Adrenaline facilitates neurogenic vasoconstriction in borderline hypertensive subjects


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Abstract

Adrenaline facilitates the neural release of endogenous noradrenaline by stimulating prejunctional β-receptors on adrenergic nerve endings. Recently, we demonstrated the functional significance of this action in the control of vascular resistance in young subjects with normal blood pressure. In the present study, we tested the hypothesis that the effects of adrenaline on neurogenic vasoconstriction are exaggerated in humans with borderline hypertension. Forearm blood flow was measured simultaneously in the experimental and contralateral arms of seven young men with borderline hypertension. We compared forearm vasoconstrictor responses to a reflex stimulus to noradrenaline release (lower-body negative pressure, LBNP) and to intra-arterial infusion of noradrenaline before and 30min after brachial artery infusion of adrenaline (50ng/min). These doses had no systemic effects. In the experimental arm, the vasoconstrictor response to LBNP was 65% greater 30min after the adrenaline infusion (P=0.075), whereas the response to intra-arterial noradrenaline decreased by 36% (P>0.1). Forearm vascular responses to LBNP in the contralateral control arm that did not receive adrenaline were similar before and after the adrenaline infusion. The ratio of forearm vasoconstrictor responses (i.e. the increase in forearm vascular resistance) with LBNP to the forearm vasoconstrictor response to noradrenaline in the experimental arm was used as an index of neural release of the neurotransmitter noradrenaline. This ratio increased from 0.8 to 2.1 (P<0.05) after the adrenaline infusion. These facilitatory neural after-effects of adrenaline were similar in magnitude to our previous observation in young normotensive subjects [1]. These experiments indicate that adrenaline has sustained facilitatory effects on neurogenic vasoconstriction that may be related to its neural uptake and subsequent release. However, these facilitatory effects of adrenaline on peripheral adrenergic mechanisms are not exaggerated in borderline hypertension.

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