Urinary Noradrenaline Excretion and Renal Function in Normal and Hypertensive 50-year-Old Men

Abstract

1. Sympathetic nervous system activity, measured by urinary noradrenaline excretion, was determined in a group of untreated hypertensive subjects (n = 35), a reference group (n = 80) and a normotensive group (n = 51), all derived from a random population sample of 50-year-old men. It was compared with casual and resting blood pressure, urinary sodium excretion, urinary cretinine concentration and glomerular filtration rate. Hypertension was defined as systolic pressure greater than 175 or diastolic greater than 115 mmHg on two separate occasions. Normotension was defined as systolic pressure less than 160 and diastolic pressure less than 95 mmHg. 2. There was no difference in the average excretion of noradrenaline during the day or night between the reference, normotensive and hypertensive groups. None of the hypertensive patients had values for urinary noradrenaline excretion during the day above the range found in normotensive subjects, indicating that hypertension with increased sympathetic nervous system activity is uncommon when hypertension in defined as above. 3. No correlation between urinary noradrenaline excretion during the day and blood pressure was found in the reference group or in the normotensive group. In the hypertensive group, there was a negative correlation between urinary noradrenaline excretion and blood pressure after rest. This finding might indicate that factors other than sympathetic nervous system activity determine the level of blood pressure in hypertensive subjects. 4. In the hypertensive group, urinary noradrenaline excretion during the day was positively correlated with both urinary sidium excretion during the day and glomerular filtration rate. Urinary noradrenaline excretion per 24 h was positively correlated with urinary sodium excretion during the same time. High resting blood pressure, low urinary sodium excretion, low glomerular filtration rate and a reversed diurnal rhythm of urinary excretion characterized hypertensive patients with low urinary noradrenaline excretion, indicating more severe hypertension in these hypertensive patients with reduced sympathetic nervous system activity.

The Urinary Excretion of Catecholamines and Their Derivatives in Primary Hypertension in Man

“…However, if plasma noradrenaline is elevated in hypertension, an increase in urinary excretion of either free catecholamines or their principal metabolites would be expected. We have been unable to demonstrate such an increase and our findings are supported by similar recent data reported by Berglund, Tibblin & Aurell (1975).…”

Recent pathogenic aspects in essential hypertension and hypertension associated with diabetes mellitus

“…In several more recent studies in which age was considered as a factor, circulating or urinary NE was found to be within the normal range in the large majority of patients with borderline or established essential hypertension [17,20,70,92,94,107,109,110,124,138,186,188] (Fig. 2).…”

Plasma Noradrenaline Concentration in Hypertensive and Normotensive 40-Year-Old Individuals: Relationship to Plasma Renin Concentration

“…-Determination of plasma noradrenaline concentration [noradrenaline] is currently throught to be a useful index of Correspondence: Dr H. Ibsen, Department of Clinical Physiology, Glostrup Hospital, 2600 Glostrup, Denmark. sympathetic nerve activity (Christensen, 1979;Lake, Ziegler, Coleman & Kopin, 1977). Whereas some investigators have found increased plasma [noradrenalinel or increased urinary excretion rate for catecholamines (De Champlain, Farley, Cousineau & Van Ameringen, 1976;DeQuattro, Campese, Miura & Meijer, 1976;Esler, Julius, Zweifler, Randall, Harburg, Gardiner & DeQuatro, 1977) in a sizeable fraction of patients with essential hypertension, others have found completely normal values (Berglund,Tibblin & Aurell, 1975;Lake el al., 1977;Pedersen & Christensen, 1975).…”