Zusammenfassung
Bei 31 Normalpersonen und 37 Patienten mit essentieller Hypertonie wurden die Beziehungen zwischen Alter, der kardiovaskulären Reaktivität gegenüber intravenös infundiertem Noradrenalin (NA) und Angiotensin II, sowie den Plasmaspiegeln von NA und Renin (PRA) untersucht. Bei den Normalpersonen nahmen sowohl die Angiotensin II-Pressor-Dosis als auch PRA mit zunehmendem Alter ab. Die Angiotensin II-Pressor-Dosis korrelierte positiv mit PRA (r=0.41,P<0.025) und negativ mit dem Alter (r=−0.46,P<0.02). Die NA-Pressor-Dosis und der basale NA-Blutspiegel korrelierten ebenfalls positiv miteinander (r=0.53,P<0.005), doch zeigten diese beiden Faktoren keine wesentliche Altersabhängigkeit. Bei der essentiellen Hypertonie ergaben sich zum Teil andere Befunde. Die Angiotensin II-Pressor-Dosis korrelierte weder mit der basalen PRA noch mit dem Alter; und die Pressor-Dosen sowohl von NA wie auch von Angiotensin II waren bei den Hypertonikern eher niedriger als bei Normalpersonen. Unsere Befunde zeigen, daß der Altersprozeß von einer physiologischen Abnahme der kardiovaskulären Reaktivität gegenüber Angiotensin II begleitet ist, wahrscheinlich als Folge einer parallelen Abnahme der PRA. Die Dissoziation zwischen Angiotensin II-Pressor-Dosis und PRA bei der essentiellen Hypertonie weist auf einen wichtigen Einfluß eines zusätzlichen Faktors auf dieses System hin.
Summary
The interrelationships among age, cardiovascular pressor reactivity to intravenously infused norepinephrine (NE) or angiotensin II, and endogenous plasma NE or renin (PRA) levels were evaluated in 31 normal subjects and 37 patients with essential hypertension. In normal subjects both angiotensin II pressor dose and PRA decreased progressively with aging. Angiotensin pressor dose correlated positively with PRA (r=0.41,P<0.025) and inversely with age (r=−0.46,P<0.02). NE pressor dose and basal plasma NE were also positively correlated (r=0.53,P<0.005), but the two factors remained largely unchanged with aging. Findings in essential hypertension differed in certain aspects. Angiotensin II pressor dose did not correlate with either basal PRA or age; and pressor doses of NE and angiotensin II tended to be lower in some patients than in normal subjects. These findings indicate that aging is accompanied by a physiologic increase in cardiovascular reactivity to angiotensin II, probably due to a concomitant decrease in circulating renin. The dissociation between angiotensin pressor dose and PRA in essential hypertension suggests an interference from an other factor.
This is a preview of subscription content, log in via an institution to check access.
References
Aurell M, Pettersson M, Berglund G (1975) Renin-angiotensin-system in essential hypertension. Lancet 2:342–345
Da Prada M, Zürcher G (1976) Simultaneous radioenzymatic determination of plasma and tissue adrenaline, noradrenaline and dopamine within the femtomole range. Life Sci 19:1161–1174
Doyle AE, Fraser JRE. Marshall RJ (1959) Reactivity of forearm vessels to vasoconstrictor substances in hypertensive and normotensive subjects. Clin Sci 18:441–454
Folkow B (1978) Cardiovascular structural adaptation; its role in the initiation and maintenance of primary hypertension. Clin Sci Mol Med 55:3s-22s
Frolkis VV, Bezrukov VV, Bogatskaya LN, Verkhratsky NS, Zamostian VP, Shevtchuk VG, Shtchegoleva IV (1970) Catecholamines in the metabolism and functions regulation in aging. Gerontologia 16:129–140
Goldenberg M, Pines KL, Baldwin E, Greene DG, Roh CE (1948) The hemodynamic response of man to norepinephrine and epinephrine and its relation to the problem of hypertension. Am J Med 5:792–806
Gribbin B, Pickering TG, Sleight P, Peto R (1971) Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res 29:424–431
Hoffmann H, Kiesewetter R, Krohs G, Schmitz C (1975) Zur Altersabhängigkeit von Katecholaminwirkungen beim Menschen. Einfluß von Noradrenalin, Adrenalin und Isoprenalin auf den Blutdruck und die Herzfrequenz. Inn Med 30:89–95
Hruza Z, Zweifach BW (1967) Effect of age on vascular reactivity to catecholamines in rats. J Geront 22:469–473
Julius S (1978) Borderline hypertension: Clinical and pathophysiologic significance. Adv Int Med Ped 41:52–84
Kaplan NM, Silah JG (1964) The effect of angiotensin II on the blood pressure in humans with hypertensive disease. J Clin Invest 43:659–669
Kosegarten DC, De Feo JJ, De Fanti DR (1972) The effect of age on vascular reactivity to norepinephrine in the rat. Pharmacol 31:1846 [Abstr]
Kowarski A, Katz H, Migeon CJ (1974) Plasma aldosterone concentration in normal subjects from infancy to adulthood. J Clin Endocrinol Metab 38:489–491
Lake CR, Ziegler MD, Coleman MD, Kopin IJ (1977) Age-adjusted plasma norepinephrine levels are similar in normotensive and hypertensive subjects. N Engl J Med 296:208–209
Mendlowitz M (1973) Vascular reactivity in systemic arterial hypertension. Am Heart J 85:252–259
Pedersen EB, Christensen NJ (1975) Catecholamines in plasma and urine in patients with essential hypertension determined by double-isotope derivative technique. Acta Med Scand 198:373–377
Philipp TH, Distler A, Cordes U (1978) Sympathetic nervous system and blood pressure control in essential hypertension. Lancet 2:959–963
Sambhi MP, Crane MG, Genest J (1973) Essential hypertension: New concepts about mechanisms. Ann Intern Med 79:411–424
Sealey JE, Gerten-Banes J, Laragh JH (1972) The renin system: Variations in man measured by radioimmunoassay or bioassay. Kidney Int 1:240–253
Silah JG, Strong CG, Nowaczynski D, Genest J (1967) The angiotensin infusion test and peripheral venous renin activity. Can Med Ass J 96:1397–1400
Tuttle RS (1966) Age-related changes in the sensitivity of rat aortic strips to norepinephrine and associated chemical and structural alterations. J Gerontol 21:510–516
Weidmann P, Endres P, Siegenthaler W (1968) Plasma renin activity and angiotensin pressor dose in hypertension. Correlation and diagnostic implications. Br Med J 3:154–156
Weidmann P, De Myttenaere-Bursztein S, Maxwell MH, De Lima J (1975) Effect of aging on plasma renin and aldosterone in normal man. Kidney Int 8:325–333
Weidmann P, De Châtel R, Schiffmann A, Bachmann E, Beretta-Piccoli C, Reubi FC, Ziegler WH, Vetter W (1977) Interrelations between age and plasma renin, aldosterone and cortisol, urinary catecholamines and the body sodium-volume state in normal man. Klin Wochenschr 55:725–733
Weidmann P, Beretta-Piccoli C, Ziegler WH, Keusch G, Glück Z, Reubi FC (1978) Age versus urinary sodium for judging renin, aldosterone and catecholamine levels. Kidney Int 14:619–628
Weidmann P, Beretta-Piccoli C, Keusch G, Glück Z, Mujagic M, Grimm M, Meier A, Ziegler WH (1979) Sodium-volume factor, cardiovascular sensitivity and hypotensive mechanism of diuretic therapy in mild hypertension associated with diabetes mellitus. Am J Med 67:779–784
Weidmann P, Grimm M, Meier A, Glück Z, Keusch G, Minder I, Beretta-Piccoli C (1979) Pathogenic and therapeutic significance of cardiovascular pressor reactivity as related to plasma catecholamines in borderline and established essential hypertension. Clin Exp Hypertension (in press)
Author information
Authors and Affiliations
Additional information
This work was supported by the Swiss National Science Foundation
Rights and permissions
About this article
Cite this article
Meier, A., Gübelin, U., Weidmann, P. et al. Age-related profile of cardiovascular reactivity to norepinephrine and angiotensin II in normal and hypertensive man. Klin Wochenschr 58, 1183–1188 (1980). https://doi.org/10.1007/BF01478874
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01478874