The Control of the Blood-Pressure

Present conceptions of the control of the general blood-pressure are based on the view that the sympathetic nerves are only constrictor in action and the circulating hormones, adrenaline and vasopressin, only pressor in effect. Surgical treatment of high blood-pressure and allied conditions has been directed accordingly to the removal of portions of the sympathetic system and to the removal of the suprarenal glands or tumours connected with them. Removal of portions of the sympathetic has been successful in relieving attacks of angina pectoris and removal of suprarenal tumours has relieved paroxysmal hypertension. Neither removal of portions of the sympathetic systems nor removal of the suprarenal glands has been successful in reducing continuous hypertension. It is suggested that our conceptions of the control of the blood-pressure need revision.The normal variation in blood-pressure is not sufficiently realized. It may be as low as 85 mm. or as high as 190 mm. About one in every 40 men has a blood-pressure higher than 160 mm. It is suggested that the diagnosis of essential hypertension should never be made unless it is known that the blood-pressure has been rising. A single observation of a high pressure is not enough for the diagnosis.Evidence is described that adrenaline and vasopressin may lower the blood-pressure as well as cause it to rise; similarly there is evidence that the sympathetic nerve supply to the skeletal muscles is dilator rather than constrictor in effect. Hence, all three mechanisms commonly thought of as pressor may also be depressor, and it seems more accurate to think of them as controlling the blood-pressure by raising or lowering it than simply as factors which raise it.

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Essential hypertension: General considerations and report of results of treatment by extensive resection of sympathetic nerves and partial resection of both suprarenal glands

American Heart Journal ◽

10.1016/s0002-8703(37)91340-1 ◽

1937 ◽

Vol 14 (2) ◽

pp. 250-251

Keyword(s):

Essential Hypertension ◽

Sympathetic Nerves ◽

Partial Resection ◽

Extensive Resection ◽

Results Of Treatment ◽

Suprarenal Glands

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The Role of the Peripheral Sympathetic Nerves and the Adrenal Medulla in Maintaining Blood Pressure of Essential Hypertension

Japanese Circulation Journal ◽

10.1253/jcj.39.591 ◽

1975 ◽

Vol 39 (5) ◽

pp. 591-595 ◽

Cited By ~ 3

Author(s):

KEIICHIRO HONDA ◽

SHIGERU MAEKAWA ◽

TOYOKAZU TAMURA ◽

SHIGEO UCHIYAMA ◽

KENICHI SUZUKI ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Adrenal Medulla ◽

Sympathetic Nerves

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Saphenion®: Oxygen Multi-Step Therapy in Varicose Veins: Improvement of the Microcirculation- Our Prospective Study Results in 118 Cases Over 6 Months

Angiology & Vascular Surgery ◽

10.24966/avs-7397/100075 ◽

2021 ◽

Vol 6 (2) ◽

pp. 1-5

Author(s):

Ulf Thorsten Zierau ◽

Keyword(s):

Blood Pressure ◽

High Pressure ◽

Prospective Study ◽

Skeletal Muscles ◽

Varicose Veins ◽

Human Organism ◽

Cardiac Work ◽

Intellectual Work ◽

Study Results ◽

Step Therapy

Oxygen multi-step therapy for Varicose Veins: Oxygen as an energy carrier, all mechanisms in the human organism during growth, its maintenance and its physical and mental activity require energy. This becomes particularly clear to the patient during cardiac work, breathing work in the lungs, skeletal muscles and intellectual work. The pathology of the microcirculation in the capillaries depends largely on the oxygen partial pressure and on the blood pressure in the supplying arteries and the high pressure in the draining veins.

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Effect of angiotensin II receptor blockade on autonomic nervous system function in patients with essential hypertension

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00885.2005 ◽

2006 ◽

Vol 290 (4) ◽

pp. H1706-H1712 ◽

Cited By ~ 50

Author(s):

Henry Krum ◽

Elisabeth Lambert ◽

Emma Windebank ◽

Duncan J. Campbell ◽

Murray Esler

Keyword(s):

Blood Pressure ◽

Nervous System ◽

Essential Hypertension ◽

Sympathetic Nerves ◽

Whole Body ◽

Sympathetic Outflow ◽

Norepinephrine Release ◽

Sympathetic Nervous ◽

Central Sympathetic Outflow ◽

Norepinephrine Spillover

It has long been proposed that the renin-angiotensin system exerts a stimulatory influence on the sympathetic nervous system, including augmentation of central sympathetic outflow and presynaptic facilitation of norepinephrine release from sympathetic nerves. We tested this proposition in 19 patients with essential hypertension, evaluating whether the angiotensin receptor blockers (ARBs) eprosartan and losartan had identifiable antiadrenergic properties. This was done in a prospective, randomized, three-way placebo-controlled study of crossover design. Patients were randomized to 600 mg of eprosartan daily, 50 mg of losartan daily, or placebo. The treatment period was 4 wk, with 2-wk washout periods. Multiunit firing rates in efferent sympathetic nerves distributed to skeletal muscle vasculature (muscle sympathetic nerve activity, MSNA) were measured with microneurography, testing whether ARBs inhibit central sympathetic outflow. In parallel, isotope dilution methodology was used to measure whole body norepinephrine spillover to plasma. Mean blood pressure on placebo was 151/98 mmHg, with both ARBs causing reductions of ∼11 mmHg systolic and 6 mmHg diastolic pressure, placebo corrected. Both MSNA [35 ± 12 bursts/min (mean ± SD) on placebo] and whole body norepinephrine spillover [366 ± 247 ng/min] were unchanged by ARB administration, indicating that the ARBs did not materially inhibit central sympathetic outflow or act presynaptically to reduce norepinephrine release at existing rates of nerve firing. These findings contrast with the easily demonstrable reduction in sympathetic nervous activity produced by antihypertensive drugs of the imidazoline-binding class, which are known to act within the brain to inhibit sympathetic nervous outflow. We conclude that sympathetic nervous inhibition is not a major component of the blood pressure-lowering action of ARBs in essential hypertension.

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Is Blood Pressure Variability Related to Activity of the Sympathetic System?

Clinical Science ◽

10.1042/cs057217s ◽

1979 ◽

Vol 57 (s5) ◽

pp. 217s-219s ◽

Cited By ~ 27

Author(s):

D. L. Clement ◽

M. M. Mussche ◽

G. Vanhoutte ◽

R. Pannier

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Standard Deviation ◽

Blood Pressure Variability ◽

Plasma Catecholamines ◽

Sympathetic Nerves ◽

Supine Blood Pressure ◽

Sympathetic Function ◽

The Mean ◽

Cold Pressure

1. In 70 patients with untreated essential hypertension, blood pressure variability was correlated to plasma catecholamines and to the response of blood pressure and peripheral flow to cold pressure and handgrip tests. 2. Supine blood pressure was recorded every 5 min, during 3 h. Variability was defined as the standard deviation of the mean of the readings in that period. 3. Blood pressure variability is positively and significantly correlated to the level of pressure and to age. 4. No significant correlation could be found with plasma catecholamines and sympathetic function tests. 5. It is concluded that blood pressure variability is related to the level of pressure but not to activity of the sympathetic nerves.

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