Circulation, Vol 66, 55-60, Copyright © 1982 by American Heart Association
FH Messerli, HO Ventura, E Reisin, GR Dreslinski, FG Dunn, AA MacPhee and ED Frohlich
Systemic, renal and splanchnic hemodynamics, intravascular volume,
circulating catecholamine levels and plasma renin activity were compared in
39 patients with borderline hypertension and 28 normotensive subjects, who
were less than 5% (n = 42, lean patients) or more than 40% overweight (n =
25, obese patients). Lean borderline hypertensive patients had greater
cardiac output (p less than 0.05), heart rate (p less than 0.01) and renal
blood flow (p less than 0.05); cardiopulmonary redistribution of
intravascular volume (p less than 0.05); and higher circulating
norepinephrine levels (p less than 0.05). Obese normotensive subjects also
showed an increased cardiac output (p less than 0.005), stroke volume (p
less than 0.01), left ventricular stroke work (p less than 0.05), and renal
blood flow (p less than 0.05) (but not respective indexes), but
intravascular volume was expanded (p less than 0.05) without redistribution
and circulating catecholamine levels were normal. Obese borderline
hypertensive patients had hemodynamic characteristics similar to those of
obese normotensive subjects except for an increased peripheral resistance
(p less than 0.05). The data indicate that although both populations have
an increased cardiac output, the lean borderline hypertensive patients have
signs of enhanced adrenergic activity as evidenced by higher circulating
catecholamine levels and heart rate with blood volume translocation to the
cardiopulmonary circulation. In contrast, the obese subjects (whether
normotensive or borderline hypertensive), who also have increased cardiac
output, seem to have normal adrenergic activity and an expanded
intravascular volume without cardiopulmonary redistribution.
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Borderline hypertension and obesity: two prehypertensive states with elevated cardiac output
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