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Antihypertensive effect of α- and β-adrenergic blockade in obese and lean hypertensive subjects
Abstract
The purpose of this study was to determine the contribution of the adrenergic system in mediating hypertension in obese and lean patients. Thirteen obese, hypertensive patients with a body mass index (BMI) > or =28 kg/m2 (obese) and nine lean patients with a BMI < or =25 kg/m2 (lean) were recruited. After a 1-week washout period, participants underwent daytime ambulatory blood pressure monitoring (ABPM). Participants were then treated with the alpha-adrenergic antagonist doxazosin, titrating to 4 mg QHS in 1 week. In the next week, the beta-adrenergic antagonist atenolol was added at an initial dose of 25 mg/day and titrated to 50 mg/day within 1 week. One month after the addition of atenolol, all patients underwent a second ABPM session. There were no differences between the obese and lean subjects in baseline systolic (SBP), diastolic (DBP), or mean arterial pressures (MAP) measured by office recording or ABPM. However, obese subjects had higher heart rates than lean subjects (87.5+/-2.4 v 76.8+/-4.9 beats/min). After 1 month of treatment with the adrenergic blockers, obese patients had a significantly lower SBP (130.0+/-2.5 v 138.9+/-2.1 mm Hg, P = .02) and MAP (99.6+/-2.3 v 107.0+/-1.5 mm Hg, P = .02) than lean patients. Obese patients also tended to have a lower DBP than lean patients (84.3+/-2.5 v 90.9+/-1.6 mm Hg, P = .057), but there was no significant difference in heart rate after 1 month of adrenergic blockade. These results indicate that blood pressure is more sensitive to adrenergic blockade in obese than in lean hypertensive patients and suggest that increased sympathetic activity may be an important factor in the maintenance of hypertension in obesity.
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In the citing paper
“However, sympathetic blockade in patients with obesity or in experimental animals with dietary-induced obesity consistently reduces BP6,158.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [158]
In the citing paper
“administration of α/β-adrenergic blockers or clonidine, which stimulates central α-2 adrenergic receptors and reduces SNS activity, prevents most of the obesity-induced rise in BP in obese animals10,62 and α/β-adrenergic blockade reduces ambulatory BP significantly more in obese than in lean hypertensive patients63”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [63]
In the citing paper
“One view is that in patients with obesity-hypertension, antiadrenergic antihypertensive drugs should be preferentially used; there is evidence of greater blood pressure lowering in them.105”
From Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form? (2018) · cites this paper as [105]
In the citing paper
“Adrenergic blockade produced a significantly greater decrease in blood pressure in obese vs lean hypertensive patients.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [68]
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Metadata
- Authors
- Wofford, M.
- Affiliations
- University of Mississippi Medical Center (US)
- Corresponding author
- Wofford, M
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-07
- Volume
- 14
- Issue
- 7
- Pages
- 694-698
- ISSN
- 0895-7061 (ISSN-L)
- OpenAlex
- W2155178368
- Cited by
- 184
- References
- 23
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 6 · 2019: 6 · 2018: 9 · 2017: 11 · 2016: 7 · 2015: 6 · 2014: 12 · 2013: 8 · 2012: 9
- FWCI
- 6.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- DigitalCommons-Cedarville (Cedarville University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- obesity, hypertension, adrenergic blockade, alpha-adrenoceptor antagonism, beta-adrenoceptor antagonism, doxazosin, atenolol, sympathetic activity, ambulatory blood pressure, heart rate
- MeSH terms
- Adrenergic alpha-Antagonists, Adrenergic beta-Antagonists, Adult, Atenolol, Female, Humans, Hypertension, Male, Middle Aged, Obesity, Prospective Studies, Sympathetic Nervous System, Doxazosin, Blood Pressure Monitoring, Ambulatory
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