Blood pressure profile, sympathetic nervous system activity, and subclinical target organ damage in patients with polycythemia vera
Jóźwik-Plebanek K, Dobrowolski P, Lewandowski J, Narkiewicz K, Sikorska A, Siński M, Eisenhofer G, Schmieder R, Januszewicz M, Windyga J, Prejbisz A, Januszewicz A (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 130
Pages Range: 607-614
Journal Issue: 7-8
DOI: 10.20452/pamw.15473
Abstract
INTRODUCTION: Polycythemia vera (PV) is a rare myeloproliferative disease associated with an increased prevalence of hypertension and increased risk of cardiovascular complications. However, the precise mechanisms leading to the elevation of blood pressure (BP) and secondary target organ damage remain poorly understood. OBJECTIVES: The study aimed to evaluate BP profile, assess the activity of the sympathetic nervous system and the renin-angiotensin system, and provide a comprehensive assessment of subclinical target organ damage in patients with PV. PATIENTS AND METHODS: Twenty consecutive patients with newly diagnosed PV and 20 control subjects were included. The following were assessed: BP, levels of catecholamines, urinary and plasma O-methylated catecholamine metabolites, concentrations of aldosterone and renin. We also assessed microneurography sympathetic nervous system activity (MSNA) and baroreflex control of heart rate as well as subclinical target organ damage. RESULTS: At similar levels of BP, BP variability was decreased in the PV group (mean [SD] 24-hour systolic BP, 9 [3] vs 12 [3] mm Hg; P = 0.003). Patients with PV had lower norepinephrine excretion (mean [SD], 16.54 [6.32] vs 25.46 [12.88] μg/d; P = 0.03) as well as decreased MSNA as assessed by microneurography compared with controls (mean [SD] MSNA, 30.7 [8.7] bursts/min vs 38.7 [5.4] bursts/min; P = 0.007 and MSNA 51.8 [11] bursts/100 beats vs 61.1 [11.3] bursts/100 heart beats; P = 0.04). Baroreflex control of HR was unaltered in the PV group. Increased hemoglobin levels and red blood cell count correlated with decreased retinal capillary flow in patients with PV. CONCLUSIONS: Patients with PV, characterized by high hemoglobin concentrations and hematocrit levels had lower sympathetic nervous activity and decreased BP variability as compared with controls. There was no relationship between hemoglobin plasma concentration, hematocrit level, and target organ damage.
Authors with CRIS profile
Involved external institutions
Institute of Cardiology in Warsaw
Poland (PL)
Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu
Poland (PL)
Medical University Gdansk / Gdański Uniwersytet Medyczny
Poland (PL)
Institute of Hematology and Blood Transfusion / Instytut Hematologii i Transfuzjologi (IHiT)
Poland (PL)
Universitätsklinikum Carl Gustav Carus Dresden
Germany (DE)
Poland (PL)
Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu
Poland (PL)
Medical University Gdansk / Gdański Uniwersytet Medyczny
Poland (PL)
Institute of Hematology and Blood Transfusion / Instytut Hematologii i Transfuzjologi (IHiT)
Poland (PL)
Universitätsklinikum Carl Gustav Carus Dresden
Germany (DE)
How to cite
APA:
Jóźwik-Plebanek, K., Dobrowolski, P., Lewandowski, J., Narkiewicz, K., Sikorska, A., Siński, M.,... Januszewicz, A. (2020). Blood pressure profile, sympathetic nervous system activity, and subclinical target organ damage in patients with polycythemia vera. Polish Archives of Internal Medicine, 130(7-8), 607-614. https://doi.org/10.20452/pamw.15473
MLA:
Jóźwik-Plebanek, Katarzyna, et al. "Blood pressure profile, sympathetic nervous system activity, and subclinical target organ damage in patients with polycythemia vera." Polish Archives of Internal Medicine 130.7-8 (2020): 607-614.
BibTeX: Download