The Comparative Effects of Small Intravenous Doses of L-Nor-Epinephrine Upon Arterial Pressure and Pulse Rate in Nor-Motensive Subjects and in Hypertensive Patients Before and After Thoracolumbar Sympathectomy

Judson, Walter E.; Epstein, Franklin H.; Wilkins, Robert W.

doi:10.1172/jci102379

Cited by 18 publications

(2 citation statements)

References 11 publications

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“…53 They found that while norepinephrine regularly decreases the heart rate in normotensive individuals by inducing a vagus reflex, no change was observed in hypertensive patients. After thoracolumbar sympathectomy, however, the normal response returned.…”

Section: Clinical Pharmacology and Therapeuticsmentioning

confidence: 99%

Epinephrine and norepinephrine actions and use in man

Euler

1960

Clin Pharma and Therapeutics

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Section: Clinical Pharmacology and Therapeuticsmentioning

confidence: 99%

Epinephrine and norepinephrine actions and use in man

Euler

1960

Clin Pharma and Therapeutics

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“…Deficient or abnormal action of the amine oxidase responsible for its local destruction might lead to more persistent vasoconstriction. It has been claimed that injected noradrenaline has a greater pressor effect in hypertensives than in normals (Goldenberg et al, 1948), but further work is required to elucidate this point (Judson et al, 1950), since any comparison must take into account the already heightened tone of the arterioles in the hypertensive. The pressor effect of both noradrenaline and adrenaline in man may be intensified by the previous administration of deoxycortone (Raab et al, 1950) or of adrenocorticotrophic hormone or cortisone (Kurland and Freedberg, 1951).…”

Section: Phaeochromocytomamentioning

confidence: 99%

The Treatment of Severe Hypertension

Rosenheim¹

1954

BMJ

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Norepinephrine Infusion in Normal Subjects and Patients with Essential or Renal Hypertension: Effect on Blood Pressure, Heart Rate, and Plasma Catecholamine Concentrations

Manger

Fröhlich

Gifford

et al. 1976

The Journal of Clinical Pharma

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Infusion of NE in seven normal subjects and 13 patients with essential or renal hypertension caused a pronounced initial rise of systolic pressure in only seven hypertensives and one normotensive. This hyperresponsiveness was not a constant finding in essential or renal hypertensives but usually occurred in patients with highest preinfusion pressures. In some of the latter, following the pronounced rise in pressure when NE infusion was started (0.05 mug/kg/min), pressure did not increase further (probably due to reflexly reduced cardiac output) despite progressively increasing the infusion rate to 0.1 and 0.2 mug/kg/min. Hyperresponsiveness could not be attributed to increased NE concentrations at receptor sites since it was not significantly correlated with elevations of NE plasma concentrations; in some essential hypertensives, mild pressure increases occurred despite marked elevations of arterial plasma NE. Since hyperresponsiveness occurred in some patients with essential and some with renal hypertension, it could not be used to differentiate these two groups of hypertensives. The mechanism for hyperresponsiveness remains unclear but may be better explained by vascular structure alterations than by hyperreactive vascular smooth muscle per se; however, a combination of these factors could participate. During NE infusion, reflex bradycardia was associated with elevated pressure and was slightly more pronounced in normotensives; this was probably related to diminished baroreflex sensitivity in essential hypertensives and due to "resetting" of their baroreceptors. During high rates of NE infusion (0.2 mu/kg/min), higher arterial plasma NE concentrations in essential hypertensives than in normotensives could result from reduction in blood flow to organs important in inactivating circulating NE; however, a defective inactivating mechanism for NE in some essential hypertensives cannot be totally excluded.

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The Comparative Effects of Small Intravenous Doses of L-Nor-Epinephrine Upon Arterial Pressure and Pulse Rate in Nor-Motensive Subjects and in Hypertensive Patients Before and After Thoracolumbar Sympathectomy

Cited by 18 publications

References 11 publications

Epinephrine and norepinephrine actions and use in man

Epinephrine and norepinephrine actions and use in man

The Treatment of Severe Hypertension

Norepinephrine Infusion in Normal Subjects and Patients with Essential or Renal Hypertension: Effect on Blood Pressure, Heart Rate, and Plasma Catecholamine Concentrations

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