(Hypertension. 1998;32:972-975.)
© 1998 American Heart Association, Inc.
Scientific Contributions |
Inverse Relationship Between Fenfluramine-Induced Prolactin Release and Blood Pressure in Humans
From the Center for Clinical Pharmacology (M.F.M.) and the Department of Psychiatry (J.M.P., K.A.M.), University of Pittsburgh School of Medicine, Penn; and the Departments of Neuroscience (A.F.S.) and Psychology (J.D.F., S.B.M.), University of Pittsburgh, Penn.
Abstract—Although substantial
evidence from experimental animals suggests that augmentation and
reduction in serotonergic neurotransmission both affect
arterial blood pressure (BP), it is unknown whether
"tonic" central serotonergic activity is related to resting BP
variability in humans. We tested this hypothesis in a community sample
by evaluating the relationship between resting BP and a
neuropharmacologic index of brain serotonergic activity (the
fenfluramine challenge test). Subjects were 270 generally healthy men
and women aged 25 to 60 years who were not receiving prescribed
antihypertensive or psychotropic medications. The sample included 216
non-Hispanic whites and 47 blacks. Resting systolic BP ranged
from 85 to 161 mm Hg and diastolic from 58 to 98
mm Hg. Each subject received 0.55 to 0.65 mg/kg
D,L-fenfluramine hydrochloride, and the plasma prolactin
concentration was measured over 3.5 hours. Analyses revealed a
linear, inverse relationship between the maximum fenfluramine-induced
prolactin rise and systolic and diastolic BP in
whites: r=-0.36 and r=-0.29,
respectively (P<0.001 for both). These relationships
were not observed in the black participants. In whites, the prolactin
response to fenfluramine remained a significant predictor of
systolic and diastolic BPs in
multivariate models including age, gender, body mass
index, physical activity, smoking, and alcohol consumption
(P
0.001). When compared with subjects in the
highest quartile of prolactin response, individuals whose prolactin
responses to fenfluramine comprised the lowest quartile were 2.6 times
more likely to have a resting systolic/diastolic BP
of >135/85 mm Hg. These data reveal that in white but not black
adults, fenfluramine-induced prolactin release correlates inversely
with BP and may indicate a role of central serotonergic activity in the
pathogenesis of hypertension.
Key Words: blood pressure • central nervous system • serotonin • fenfluramine • prolactin
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