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Original Articles

Systemic and Renal-Specific Sympathoinhibition in Obesity Hypertension

Thomas E. Lohmeier, Radu Iliescu, Boshen Liu, Jeffrey R. Henegar, Christine Maric-Bilkan, Eric D. Irwin
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https://doi.org/10.1161/HYPERTENSIONAHA.111.185074
Hypertension. 2011;HYPERTENSIONAHA.111.185074
Originally published December 19, 2011
Thomas E. Lohmeier
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Radu Iliescu
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Boshen Liu
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Jeffrey R. Henegar
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Christine Maric-Bilkan
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Eric D. Irwin
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Abstract

Chronic pressure-mediated baroreflex activation suppresses renal sympathetic nerve activity. Recent observations indicate that chronic electric activation of the carotid baroreflex produces sustained reductions in global sympathetic activity and arterial pressure. Thus, we investigated the effects of global and renal specific suppression of sympathetic activity in dogs with sympathetically mediated, obesity-induced hypertension by comparing the cardiovascular, renal, and neurohormonal responses to chronic baroreflex activation and bilateral surgical renal denervation. After control measurements, the diet was supplemented with beef fat, whereas sodium intake was held constant. After 4 weeks on the high-fat diet, when body weight had increased ≈50%, fat intake was reduced to a level that maintained this body weight. This weight increase was associated with an increase in mean arterial pressure from 100±2 to 117±3 mm Hg and heart rate from 86±3 to 130±4 bpm. The hypertension was associated with a marked increase in cumulative sodium balance despite an approximately 35% increase in glomerular filtration rate. The importance of increased tubular reabsorption to sodium retention was further reflected by ≈35% decrease in fractional sodium excretion. Subsequently, both chronic baroreflex activation (7 days) and renal denervation decreased plasma renin activity and abolished the hypertension. However, baroreflex activation also suppressed systemic sympathetic activity and tachycardia and reduced glomerular hyperfiltration while increasing fractional sodium excretion. In contrast, glomerular filtration rate increased further after renal denervation. Thus, by improving autonomic control of cardiac function and diminishing glomerular hyperfiltration, suppression of global sympathetic activity by baroreflex activation may have beneficial effects in obesity beyond simply attenuating hypertension.

  • obesity
  • hypertension
  • baroreflex
  • sympathetic nervous system
  • renal nerves
  • renal function
  • renin-angiotensin system
  • Received October 7, 2011.
  • Revision received October 13, 2011.
  • Accepted November 23, 2011.
  • © 2011 American Heart Association, Inc.
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    Systemic and Renal-Specific Sympathoinhibition in Obesity Hypertension
    Thomas E. Lohmeier, Radu Iliescu, Boshen Liu, Jeffrey R. Henegar, Christine Maric-Bilkan and Eric D. Irwin
    Hypertension. 2011;HYPERTENSIONAHA.111.185074, originally published December 19, 2011
    https://doi.org/10.1161/HYPERTENSIONAHA.111.185074

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    Systemic and Renal-Specific Sympathoinhibition in Obesity Hypertension
    Thomas E. Lohmeier, Radu Iliescu, Boshen Liu, Jeffrey R. Henegar, Christine Maric-Bilkan and Eric D. Irwin
    Hypertension. 2011;HYPERTENSIONAHA.111.185074, originally published December 19, 2011
    https://doi.org/10.1161/HYPERTENSIONAHA.111.185074
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