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Target Concepts:
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Query: EC:3.4.11.18 (
MAP
)
7,412
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The antihypertensive effect of clonidine has been attributed to acute inhibition of sympathetic outflow from the central nervous system. This conclusion is derived from experiments with single doses of clonidine. The mechanism of the long-term blood pressure-lowering effect of clonidine has been less well characterized. Antihypertensive therapy may alter renal hemodynamics and these changes may ultimately affect systemic blood pressure. We studied the effect of long-term clonidine therapy on intrarenal hemodynamics, the renin-angiotensin system, and selected indices of sympathetic nervous system activity in 13 patients with essential hypertension to further elucidate its action. Long-term clonidine therapy resulted in decreased
MAP
and RVR associated with the suppression of supine but not upright PRA. RPF, RBF, FF, and WBV did not change. UKA, on index of the the putative vasodilating
renal kallikrein
-kinin system, was also not changed. Our findings suggest a role for PRA in modulating RVR during long-term clonidine therapy. This was associated with the reduction observed in
MAP
.
...
PMID:Reduced renovascular resistance by clonidine. 49 99
In twenty-five outpatients with essential hypertension, the relevance of
renal kallikrein
excretion for inter-individual differences in the blood pressure response to changes in dietary sodium intake was investigated. The patients were studied during 2 weeks of high (300 mmol) and 2 weeks of low (50-100 mmol) sodium intake. In addition there were two control periods of normal sodium intake, one lasting 4 weeks at the beginning and one lasting 2 weeks at the end of the study. Blood pressure, body weight and 24 h urinary sodium and kallikrein excretion were measured at the end of all periods. At the end of the first control period, 1 mg furosemide per kg body weight was administered intravenously, and the urinary excretion of kallikrein and sodium were measured 30 and 120 min later. The difference in mean arterial pressure (delta
MAP
) between high and low sodium intake ranged from + 18 to -8 mmHg. The eight patients with a delta
MAP
greater than 10 mmHg were regarded as salt-sensitive. They were older and had a higher initial blood pressure than salt-insensitive patients. For all patients,
urinary kallikrein
excretion at the end of the low sodium period (123(SEM 20.3) micrograms 24 h-1) was significantly higher than at the end of the first control period (96(SEM 16.3) micrograms 24 h-1, P less than 0.01) and at the end of the high sodium period (96(SEM 23.7) micrograms 24(-1), P less than 0.01). When compared with salt-insensitive patients, salt-sensitives had lower levels of
urinary kallikrein
excretion and a blunted kallikrein response to dietary sodium restriction and furosemide.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Is the renal kallikrein system relevant to sodium sensitivity in patients with essential hypertension. 392 10
Factors contributing to the blood pressure (BP) response to changes in dietary sodium intake were studied in 25 patients with essential hypertension (EH). Relevant clinical, biochemical and haemodynamic variables were measured after two weeks on a low sodium diet (LS, 50 mmol) and after two weeks on a high sodium diet (HS, 300 mmol). BP was significantly higher during HS. The difference in mean arterial pressure between HS and LS (delta
MAP
) was taken as a measure of sodium sensitivity. delta
MAP
was directly related to age, initial BP, plasma noradrenaline during HS and changes in forearm vascular resistance. It was indirectly related to plasma aldosterone during LS. No correlation was found with renin or with the excretion of
urinary kallikrein
. It is concluded that sodium sensitivity in EH is related to age and blood pressure and is predominantly mediated by changes in vascular resistance to which aldosterone and adrenergic mechanisms are likely to contribute.
...
PMID:Clinical biochemical and haemodynamic correlates of sodium sensitivity in essential hypertension. 640 Jan 14