular bed and to the heart. 10,18,19) As shown in Figure 2, Av-ME-SBP and Di-ME-SBP were both significantly reduced after cilnidipine administration. Since both the Av-ME-SBP and Di-ME-SBP were associated with future stroke events independently of each other, 6) cilnidipine seemed to be an ideal agent for controlling morning hypertension.…”

Section: Discussionmentioning

confidence: 81%

<b>Bedtime Administration of Cilnidipine Controls Morning Hypertension</b>

et al. 2007

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SUMMARYMorning blood pressure (BP) level plays an important role in the incidence of cardiovascular disease. Recently, Kario, et al proposed the usefulness of ME difference (morning minus evening systolic BP) and ME average (average of morning and evening systolic BP) for the evaluation of antihypertensive treatment. Cilnidipine is a novel calcium channel blocker (CCB) that exerts inhibitory actions not only on L-type but also on N-type calcium channels. We investigated the effect of bedtime administration of cilnidipine (10 mg) in addition to the antihypertensive treatment for uncontrolled morning hypertension. Twenty-three hypertensive outpatients (13 males and 10 females; mean age, 66.9 years) with stable antihypertensive medication and uncontrolled morning BP were studied using self-measured BP monitoring in the morning and evening. Morning SBP (P < 0.001) and DBP (P < 0.001) decreased significantly from 150.2 ± 8.7 and 87.8 ± 9.3 to 132.7 ± 7.4 and 77.5 ± 8.5 mmHg, respectively, after the addition of cilnidipine. Morning heart rate did not change (63.3 ± 7.0 to 64.1 ± 9.4). The evening SBP, but not DBP, decreased significantly after treatment. Both the ME average (P < 0.001) and ME difference (P < 0.01) significantly decreased from 143.0 ± 9.2 and 14.3 ± 12.4 to 131.3 ± 7.2 and 2.8 ± 9.2 mmHg after treatment, respectively. The microalbuminuria decreased from 39.6 ± 13.2 to 27.3 ± 8.4 mg/g Cr. In conclusion, L-/N-type CCB cilnidipine may be useful for patients with uncontrollable morning hypertension by reducing both ME average and ME difference. (Int Heart J 2007; 48: 597-603) Key words: L-/N-type calcium channel blocker, Morning hypertension, Microalbuminuria CARDIOVASCULAR events occur most frequently in the morning 1,2) especially within 3 hours after waking.3) An elevated morning blood pressure (BP) level has been associated with target organ damage: left ventricular hypertrophy 4) and microalbuminuria.5) Recent reports demonstrated that morning hypertension measured either by ambulatory BP monitoring (ABPM) 6) or by self-measured BP From the

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Effects of selective angiotensin II receptor blockade on sympathetic nerve activity in primary hypertensive subjects

Cited by 71 publications

References 31 publications

Efficacy of Azelnidipine on Home Blood Pressure and Pulse Rate in Patients with Essential Hypertension: Comparison with Amlodipine

Efficacy of Azelnidipine on Home Blood Pressure and Pulse Rate in Patients with Essential Hypertension: Comparison with Amlodipine

The effect of gender on the sympathetic nerve hyperactivity of essential hypertension

<b>Bedtime Administration of Cilnidipine Controls Morning Hypertension</b>

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