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(Hypertension. 2004;44:e3.)
© 2004 American Heart Association, Inc.

Letters to the Editor

Neural Sympathetic Activity in Essential Hypertension

Department of Physiological Sciences, Sections of Neurochemical, Neurophysiology, Neuroimmunology, and Neuropharmacology, Instituto de Medicina Experimental, Universidad Central de Venezuela, Caracas, Venezuela

Alex E. Lechin

Sleep Disorders Center, Memorial Herman Hospital, Houston, Tex

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We read with great interest the article by Schlaich et al¹ dealing with the issue of sympathetic augmentation in hypertension. In 1993, we demonstrated that neural sympathetic activity predominance is registered in essential hypertensive patients.² These findings were supported by the overwhelming circulating noradrenaline (NA) versus adrenaline (Ad) levels registered throughout the oral glucose tolerance test. This NA versus Ad predominance has also been demonstrated through the supine-resting/1-minute orthostasis/5-minute moderate exercise test. This test is based on the findings of Robertson et al, who demonstrated that NA, but not Ad, peaks at 1-minute orthostasis. Thus, this test allowed the investigation of both neural and adrenal sympathetic release, separately. With respect to this, we have performed this test in some 25 000 normal and diseased subjects, and the results have been published in >50 research articles and in 3 books dealing with the autonomic nervous system.^3,4 Our results might be summarized as follows: the normal NA/Ad plasma ratio is lower than 2 during the supine-resting situation. This NA/Ad ratio rises to 3 to 4 in normal subjects during 1-minute orthostasis. The NA/Ad ratio does not increase, but decreases in nonessential hypertensive and/or stressed subjects, despite the global assessment that plasma catecholamines show significant increases. Conversely, essential hypertensive patients show great NA rise but none or poor Ad rise at 1-minute orthostasis. Thus, the NA/Ad ratio shows maximal increase, reaching levels >8. Plasma dopamine (DA) values do not increase in essential hypertensive patients. Thus, the NA/DA ratio shows significant . . . [Full Text of this Article]

Markus P. Schlaich

Department of Medicine IV, University of Erlangen-Nuernberg, Erlangen, Germany

Murray D. Esler

Baker Heart Research Institute and Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia

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				J. E. Hall Hypertension Online Only: August 2004 Hypertension, August 1, 2004; 44(2): 244 - 244. [Full Text] [PDF]