What question did this study set out to answer?

To assess whether physiological levels of epinephrine enhance arterial norepinephrine release and local sympathetic activity in humans, and whether beta-adrenoceptor blockers inhibit this effect.

April 1, 1990Journal of Cardiovascular Pharmacology

Epinephrine-Induced Enhancement of Sympathetic Activity in Humans

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Why the study?

Does beta-blockade with atenolol or bopindolol prevent epinephrine-induced enhancement of norepinephrine release in subjects with borderline to mild hypertension?

Key Points

To assess whether physiological levels of epinephrine enhance arterial norepinephrine release and local sympathetic activity in humans, and whether beta-adrenoceptor blockers inhibit this effect.
Randomized double-blind crossover study in 10 subjects with borderline to mild hypertension receiving low-dose intravenous epinephrine infusion (20 ng/kg/min).
Subjects were tested under resting conditions and during four stress tests (isometric exercise, cold provocation, head-up tilting, mental stress) while receiving placebo, atenolol (50 mg/day), or bopindolol (1 mg/day) for 1 week each, spaced 2 weeks apart.
Under placebo, epinephrine infusion increased resting arterial norepinephrine from 214 ± 20 to 263 ± 26 pg/ml (p < 0.01) and resting forearm norepinephrine production from 296 ± 48 to 529 ± 98 pg/100 ml/min (p < 0.01).
Epinephrine significantly increased arterial norepinephrine responses to 3 of the 4 stress tests (p < 0.05), and all resting and stress-related sympathetic enhancements were completely abolished by both atenolol and bopindolol.

Structured PICO

Does beta-blockade with atenolol or bopindolol prevent epinephrine-induced enhancement of norepinephrine release in subjects with borderline to mild hypertension?

Population

10 subjects with borderline to mild hypertension

Intervention

Intravenous infusion of epinephrine (20 ng/kg/min) during treatment with beta 1-selective beta-adrenoceptor blockade (atenolol 50 mg once daily) or nonselective beta-blockade (bopindolol 1 mg once daily) for 1 week

Comparator

Intravenous infusion of epinephrine during placebo treatment

Outcome

Arterial levels of norepinephrine (NE) and local production of NE in the forearm at rest and during stress tests (isometric exercise, cold provocation, head-up tilting, and mental stress)surrogate

Physiologic levels of epinephrine enhance sympathetic activity in humans, an effect mediated by beta-adrenoceptors that can be blocked by both selective and nonselective beta-blockers.

Discussion

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Implication

Beta-blockade prevents epinephrine-driven sympathetic activation in mild hypertension; confirms beta-adrenoceptor mediation of norepinephrine release.

Cite This Study

Meiracker et al. (1990) studied this question.

synapsesocial.com/papers/6a75928efd25b6479067a456 https://doi.org/10.1097/00005344-199004000-00014

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Implication

Beta-blockade prevents epinephrine-driven sympathetic activation in mild hypertension; confirms beta-adrenoceptor mediation of norepinephrine release.

Epinephrine-Induced Enhancement of Sympathetic Activity in Humans

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Epinephrine-Induced Enhancement of Sympathetic Activity in Humans

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider