β-Endorphin in pressor response to hyperventilation in elderly patients with essential and secondary hypertension

• Authors: Fiorella Fontana , Pasquale Bernardi , Carmine Pizzi , Rosanna Toro , Santi Spampinato
• Languages of publication: EN

Abstracts

EN

It has been observed that a distinct blood pressure (BP) response to prolonged and forced hyperventilation in adult patients with essential hypertension is associated with significant changes in plasma catecholamine and β-endorphin levels. This paper investigated whether hemodynamic and neuro-endocrine responses to hyperventilation in elderly patients with essential hypertension (n = 39, mean age 81 ± 3 years) differ from those in elderly patients with secondary hypertension (isolated systolic hypertension, bilateral chronic nephropathy, nephroangiosclerosis, diabetic nephropathy and hyperparathyroidism) (n = 39, mean age 80 ± 1 years). Plasma β-endorphin levels were normal in patients with essential hypertension and increased in patients with secondary hypertension. Plasma norepinephrine levels were normal in both populations. Hyperventilation decreased BP and norepinephrine levels and increased β-endorphin levels in essential hypertensive patients, whereas it did not significantly change BP or neuro-hormonal levels in secondary hypertensive patients. Hierarchical cluster analysis based on BP response to hyperventilation disclosed a sub-group of essential hypertensive patients with the highest basal levels of norepinephrine and the lowest β-endorphin levels, in whom the BP decrease following hyperventilation was correlated with the decrease in norepinephrine and increase in β-endorphin levels. This suggests that b-endorphin may be involved in modulating sympatho-adrenergic activity in elderly patients with essential hypertension.

Keywords

EN

β-Endorphin; Norepinephrine; Hyperventilation; Elderly hypertensive patients

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2008
• Volume: 3
• Issue: 1
• Pages: 55-63

Dates

published

1 - 3 - 2008

online

1 - 3 - 2008

Contributors

author

Fiorella Fontana

• Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Ospedale S. Orsola, Via Massarenti 9, 40138, Bologna, Italy

author

Pasquale Bernardi

• Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Ospedale S. Orsola, Via Massarenti 9, 40138, Bologna, Italy

author

Carmine Pizzi

• Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Ospedale S. Orsola, Via Massarenti 9, 40138, Bologna, Italy

author

Rosanna Toro

• Dipartimento di Farmacologia, Via Irnerio 48, 40126, Bologna, Italy

author

Santi Spampinato

• Dipartimento di Farmacologia, Via Irnerio 48, 40126, Bologna, Italy

References

• [1] Barnes R.F., Raskind M., Gumbrecht G., Halter J.B., The effect of age on the plasma catecholamine response to mental stress in man, J. Clin. Endocrinol. Metab., 1982, 54, 64–69 http://dx.doi.org/10.1210/jcem-54-1-64[Crossref]
• [2] Rowe J.W., Troen B.R., Sympathetic nervous system and aging in man, Endocr. Rev., 1980, 1, 167–178 [Crossref]
• [3] Esler M.D., Thompson J.M., Kaye D.M., Turner A.G., Jennings G.L., Cox H.S., et al., Effects of aging on the responsiveness of the human cardiac sympathetic nerves to stressors, Circulation, 1995, 91, 351–358 [Crossref]
• [4] Rowlands D.B., Stallard T.J., Littler W.A., Comparison of ambulatory blood pressure and cardiovascular reflexes in elderly hypertensives, elderly normotensives and young hypertensives, J. Hypertens., 1983, 1, 71–73
• [5] Cugini P., Lucia P., Di Palma L., Re M., Canova R., Gasparrone L., et al., The circadian rhythm of atrial natriuretic peptide, vasoactive intestinal peptide, beta-endorphin and cortisol in healthy young and elderly subjects, Clin. Auton. Res., 1992, 2, 113–118 http://dx.doi.org/10.1007/BF01819666[Crossref]
• [6] Fontana F., Bernardi P., Spampinato S., Di Toro R., Bugiardini R., β-endorphin modulation of pressor response to hyperventilation in hypertensive patients, Peptides, 2002, 23, 911–918 http://dx.doi.org/10.1016/S0196-9781(02)00018-9[Crossref]
• [7] Zheng X, Zhang T., Ding H., Wang C., Plasma levels of β-endorphin, leucine enkephalin and arginine vasopressin in patients with essential hypertension and the effects of clonidine, Int. J. Cardiol., 1995, 51, 233–244 http://dx.doi.org/10.1016/0167-5273(95)02423-T[Crossref]
• [8] Aronin N., Krieger D.T., Plasma immunoreactive β-endorphin is elevated in uraemia, Clin. Endocrinol., 1983, 18, 459–464 [Crossref]
• [9] Smith R., Grossman A., Gaillard R., Clement-Jones V., Ratter S., Mallinson J., et al., Studies on circulating met-enkephalin and β-endorphin: Normal subjects and patients with renal and adrenal disease, Clin. Endocrinol., 1981, 15, 291–300 [Crossref]
• [10] Chalmers J., Pilowsky P., Brainstem and bulbospinal neurotransmitter systems in the control of blood pressure, J. Hypertens., 1991, 9, 675–694 http://dx.doi.org/10.1097/00004872-199108000-00001[Crossref]
• [11] Gaddis R.R., Dixon W.R., Modulation of peripheral adrenergic neurotransmission by metionine enkephalin, J. Pharmachol. Exp. Ther., 1982, 221, 282–287
• [12] Bernardi P., Fontana F., Merlo Pich E., Spampinato S., Canossa M., Plasma endogenous opioid levels in acute myocardial infarction patients, with and without pain, Eur. Heart. J., 1992, 13, 1074–1079
• [13] Fontana F., Bernardi P., Spampinato S., Boschi S., De Iasio R., Grossi G., Pressor effects of endogenous opioid system during acute episodes of blood pressure increases in hypertensive patients, Hypertension, 1997, 29, 105–110 [Crossref]
• [14] McCubbin J.A., Surwit R.S., Williams R.B. Jr, Endogenous opiate peptides, stress reactivity, and risk for hypertension, Hypertension, 1985, 7, 808–811 [Crossref]
• [15] Fontana F., Bernardi P., Merlo Pich E., Tartuferi L., Boschi S., Spampinato S., Opioid peptide modulation of circulatory response to hyperventilation in humans, Peptides, 2000, 21, 1223–1230 http://dx.doi.org/10.1016/S0196-9781(00)00263-1[Crossref]
• [16] Fontana F., Bernardi P., Lanfranchi G.,. Pisati M.S., Merlo Pich E., Blood pressure response to hyperventilation test reflects daytime pressor profile, Hypertension, 2003, 41, 244–248 http://dx.doi.org/10.1161/01.HYP.0000052315.51182.3D[Crossref]
• [17] Guidelines Subcommittee, 1999 World Health Organization-International Society of Hypertension guidelines for the management of hypertension, J. Hypertens., 1999, 17, 151–183
• [18] Grossi G., Bargossi A.M., Lucarelli C., Paradisi R., Sprovieri C., Sprovieri G., Improvements in automated analysis of catecholamine and related metabolites in biological samples by column switching high-performance liquid chromatography, J. Chromatogr., 1991, 541, 273–284 http://dx.doi.org/10.1016/S0021-9673(01)95999-0[Crossref]
• [19] Fontana F., Bernardi P., Merlo Pich E., Boschi S., De Iasio R, Spampinato S., et al., Opioid peptide modulation of circulatory and endocrine response to mental stress in humans, Peptides, 1997, 18, 169–175 http://dx.doi.org/10.1016/S0196-9781(96)00319-1[Crossref]
• [20] Romesburg C., Cluster analysis for researchers, Lulu press, North Carolina, 2004
• [21] Pfeifer M.A., Weinberg C.R., Cook D., Best J.D., Reenan A., Halter J.B., Differential changes of autonomic nervous system function with age in man, Am. J. Med., 1983, 75, 249–258 http://dx.doi.org/10.1016/0002-9343(83)91201-9[Crossref]
• [22] Matzen S., Secher N.H., Knigge U., Pawelczyk J., Perko G., Iversen H., et al., Effect of serotonin receptor blockade on endocrine and cardiovascular responses to head-up tilt in humans, Acta Physiol. Scand., 1993, 149, 163–176 http://dx.doi.org/10.1111/j.1748-1716.1993.tb09609.x[Crossref]
• [23] Sander-Jensen K., Mehlsen J., Secher N.H., Bach F.W., Bie P., Giese J., et al., Progressive central hypovolaemia in man resulting in a vasovagal syncope? Haemodynamic and endocrine variables during venous tourniquets of the thighs, Clin. Physiol., 1987, 7, 231–242 [Crossref]
• [24] Dubocovich M.L., Langer S.Z., Pharmacological differentiation of presynaptic inhibitory α-adrenoceptors and opiate receptors in the cat nictitating membrane, Br. J. Pharmacol., 1980, 70, 383–388
• [25] Kumakura R,. Guidotti A, Yang H.Y.T., Saiani L., Costa E., A role for the opiate peptides that presumably coexist with acetylcholine in splanchnic nerves, In: Costa E., Trabucchi M. (Eds.), Neural peptides and neuronal communication, Raven Press, New York, 1980
• [26] Catlin D.H., Gorelick D.A., Gerner R.H., Clinical pharmacology of b-endorphin in depression and schizophrenia, In: Verebey K. (Ed.), Opioids in mental illness: theories, clinical observations, and treatment possibilities, Annals of the New York Academy of Sciences, New York, 1982
• [27] Bhattacharyya A., Das P., Hypertension in ederly-an overview, J. Indian Med. Assoc., 1999, 97, 96–101
• [28] Cerasola G., Cottone S., D’Ignoto G., Grasso L., Carone M.B., Sympathetic activity in borderline and established hypertension in the elderly, J. Hypertens., 1988, 6, 55–58 http://dx.doi.org/10.1097/00004872-198801000-00013[Crossref]
• [29] Dluhy R.G., Uncommon forms of secondary hypertension in older patients, Am. J. Hypertens., 1998, 11, 52–56 http://dx.doi.org/10.1016/S0895-7061(98)00011-9[Crossref]
• [30] Sagie A., Larson M.G., Levy D., The natural history of borderline isolated systolic hypertension, N. Engl. J. Med., 1993, 329, 1912–1917 http://dx.doi.org/10.1056/NEJM199312233292602[Crossref]
• [31] Julius S., Valentini M., Consequences of the increased autonomic nervous drive in hypertension, heart failure and diabetes, Blood Press., 1998, 3, 5–13
• [32] Wanke T., Lahrmann H., Auinger M., Merkle M., Formanek D., Ogris E., et al., Endogenous opioid system during inspiratory loading in patients with type I diabetes, Am. Rev. Respir. Dis., 1993, 148, 1335–1340 [Crossref]
• [33] Wanke T., Auinger M., Formanek D., Merkle M., Lahrmann H., Ogris E., et al., Defective endogenous opioid response to exercise in type I diabetic patients, Metabolism, 1996, 45, 137–142 http://dx.doi.org/10.1016/S0026-0495(96)90043-8[Crossref]

Identifiers

DOI

10.2478/s11536-007-0071-x