OBESITY-INDUCED HYPERTENSION - RENAL-FUNCTION AND SYSTEMIC HEMODYNAMICS

被引:256
作者
HALL, JE
BRANDS, MW
DIXON, WN
SMITH, MJ
机构
[1] Univ. of Mississippi Medical Center, Dept. of Physiology and Biophysics, Jackson, MS
[2] Dept. of Physiology and Biophysics, Univ. of Mississippi Medical Center, Jackson, MS 39216-4505
关键词
OBESITY; SODIUM; KIDNEY; GLOMERULAR FILTRATION RATE; INSULIN; CARDIAC OUTPUT; RENIN;
D O I
10.1161/01.HYP.22.3.292
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
This study examined the control of renal hemodynamics and tubular function, as well as systemic hemodynamics, during obesity-induced hypertension in chronically instrumented conscious dogs. Mean arterial pressure, cardiac output, and heart rate were monitored 24 hours a day using computerized methods, water and electrolyte balances were measured daily, and renal hemodynamics were measured each week during the control period and 5 weeks of a high-fat diet. After 7 to 10 days of control measurements, 0.5 to 0.9 kg of cooked beef fat was added to the regular diet, and sodium intake was maintained constant at 76 mmol/d throughout the study. After 5 weeks of the high-fat diet, body weight increased from 24.0 +/- 1.0 to 35.9 +/- 4.9 kg, mean arterial pressure increased from 83 +/- 5 to 100 +/- 4 mm Hg, cardiac output increased from 2.86 +/- 0.27 to 4.45 +/- 0.55 L/min, and heart rate rose from 68 +/- 5 to 107 +/- 9 beats per minute. Associated with the hypertension was an increase in cumulative sodium balance to 507 +/- 107 mmol after 35 days and a rise in sodium iothalamate space, an index of extracellular fluid volume, to 131 +/- 4% of control. Sodium retention was due to increased tubular reabsorption, because glomerular filtration rate and effective renal plasma flow increased throughout the 5 weeks of the high-fat diet, averaging 135 +/- 4% and 149 +/- 19% of control, respectively, during the fifth week of the high-fat diet. Plasma renin activity and plasma insulin concentration increased from 0.46 +/- 0.12 ng angiotensin I/mL per hour and 11.1 +/- 2.6 muU/mL, respectively, to 1.10 +/- 0.23 ng angiotensin I/mL per hour and 30.1 +/- 7.0 muU/mL after 5 weeks. Because decreased sodium excretion occurred despite elevated mean arterial pressure, obesity-induced hypertension in dogs is associated with a shift of renal pressure natriuresis that is caused by increased tubular reabsorption, although the exact mechanism by which this occurs is still unclear.
引用
收藏
页码:292 / 299
页数:8
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