Effects of Chronic Clonidine Administration on Sympathetic Nerve Traffic and Baroreflex Function in Heart Failure

ABSTRACT—Congestive heart failure is characterized by a sympathetic activation that is coupled with a baroreflex impairment. Whether these alterations are affected by clonidine is unknown. In 26 normotensive patients age 58.0±1.1 years (mean±SEM) affected by congestive heart failure (New York Heart...

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Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2001-08, Vol.38 (2), p.286-291
Main Authors: Grassi, Guido, Turri, Carlo, Seravalle, Gino, Bertinieri, Giovanni, Pierini, Alberto, Mancia, Giuseppe
Format: Article
Language:English
Subjects:
Antihypertensive agents
Baroreflex - drug effects
Biological and medical sciences
Blood Pressure - drug effects
Cardiovascular system
Clonidine - administration & dosage
Clonidine - pharmacology
Double-Blind Method
Female
Heart Failure - blood
Heart Failure - drug therapy
Heart Failure - physiopathology
Heart Rate - drug effects
Humans
Male
Medical sciences
Middle Aged
Nitroprusside - pharmacology
Norepinephrine - blood
Pharmacology. Drug treatments
Phenylephrine - pharmacology
Sympathetic Nervous System - drug effects
Sympatholytics - administration & dosage
Sympatholytics - pharmacology
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Summary:ABSTRACT—Congestive heart failure is characterized by a sympathetic activation that is coupled with a baroreflex impairment. Whether these alterations are affected by clonidine is unknown. In 26 normotensive patients age 58.0±1.1 years (mean±SEM) affected by congestive heart failure (New York Heart Association functional class II or III) and treated with furosemide and enalapril, we measured mean arterial pressure, heart rate, venous plasma norepinephrine, and muscle sympathetic nerve traffic (microneurography) at rest and during baroreceptor stimulation and deactivation caused by stepwise intravenous infusions of phenylephrine and nitroprusside, respectively. Measurements were repeated after a 2-month administration of transdermal clonidine patch (14 patients) or placebo (12 patients) according to a double-blind, randomized sequence. Clonidine caused a slight, nonsignificant reduction in mean arterial pressure and heart rate without affecting exercise capacity and echocardiographically determined left ventricular ejection fraction. In contrast, both plasma norepinephrine and sympathetic nerve traffic were significantly reduced (−46.8% and −26.7%, respectively;P
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.38.2.286