Sex differences in the systemic response to adrenoreceptor antagonists during sympathetic activation

Coulson, James; Cockcroft, John R.

doi:10.1111/j.1365-2362.2011.02521.x

Cited by 6 publications

(3 citation statements)

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“…␤ 1 -Receptors are also involved in lipolysis (2) and renin release (17). However, only a handful of prior investigators have used esmolol infusion to study blood flow regulation in humans; these studies either used single bolus injections (9,15) or did not state how long the maintenance infusion continued (27,50) or did not compare esmolol with propranolol (24,54,55). Indeed, there is no established "cardioselective" dose of esmolol in the published literature.…”

Section: Discussionmentioning

confidence: 99%

“…However, these prior studies have several limitations, including poor reporting of infusion parameters, no measurement of arterial blood pressure (BP), unclear onset and offset of ␤-blockade, and uncertainty about ␤ 2 -receptor involvement in the observed responses. To summarize, the dose and infusion parameters used in prior publications are widely variable (1,9,13,24,48,49,55) and may not be adequate to fully antagonize the ␤ 1 -adrenergic receptor. Because esmolol is short-acting, it would be an ideal ␤-blocker to use in human physiology research in which participants are commonly discharged home at the completion of the study.…”

Section: New and Noteworthymentioning

confidence: 99%

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Esmolol infusion versus propranolol infusion: effects on heart rate and blood pressure in healthy volunteers

Müller

Ahmad

Pelaez

et al. 2017

Journal of Applied Physiology

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Despite its widespread clinical use, the β-adrenergic receptor antagonist esmolol hydrochloride is not commonly used in human physiology research, and the effective dose of esmolol (compared with the nonselective β-blocker propranolol) is unclear. In four separate studies we used cycle ergometry exercise and infusions of isoproterenol and epinephrine to test the heart rate (HR)-lowering effect of esmolol compared with propranolol and saline in healthy humans. In , both esmolol (ΔHR 57 ± 6 beats/min) and propranolol (ΔHR 56 ± 7 beats/min) attenuated exercise tachycardia compared with saline (ΔHR 88 ± 17 beats/min). In, we found that the HR response to exercise was similar at 5 min (ΔHR 57 ± 9 beats/min) and 60 min (ΔHR 55 ± 9 beats/min) after initiation of the esmolol maintenance infusion. In , we confirmed that the HR-lowering effect of esmolol disappeared 45 min after termination of the maintenance infusion. In, changes in femoral blood flow and hematological parameters in response to epinephrine infusion were not different between esmolol and saline infusion, indicating that our esmolol infusion paradigm does not block β-receptors. Collectively, our data indicate that infusion of ~160 mg of esmolol (range 110-200 mg in the 5 min before exercise) acutely and selectively blocks β-receptors in healthy humans. Additionally, β-receptors remain blocked 60 min later if a maintenance infusion of ~0.2 mg·kg total body mass·min- continues. The current data lay the foundation for future studies to evaluate β- vs. β-receptor control of the circulation in humans. We used cycle ergometry exercise and infusions of isoproterenol and epinephrine to test the heart rate-lowering effect of esmolol compared with propranolol and saline in healthy humans. Collectively, our data indicate that infusion of ~160 mg of esmolol (range 110-200 mg in the 5 min before exercise) acutely and selectively blocks β1-adrenergic receptors. These infusion parameters can be used in future experiments to evaluate β1- vs. β2-receptor control of the circulation in humans.

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Section: Discussionmentioning

confidence: 99%

Section: New and Noteworthymentioning

confidence: 99%

Esmolol infusion versus propranolol infusion: effects on heart rate and blood pressure in healthy volunteers

Müller

Ahmad

Pelaez

et al. 2017

Journal of Applied Physiology

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“…Human studies on erythropoiesis after trauma have not assessed differences between males and females in response to adrenergic modulation after trauma, despite different physiologic reactions to these medications between sexes. In a human study, esmolol, a beta-1 antagonist, significantly decreased the mean arterial pressure of males but not females in the setting of adrenergic stimulation ( Coulson and Cockcroft, 2011 ). In addition, men have shown increased sensitivity to propranolol and exhibited a more pronounced drop in blood pressure compared to women after exercise ( Samora et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Adrenergic Modulation of Erythropoiesis After Trauma

Munley

Kelly²,

Mohr³

2022

Front. Physiol.

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Severe traumatic injury results in a cascade of systemic changes which negatively affect normal erythropoiesis. Immediately after injury, acute blood loss leads to anemia, however, patients can remain anemic for as long as 6 months after injury. Research on the underlying mechanisms of such alterations of erythropoiesis after trauma has focused on the prolonged hypercatecholaminemia seen after trauma. Supraphysiologic elevation of catecholamines leads to an inhibitive effect on erythropoiesis. There is evidence to show that alleviation of the neuroendocrine stress response following trauma reduces these inhibitory effects. Both beta blockade and alpha-2 adrenergic receptor stimulation have demonstrated increased growth of hematopoietic progenitor cells as well as increased pro-erythropoietic cytokines after trauma. This review will describe prior research on the neuroendocrine stress response after trauma and its consequences on erythropoiesis, which offer insight into underlying mechanisms of prolonged anemia postinjury. We will then discuss the beneficial effects of adrenergic modulation to improve erythropoiesis following injury and propose future directions for the field.

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Sex and Gender Differences in Cardiovascular Drug Therapy

Seeland

Regitz‐Zagrosek

2012

Handbook of Experimental Pharmacology

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This chapter outlines sex differences in pharmacokinetics and pharmacodynamics of the most frequently used drugs in cardiovascular diseases, e.g., coronary artery disease, hypertension, heart failure. Retrospective analysis of previously published drug trials revealed marked sex differences in efficacy and adverse effects in a number of cardiovascular drugs. This includes a higher mortality among women taking digoxin for heart failure, more torsade de pointes arrhythmia in QT prolonging drugs and more cough with ACE inhibitors. Trends towards a greater benefit for women and/or female animals have been observed in some studies for endothelin receptor antagonists, the calcium channel blocker amlodipine, the ACE-inhibitor ramipril and the aldosterone antagonist eplerenone. However, reproduction of these results in independent studies and solid statistical evidence is still lacking. Some drugs require a particularly careful dose adaptation in women: the beta-blocker metoprolol, the calcium channel blocker verapamil, loop-, and thiazide diuretics. In conclusion, sex differences in pharmacokinetics and pharmacodynamics have to be taken into account for cardiovascular drug therapy in women.

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Sex differences in the systemic response to adrenoreceptor antagonists during sympathetic activation

Abstract: This study supports previous findings of sex differences in adrenergic responsiveness and suggests that its consequences are systemically relevant.

Cited by 6 publications

References 12 publications

Esmolol infusion versus propranolol infusion: effects on heart rate and blood pressure in healthy volunteers

Esmolol infusion versus propranolol infusion: effects on heart rate and blood pressure in healthy volunteers

Adrenergic Modulation of Erythropoiesis After Trauma

Sex and Gender Differences in Cardiovascular Drug Therapy

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