Urinary catecholamines and the relationship with blood pressure and pharmacological therapy.
File(s)
Author(s)
Type
Journal Article
Abstract
OBJECTIVES: Our aim was to assess the importance of the sympathetic nervous system as assessed by urinary catecholamine measurement in the aetiology of essential hypertension and the importance of antihypertensive therapy in the excretion of urinary catecholamines. METHODS: Twenty-four-hour urinary catecholamine measurement was performed in 1925 patients who were referred for treatment of hypertension and grouped according to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure classification: of the 655 untreated patients, 59 were normotensive individuals (SBP < 140 and DBP < 90 mmHg), n = 219 stage 1 (SBP 140-159 or DBP 90-99 mmHg), n = 236 stage 2 (SBP 160-179 or DBP 100-109 mmHg) and n = 141 stage 3 (SBP ≥ 180 or DBP ≥ 110 mmHg). RESULTS: There was a statistically significant positive relationship between 24-h urinary norepinephrine excretion and the severity of hypertension, such that the higher the blood pressure the higher the urinary norepinephrine excretion (mean ± standard error of mean): normotensive group, 221 ± 13 nmol/24 h; stage 1, 254 ± 8 nmol/24 h; stage 2, 263 ± 7 nmol/24 h and stage 3, 296 ± 12 nmol/24 h (P < 0.001). The above relationship remained highly significant when corrected for urinary creatinine, weight, age and sex. No differences were found with urinary epinephrine or dopamine excretion. Urinary norepinephrine excretion was increased in those patients taking single-drug therapy with either a long-acting dihydropyridine calcium antagonist or a β-blocker. CONCLUSION: Our results demonstrate that in untreated hypertensive patients, urinary norepinephrine excretion is increased in proportion to the severity of blood pressure rise and also in patients taking a long-acting dihydropyridine calcium antagonist or a β-blocker. Sympathetic overactivity may play a role in the aetiology and maintenance of essential hypertension.
Date Issued
2016-01-29
Date Acceptance
2015-12-09
Citation
Journal of Hypertension, 2016, 34 (4), pp.704-709
ISSN
1473-5598
Publisher
Lippincott, Williams & Wilkins
Start Page
704
End Page
709
Journal / Book Title
Journal of Hypertension
Volume
34
Issue
4
Copyright Statement
This is the accepted manuscript of the article 'Urinary catecholamines and the relationship with
blood pressure and pharmacological therapy'. The published version can be accessed at https://dx.doi.org/10.1097/HJH.0000000000000843
blood pressure and pharmacological therapy'. The published version can be accessed at https://dx.doi.org/10.1097/HJH.0000000000000843
Subjects
Cardiovascular System & Hematology
1103 Clinical Sciences
1102 Cardiovascular Medicine And Haematology
Publication Status
Published