This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carvalho, M. J. Articles by de Freitas, A. F. Search for Related Content PubMed PubMed Citation Articles by Carvalho, M. J. Articles by de Freitas, A. F. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CYCLOSPORIN A Related Collections Cardio-renal physiology/pathophysiology Cardiovascular Pharmacology

(Hypertension. 1999;34:102-106.)
© 1999 American Heart Association, Inc.

Scientific Contribution

Role of Sympathetic Nervous System in Cyclosporine-Induced Rise in Blood Pressure

Mario J. Carvalho; Anton H. van den Meiracker; Frans Boomsma; Joao Freitas; Arie J. Man in `t Veld; Ovidio Costa; Antonio Falcão de Freitas

From the Centro de Estudos de Função Autonomica, Hospital S. Joao, Oporto Medical School, Oporto (M.J.C., J.F., O.C., A.F.), Portugal, and the Department of Internal Medicine I, University Hospital Dijkzigt, Erasmus University, Rotterdam (A.H.M., F.B., A.J.M.), The Netherlands.

Correspondence to Dr A.H. van den Meiracker, Department of Internal Medicine I, University Hospital Dijkzigt, Room L253, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. E-mail meirack.{at}mediaport.org

Abstract—To clarify the role of the sympathetic nervous system in the development of cyclosporine A (CsA)-induced rise in blood pressure (BP), the effects of CsA on 24-hour ambulatory BP (ABP) were studied in patients with familial amyloid polyneuropathy (FAP) who underwent a liver transplantation. On the basis of autonomic function tests, patients with absent or mild-to-moderate sympathetic damage (Group A, n=11, age 29 to 43 years, disease duration 2 to 6 years) and patients with severe sympathetic damage (Group B, n=9, age 27 to 38 years, disease duration 3 to 9 years) were identified. Both groups were followed for 1 year. The daily doses of CsA and the CsA whole blood trough levels between the groups did not differ. Pretransplantation values of daytime and nighttime ABP were, respectively, 117±8/76±7 mm Hg and 108±12/68±9 mm Hg in group A and 107±6/66±4 mm Hg (P<0.05 group A versus group B) and 102±6/62±4 mm Hg in group B. In response to CsA, BP increased in all patients, but more so in patients of group B than in patients of group A. One year after transplantation, daytime and nighttime ABP had increased by 6±9/3±11% and 12±10/14±14% in group A and by 12±6/13±10% (P<0.05) and 21±11/27±21% (P<0.01) in group B. In both groups, the increase in nighttime ABP was greater than the increase in daytime ABP, which resulted in an attenuation or, even, a reversal of the diurnal BP rhythm. Because the rise in BP was greater in patients with more advanced sympathetic dysfunction, the sympathetic nervous system appears to counteract the CsA-induced rise in BP rather than causing it. This implies involvement of factors other than sympathetic activation in the pathogenesis of CsA-induced rise in BP in patients with familial amyloid polyneuropathy.

Key Words: amyloid neuropathies • cyclosporine • blood pressure monitoring, ambulatory • transplantation, liver

This article has been cited by other articles:

				G. LIGTENBERG, R. J. HENÉ, P. J. BLANKESTIJN, and H. A. KOOMANS Cardiovascular Risk Factors in Renal Transplant Patients: Cyclosporin A Versus Tacrolimus J. Am. Soc. Nephrol., February 1, 2001; 12(2): 368 - 373. [Abstract] [Full Text]

				M. J. Carvalho, A. H. van den Meiracker, F. Boomsma, M. Lima, J. Freitas, A. J. M. i.’t Veld, and A. Falcao de Freitas Diurnal Blood Pressure Variation in Progressive Autonomic Failure Hypertension, April 1, 2000; 35(4): 892 - 897. [Abstract] [Full Text] [PDF]