(Hypertension. 1997;30:1471-1478.)
© 1997 American Heart Association, Inc.
Articles |
From the Smooth Muscle Research Programme and Department of Anaesthesia, McMaster University, Hamilton, Ontario, Canada.
Correspondence to Dr R.M.K.W. Lee, Department of Anaesthesia (HSC-2U3), McMaster University, 1200 Main St West, Hamilton, Ontario, Canada L8N 3Z5.
| Abstract |
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Key Words: L-158,809 artery reactivity artery structure morphometry
| Introduction |
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The aim of this study was to assess the effects of chronic blockade of AT1 receptors on the development of hypertension, vascular and cardiac structure, and vascular reactivity, with treatment initiated in young SHR and WKY. We hypothesized that if angiotensin II is a major factor in the development of hypertension, early blockade of the AT1 receptors would result in the permanent attenuation of hypertension, possibly through its effects on the these cardiovascular parameters. The AT1 antagonist that we have used in this study (L-158,809) is 30 times more potent than losartan (PO dosing) in rats.7 We have shown previously that L-158,809 treatment of adult SHR at a dose of 0.6 mg/kg maximally lowered the SHR BP, an effect that was partially persistent on withdrawal of the L-158,809.8
| Methods |
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Study Design
Forty each of male SHR and WKY were obtained from the McMaster
University colonies that originated from the Charles River strains.
Through inbreeding we have maintained the SHR colony since 1976 and the
WKY colony since 1983. After weaning, the rats were kept under a
12-hour light/dark cycle. Food and water were constantly accessible.
Daily L-158,809 treatment of SHR and WKY began at 3 weeks of age.
Treatment was given by gavage for 12 weeks until the animals reached 15
weeks of age. At 15 weeks of age, half of the animals in the SHR and
WKY control and SHR and WKY treated groups were killed and used for
experiments. The other half were monitored for a further 10-week
treatment withdrawal period. The care of these animals was in
accordance with the guidelines of the Canadian Council on Animal
Care.
Treatment with the AT1 receptor antagonist L-158,809 (tetrazolic acid monohydrate, Merck Research Laboratories) was carried out at a dose of 0.6 mg · kg-1 · d-1. L-158,809 was dissolved in a saturated NaHCO3 solution and then diluted with 0.5% methyl cellulose. The control groups received the vehicle alone at 0.2 mL/100 g body wt/d. Body weight was measured daily for the calculation of the treatment dose.
Systolic BP was measured weekly by the tail-cuff compression method (model PE300, Narco Bio-Systems) for the duration of the treatment and withdrawal periods.
Preparation of Animals and Sampling of the Tissues
The rats were anaesthetized with sodium pentobarbital (45 mg/kg
IP) (MTC Pharmaceuticals). The kidneys and heart were removed and
weighed. To obtain the dry weight, the left kidney was dried in a
40°C oven, then reweighed.
Reactivity Experiments
Reactivity experiments were carried out using the pressure
myograph system previously described by Smeda,9 similar to
that used by Osol and Halpern.10 This system allowed the
measurement of the lumen alterations of the large mesenteric artery
(first branch from the superior mesenteric artery), in response to
pressure changes, chemical stimulations, or electrical stimulations
(via two electrodes surrounding the artery, connected to a stimulator,
model S48, Grass Medical Instruments). The artery was viewed through a
microscope (model M3C, Leica), observed as a transparent image with the
lumen visible. Alterations in lumen diameter were recorded via a
video camera connected to a video recorder. The images were
measured when played back on a television monitor.
Arterial reactivity was measured in response to a 20-Hz stimulation at a 10-second train of monophasic 0.85-ms pulses at 150 mV, with 20 mm Hg incremental steps of TMP from 20 to 140 mm Hg. Then, reactivity was measured in response to increasing stimulation frequencies (2 to 20 Hz) with a constant TMP of 100 mm Hg. The response of the arteries to a 20-Hz stimulation at 60 mm Hg TMP in the presence or absence of 10-8 mol/L angiotensin II was also measured. On separate arteries, concentration-response curves to NE were constructed in the presence of propranolol (3 µmol/L) and desipramine (1 µmol/L) to block ß-adrenoceptorinduced stimulations and neuronal reuptake of NE, respectively. Response to 100 mmol/L KCl was used as 100%, and the response to NE was normalized to KCl response.
Morphometry
Morphometric measurements on large mesenteric
(first-order) arteries were made using two techniques.1
Wall thickness and lumen diameters were measured during the reactivity
experiments at TMPs of 20 and 100 mm Hg. When this technique was
used, it was impossible to define the boundary between the media and
adventitia layers due to limited resolution, so that wall thickness was
measured.2 Wall, media, and lumen cross-sectional areas
(CSA) and SMC layers were measured from the tracings of
perfusion-fixed, maximally dilated arteries, as described
previously.11 These arteries were fixed under low pressure
(
20 mm Hg) and flow (1 mL/min per 100 g body wt)
conditions, and prepared for light microscopy as previously
reported.11 CSA measurements were made by tracing the image
of the cross section on a digitizing board (GraphicMaster, Labtronics).
Lumen diameter and media thickness were calculated from the CSA using
the equation area=
r2.
Statistical Analyses
Values are expressed as mean±SEM. Statistical analysis
was performed using the SigmaStat program (Jandel Scientific). For
multiple comparisons of three or more groups of data, one-way ANOVA and
the Student-Neuman-Keuls multiple comparisons test were used. For
repeated multiple comparisons, a two-way ANOVA with repeated measures
was used. Two-tailed Student's t tests were used to compare
two individual groups. Results were considered significant at
P<.05.
| Results |
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The body weights of SHR and WKY were similar at the beginning of the
treatment. Both treated and control SHR showed faster growth than WKY,
so that overall the body weights of both SHR groups were higher than
those of the WKY groups (Fig 1B
). Treatment with L-158,809 did not
affect the body weight of SHR or WKY. However, treatment significantly
lowered the heart weight of SHR and WKY as compared with control SHR
and WKY (Table 1
). After treatment
withdrawal there were no differences in the heart weights between the
control and treated SHR or WKY. L-158,809 treatment or
treatment-withdrawal did not affect the wet weight or the dry weight of
the kidneys in either SHR or WKY (data not shown). There was no
difference in wet-to-dry weight ratio of the kidneys among the treated
and control SHR and WKY, indicating that there was no tissue edema
(Table 1
).
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Morphometry
At a TMP of 100 mm Hg, lumen diameter was similar among the
arteries from treated and control SHR and WKY at 15 or 25 weeks of age,
except in arteries from treatment withdrawn SHR, which had a larger
lumen at 25 weeks than the treated SHR at 15 weeks (Table 2
). Wall thickness and w/l ratio values
were higher in control SHR than the other three groups after the
treatment period (15 weeks of age). Unlike the SHR, in WKY L-158,809
treatment did not affect the lumen, wall thickness, or w/l ratio.
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After the withdrawal period, control SHR arteries still had thicker
walls than control and treatment-withdrawn WKY arteries but not
treatment-withdrawn SHR, because of the increase in the wall thickness
in these SHR at 25 weeks as compared with 15 weeks (Table 2
).
Nevertheless, for the w/l ratio, the control SHR ratio remained higher
than the treatment-withdrawn SHR ratio because of an increase in the
lumen size from 15 to 25 weeks. Control SHR w/l ratio was also higher
than both WKY groups' ratios. A positive correlation was found between
wall thickness and BP (r=.9787, P<.0001), and
w/l and BP (r=.9423, P=.0005) among the 8 groups
of rats (Fig 2
).
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Values from morphometric measurements of the perfusion-fixed arteries
under maximal relaxation again showed no significant difference in
lumen size between control and treated SHR at 15 or 25 weeks of age
(Table 3
). Lumen size of the treated WKY
at both 15 and 25 weeks was significantly larger than the age-matched
control WKY. Control SHR medial layer CSA was larger than control WKY
at 15 and 25 weeks. Treatment did not alter the medial layer CSA of SHR
or WKY, at 15 or at 25 weeks of age. Media-to-lumen ratios (m/l) were
significantly higher in control SHR as compared with the age-matched
WKY, at both 15 and 25 weeks. Treatment of SHR or WKY did not affect
the m/l ratio at 15 weeks of age. However, at 25 weeks of age, the m/l
ratio was smaller in treatment-withdrawn SHR and WKY than in the
control animals. A positive correlation existed between medial CSA and
BP (r=.7494, P<.03) and between m/l ratio and BP
(r=.9047, P=.002) among the 8 groups of rats.
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When calculated as linear dimensions, the lumen diameter of the control
SHR was similar to that of control WKY at 15 and 25 weeks of age (Table 3
). Treatment did not affect the SHR lumen diameter but affected the
lumen diameter in treated WKY at 15 and 25 weeks. Wall thickness and
w/l ratio were higher in control SHR than in control WKY at 15 and 25
weeks. Neither the treatment nor the treatment withdrawal altered the
wall thickness or w/l ratio of SHR; however, w/l ratio was decreased in
the treatment-withdrawn WKY compared with control WKY.
The number of SMC layers was always higher in the SHR than WKY arteries at 15 and 25 weeks of age. Treatment with L-158,809 did not affect the number of SMC layers in the arteries from SHR or WKY. There was an age-related increase in the number of SMC layers in the WKY in both control and treatment-withdrawn WKY.
In comparison to the linear dimensions calculated for arteries measured
after perfusion fixation, the linear dimensions measured during
reactivity experiments (20 mm Hg TMP), showed no differences
among the lumen diameters of the 8 groups (Table 3
). The vessel wall
from control SHR was thicker than that from control WKY at 15 and 25
weeks. Values for w/l ratio were smaller in WKY than in SHR in both age
groups. Treatment did not alter the wall thickness or w/l ratio of
arteries from SHR or WKY at 15 and 25 weeks.
Reactivity Studies
In response to a 20-Hz stimulation, mesenteric arteries from
15-week-old control SHR showed significantly greater contraction than
treated SHR arteries at TMPs greater than 80 mm Hg, and they also
generated more contraction than WKY arteries at almost all TMPs tested
(Fig 3A
). After the treatment withdrawal
period, arteries from the 25-week-old control SHR still contracted more
than those from treatment-withdrawn SHR at TMPs greater than 80
mm Hg, and more than WKY at TMPs greater than 60 mm Hg (Fig 3B
).
When the resultant lumen diameters were compared, lumen diameters of
control SHR arteries were smaller than those of WKY at pressures
greater than 20 mm Hg at 15 and 25 weeks; smaller than those of
treated SHR at pressures greater than 60 mm Hg at 15 weeks (Fig 4A
), and smaller than those of treated
SHR at pressures greater than 80 mm Hg at 25 weeks (Fig 4B
).
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At a TMP of 100 mm Hg, mesenteric arteries from SHR and WKY
showed a linear contractile response to increasing frequencies of
electrical stimulation (Fig 5
). At 15
weeks and 25 weeks, control SHR arteries contracted more than treated
SHR arteries at frequencies greater than 8 Hz. WKY arteries contracted
less than control SHR arteries at frequencies greater than 8 Hz at 15
weeks (Fig 5A
) and at all frequencies at 25 weeks (Fig 5B
). All of
these stimulated contractions could be blocked by tetrodotoxin.
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The arteries from control and treated SHR and WKY showed similar
NE concentration dose-response curves at 15 weeks (Fig 6A
) and 25 weeks (Fig 6B
). The calculated
EC50 values at 15 weeks were similar in the control and
treated SHR (4.9±0.9x10-5 and
5.5±3.5x10-5 mol/L, respectively) and WKY
(1.1±1.0x10-4 and 7.7±6.7x10-5 mol/L). At
25 weeks, EC50 values were similar between control and
treated SHR (2.1±0.5x10-5 and
1.7±0.6x10-5 mol/L, respectively) and between control
and treated WKY (2.7±1.1x10-5 and
1.4±0.3x10-5 mol/L, respectively). There was no
difference between control and treated SHR or WKY at 15 or 25
weeks.
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After the treatment-withdrawal period, contractility of
the mesenteric arteries from the 25-week-old control SHR and WKY in
response to a 20-Hz stimulation was significantly enhanced in the
presence of angiotensin II (Fig 7
). This potentiation effect of
angiotensin II was not found in arteries from treated SHR
and WKY.
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| Discussion |
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Treatment Effects on BP Level
The level of BP control in the SHR obtained with L-158,809
treatment in this study was similar to the level observed with
losartan treatment in young animals2 (31% and 32%
reduction in BP, respectively) and was better than L-158,809 treatment
initiated in adult SHR with established hypertension (24%
reduction).8 However, the level of BP reduction after
withdrawal of the treatment was similar (17% to 18%, 10 to 17 weeks
after treatment withdrawal), regardless of whether treatment was
initiated in young (see Reference 22 and this study) or adult
SHR.8 These results indicate that better BP control can be
achieved during the treatment period with an AT1-receptor
antagonist when treatment is initiated in young SHR before
the development of hypertension, but early treatment is not more
beneficial than treatment of adult SHR with regard to the persistence
of BP reduction after treatment withdrawal.
The fact that the BP of both SHR and WKY was lowered by the L-158,809 treatment highlights the involvement of the AT1 receptors in normal BP regulation in these animals. Because of this, and because early AT1-antagonist treatment did not permanently prevent the development of hypertension, the action of angiotensin II on AT1 receptors is not likely the primary initiator of hypertension development in SHR. Nevertheless, treatment with L-158,809 did attenuate the level of BP rise after withdrawal of the treatment in SHR, suggesting that persistent changes in BP homeostasis were induced by the treatment in these rats. Our results indicate that some of these changes are related to the changes in the arteries as discussed below.
Treatment Effects on Arterial Structure and
Function
Prehypertensive SHR (3 to 4 weeks of age) have an increased
arterial media mass and an increased number of SMC layers
when compared with WKY arteries, but BP is similar to that in
age-matched WKY.12 13 These changes contribute to the
ability of these arteries to produce more contraction when challenged
with agonists and electrical field stimulation, and also to withstand a
higher TMP than arteries from WKY.13 As these changes occur
before the increase in BP in SHR, it can be concluded that increased BP
level is not a mechanism contributing to these artery structural
changes. Vascular dimensions measured in perfusion-fixed arteries
at maximal relaxation showed that the SHR arteries had a thicker wall
and a higher m/l ratio than the WKY arteries, as was expected. However,
treatment with L-158,809 did not alter these parameters or
the number of SMC layers, indicating that activation of the
AT1 receptor is also not an important mechanism
contributing to these artery structural changes, as blockade of the
receptor did not reverse these changes. However, the fact that the
structure of the arteries did not change with treatment does not mean
that the arteries were not affected by the treatment. For this reason,
it is important to consider the functional reactivity of these arteries
in order to understand the significance of the changes that did occur
in these arteries with L-158,809 treatment. We therefore also studied
these arteries in vitro to look at the vascular dimensions under
pressure and also the contractile responses of these arteries.
Measurements made using the pressurized myograph system showed again
that under low TMP conditions (20 mm Hg) no structural
differences were observed between the arteries from treated and those
from control animals, similar to what was observed with the in situ
measurement method. However, in vascular measurements made at 100
mm Hg TMP, the w/l ratio was reduced in the treated SHR as compared
with control SHR, indicating that L-158,809 treatment had indeed caused
some alterations of the SHR arteries. This was a persistent change as
it was also observed 10 weeks after treatment withdrawal.
The wall thickness and w/l ratio both correlated positively and significantly with the BP levels after the treatment and withdrawal periods, which is consistent with previous observations made after chronic losartan treatment of young SHR.2 However, the change in structure observed with this technique was due to functional changes of the arteries, as the arteries from treated SHR tended to yield to higher pressures than control SHR. Part of this change may have been due to the preservation of endothelial cell function in the treated SHR so that the endothelial cells released endothelium-derived relaxing factor when stimulated by high pressure, therefore causing relaxation. This hypothesis is consistent with the recent finding that 12 weeks of treatment with losartan enhanced endothelium-dependent relaxation and abolished acetylcholine-induced endothelium-dependent contraction of small arteries from SHR.14
The functional correlate of the reduction in the w/l ratio due to treatment with L-158,809 in the SHR and WKY arteries is in the reactivity responses of these arteries. Electrical stimulation at higher TMP caused arteries from control SHR to contract more than those from treated SHR. The greater level of contraction corresponded to a significantly smaller lumen size in the control SHR arteries. This response was also observed after the treatment-withdrawal period, indicating the persistence of this treatment effect and suggesting that a persistent reactivity change in the arteries had been invoked by the L-158,809 treatment. Such an effect was not seen in response to stimulation by NE, suggesting a presynaptic site for this reactivity change. We believe that these presynaptic changes are related to the functional maturation of the innervation of these arteries as discussed below.
We have shown recently that in neonatal SHR arteries there is a delay in the maturation between the interaction of sympathetic innervation and vascular smooth muscle when compared with WKY arteries.13 At 3 weeks of age, nerve-evoked vascular response in the SHR was minimal or absent as compared with age-matched WKY, despite the presence of a hypertrophied medial wall.13 It is therefore possible that treatment of young SHR with L-158,809 may have prolonged this delay in the maturation of nerve-muscle interaction, which resulted in a reduced nerve-stimulated response. Support for this hypothesis also stems from the fact that persistent changes in WKY arterial reactivity did not occur with L-158,809 treatment, presumably due to the more advanced maturation of the nerve-muscle interaction in WKY arteries, which existed at the initiation of treatment. Likewise, adult SHR also did not show altered arterial reactivity in response to L-158,809 treatment,8 indicating that treatment must be initiated during the development of nerve-muscle interactions in order to induce changes in the arterial reactivity.
Another effect on arterial function induced by AT1-receptor antagonist treatment was the permanent inhibition of the potentiating effects of angiotensin II on sympathetic nerve function. The potentiating effect of angiotensin II on vascular functions is well documented.15 16 17 It is postulated that angiotensin II acts presynaptically to enhance NE release.15 18 19 We have reported previously that treatment of adult SHR with L-158,809 for 12 weeks abolished the potentiating effects of angiotensin II to nerve-stimulated responses.8 In this study we have extended this observation by finding that the interference with the potentiating effect of angiotensin II on nerve-stimulated response due to treatment with L-158,809 was persistent, because the effect was still present in treated SHR and WKY 10 weeks after withdrawal of the treatment. The cause of this treatment effect is unknown. It is possible that chronic inhibition of AT1 receptors at the presynaptic site has contributed to this persistent effect.
Treatment Effects on the Heart
In this study we found that treatment of young SHR with L-158,809
reduced the weight of the heart but not the body weight. The regression
of left ventricular hypertrophy with
antihypertensive therapy is well documented.2 3 20 Chronic
treatment of young SHR with losartan was reported to cause a
reduction in body weight,2 although treatment with D 8731
did not.1 Losartan may have nonspecific effects in
addition to AT1 blockade that caused this alteration in
body weight.
Consideration of the Methods
In this study vascular dimensions were measured using two
different techniques, which yielded different results. Vessels fixed in
situ by perfusion fixation experienced a low perfusion pressure (15 to
24 mm Hg) and are fixed in a maximally relaxed
condition.11 12 Under these conditions, vascular wall
dimensions represent the basal, unstimulated state of the
vessels. Results obtained using this technique have
consistently shown structural changes in the large mesenteric
arteries of various animal models of human essential hypertension,
typified by an increase in the medial wall area and m/l ratio. In some
models such as SHR, an increased number of SMC layers is also
observed.6 In this study we found that L-158,809 treatment
did not affect the CSA, medial thickness, or the number of SMC layers
in the SHR when measured at maximal dilation, indicating that the
treatment had minimal effect on the structure of the vessel wall. This
is consistent with the vascular dimensions measured using the
functional technique at a TMP of 20 mm Hg. However, as this low
TMP level is nonphysiological, it is not possible
to use these morphological results to predict the reactivity of these
vessels under physiological situations. Our
functional experiment results indeed showed that at a low TMP (20
mm Hg), there were no differences in arterial reactivity
between treated and control SHR in response to electrical stimulation.
At higher TMP levels, the contractile response of the arteries from
treated SHR was less than control SHR, suggesting functional alteration
of the treated SHR arteries. Likewise, the vascular wall dimensions
measured at a higher TMP (100 mm Hg) showed significant
differences between the control and treated SHR arteries in both wall
thickness and w/l ratio.
Although the observed changes are indicative of the functional manifestation of the arterial changes, there may be an inherent distortion of vascular dimensions because of the technique. In vessels fixed in situ by perfusion fixation, no change in the axial or radial dimensions of the arteries was observed (Dickhout and Lee, unpublished results, 1997). In contrast, in vessels pressurized using the blind-sac preparation, there is always a change in the axial length of the vessels with pressurization, affecting the arterial wall thickness.21 Since arteries from treated SHR yielded more under pressure, which translates to a reduced ability to contract against higher pressure when stimulated, it is likely that the difference in wall thickness between arteries from control and treated SHR measured at 100 mm Hg was due to the relative increases in axial length of the arteries in response to pressure. It is clear that each measurement method provides a different type of information about these arteries and that each method has its inherent merits and pitfalls. Therefore, it is important to take these factors into consideration when relating findings on structural changes to artery function.
In conclusion, we have shown that treatment with the AT1 receptor antagonist L-158,809 prevented hypertension during the treatment period and reduced the severity of hypertension development after withdrawal of the treatment. However, the effect of such a treatment is likely due to the blockade of a major BP regulator (ie, angiotensin II) and not due to the blockade of an early hypertension initiator. The antihypertensive effect of chronic AT1-receptor blockade was associated with a persistent decrease in the reactivity of the SHR arteries, which may have contributed to the persistently lower BP levels on withdrawal of the treatment.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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Received April 8, 1997; first decision May 5, 1997; accepted June 18, 1997.
| References |
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