deamino-arginine-vasopressin and Hypertension

Describe current shortcomings in clinical research on the treatment of nocturia in adults, and suggest new directions for future studies in this field.. A literature search was conducted using the keywords 'nocturia,' 'nocturnal polyuria,' 'sleep,' and 'hypertension.'. Nocturia, or waking up at night to void, is a highly prevalent and bothersome lower urinary tract symptom (LUTS) affecting up to 40% of adults. Since the majority of patients are diagnosed with nocturnal polyuria (NP) as one of the underlying causes, it is not surprising that the effect of treatments for overactive bladder (OAB) and bladder outlet obstruction (BOO) are disappointing with regard to nocturia. Therefore, we suggest to conduct studies in which nocturic patients are treated according to the underlying pathophysiology: (1) antimuscarinics or β3-agonists for OAB symptoms, (2) α-blockers or 5α-reductase inhibitors in men with BOO caused by enlarged prostates, (3) desmopressin or diuretics for NP, (4) continuous positive airway pressure in nocturic patients with obstructive sleep apnea, and (5) all its combinations in case of combined pathophysiology. Not only the effect on treatment efficacy or side effects needs to be assessed, but also the impact on related comorbidities such as sleep disorders, hypertension, and endocrine functions such as blood glucose regulation.. Future research needs to subtype nocturic patients in order to adapt treatment according to the underlying cause.

Topics: Antidiuretic Agents; Clinical Protocols; Deamino Arginine Vasopressin; Diuretics; Humans; Hypertension; Interdisciplinary Communication; Nocturia; Sleep Deprivation

The aim of this study was to review the literature published and the most important papers presented to meetings on Cushing's disease from October 2011 to September 2012. The selection has been performed according to the authors' criteria. Articles have been classified into five groups: quality of life and perception of the disease, clinical features and pathophysiology, comorbidity conditions, diagnosis, and treatment. The results and conclusions of each publication are discussed.

Topics: ACTH-Secreting Pituitary Adenoma; Deamino Arginine Vasopressin; Endomyocardial Fibrosis; Humans; Hyperglycemia; Hypertension; Hypoglycemic Agents; Hypophysectomy; Neoplasm Proteins; Pituitary ACTH Hypersecretion; Pituitary Neoplasms; Prognosis; Quality of Life; Somatostatin; Thrombophilia

In the kidney, the fine control of NaCl absorption takes place in the distal nephron and is controlled by aldosterone and vasopressin. This review summarizes the effects of vasopressin on Na+ transport mediated by the amiloride-sensitive epithelial sodium channel (ENaC) and the cystic fibrosis transmembrane conductance regulator (CFTR) Cl- channel in immortalized or primary cultured cortical collecting duct cells, expressing either the wild-type ENaC subunits, or mutations, or deletions of the PY domain of the beta- or gamma-ENaC subunits responsible for Liddle's syndrome, an inherited form of hypertension due to excessive salt absorption.

Topics: Absorption; Aldosterone; Amiloride; Animals; Cells, Cultured; Chlorides; Cystic Fibrosis Transmembrane Conductance Regulator; Deamino Arginine Vasopressin; Epithelial Sodium Channels; Humans; Hypertension; Ion Transport; Kidney Tubules, Collecting; Mice; Mice, Mutant Strains; Models, Biological; Natriuresis; Oocytes; Protein Subunits; Recombinant Fusion Proteins; Sodium Channels; Sodium Chloride; Syndrome; Vasopressins; Water-Electrolyte Balance; Xenopus laevis

Transient diabetes insipidus (DI) is a disease of late pregnancy, that has been reported with increasing frequency. Although initially thought to be nephrogenic, the etiology of this syndrome is most likely excess vasopressinase activity. The disease is associated with preeclampsia with liver involvement. Infants of mothers with the syndrome are predominantly male. Management may be with deamino D arginine vasopressin (dDAVP) during gestation and postpartum since vasopressinase does not break down dDAVP. The copious urine output may disguise preeclampsia. Fluid restriction should be avoided as it will lead to dehydration and hemoconcentration.

Topics: Adult; Cystinyl Aminopeptidase; Deamino Arginine Vasopressin; Diabetes Insipidus; Female; Humans; Hypertension; Infant, Newborn; Liver; Polyuria; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Syndrome

Atriopeptins are biologically active peptides with potent natriuretic, diuretic, and vasorelaxant activities. Manipulation of an animal's salt and water intake influences the synthesis, storage, and release of atriopeptin. In addition to its direct effects on fluid and electrolyte balance, atriopeptin influences other volume regulatory hormones, including renin, aldosterone, and vasopressin. Atriopeptin, by its direct actions and its effects on hormone systems, provides a means for delicate hormonal control of fluid and electrolyte homeostasis.

Topics: Animals; Atrial Natriuretic Factor; Blood Volume; Deamino Arginine Vasopressin; Dogs; Hydroxydopamines; Hypertension; Myocardium; Oxidopamine; Rats; Rats, Inbred SHR; RNA, Messenger; Vasopressins; Water-Electrolyte Balance

Desmopressin acetate (DDAVP) has been advocated as efficacious in reducing mediastinal bleeding following cardiopulmonary bypass (CPB), and has been shown to ameliorate platelet dysfunction; however, this has not been evaluated during routine coronary artery bypass grafting (CABG). In the present study, this therapy was evaluated utilizing the thromboelastograph (TEG), a rapid, on-line means of diagnosing a coagulopathy. During elective CABG, 20 patients received either DDAVP, 0.3 microgram/kg, intravenously, following heparin reversal after CPB, or a placebo infusion, in a randomized, double-blind fashion. Hemostasis was monitored with both the TEG and conventional coagulation tests. No significant differences between the two groups were found at induction, postprotamine, post-"study infusion," or 2 hours postoperatively, with the exception of the postoperative PTT (31.1 +/- 3.2 v 36.5 +/- 5.9 seconds for DDAVP v placebo, P = 0.03). Total blood products transfused intraoperatively, and in the first 8, 16, 24, or 48 postoperative hours, were also similar between the groups. No manifestations of hypercoagulability were seen, but hypotension during the infusion was noted in four patients receiving DDAVP, and in none of the controls. It is concluded that the expense and potential complications of DDAVP therapy do not justify its routine use in CABG.

Topics: Blood Coagulation; Blood Platelets; Cardiopulmonary Bypass; Coronary Artery Bypass; Deamino Arginine Vasopressin; Double-Blind Method; Female; Hematocrit; Humans; Hypertension; Male; Middle Aged; Partial Thromboplastin Time; Placebos; Platelet Count; Thrombelastography; Whole Blood Coagulation Time

Impaired kidney concentration capacity is present in half of the patients with autosomal dominant polycystic kidney disease (ADPKD). The kidney concentrating capacity was further impaired within the animal model of autosomal recessive polycystic kidney disease (ARPKD). To date, only one small study has investigated it in children having ARPKD. Therefore, we aimed to study the kidney concentrating ability in a larger cohort of children with ARPKD.. Eighteen children (median age 8.5 years, range 1.3-16.8) were retrospectively investigated. A standardized kidney concentrating capacity test was performed after the application of a nasal drop of desmopressin (urine osmolality > 900 mOsmol/kg). The glomerular filtration rate was estimated using the Schwartz formula (eGFR) and blood pressure (BP) was measured as office BP.. Kidney concentrating capacity was decreased (urine osmolality < 900 mOsmol/kg) in 100% of children with ARPKD. The median urine osmolality after desmopressin application was 389 (range 235-601) mOsmol/kg. Sixteen patients (89%) were defined as hypertensive based on their actual BP level or their use of antihypertensive drugs. The maximum amounts of urinary concentration correlated significantly with eGFR (r = 0.72, p < 0.0001) and hypertensive scores (r = 0.50, p < 0.05), but not with kidney size. Twelve patients (67%) were defined as having CKD stages 2-4. The median concentrating capacity was significantly lower in children within this group, when compared to children with CKD stage 1 possessing a normal eGFR (544 mOsmol/kg, range 413-600 mOsmol/kg vs. 327 mOsmol/kg, range 235-417 mOsmol/l, p < 0.001).. Impaired kidney concentrating capacity is present in most children with ARPKD and is associated with decreased eGFR and hypertension. A higher resolution version of the Graphical abstract is available as Supplementary information.

Topics: Child; Deamino Arginine Vasopressin; Glomerular Filtration Rate; Humans; Hypertension; Kidney; Polycystic Kidney, Autosomal Dominant; Polycystic Kidney, Autosomal Recessive; Renal Insufficiency, Chronic; Retrospective Studies

The renin-angiotensin-aldosterone and arginine vasopressin-V2 receptor-aquaporin-2 (AQP2) systems converge on the epithelial Na

Topics: Animals; Aquaporin 2; Deamino Arginine Vasopressin; Epithelial Sodium Channels; Hypertension; Mice; Receptors, Vasopressin; Sodium; Water; Water-Electrolyte Imbalance

Previously, we demonstrated that rats undergoing vasopressin escape had increased mean arterial blood pressure (MAP), plasma and urine aldosterone, and increased renal protein abundance of the alpha-subunit of the epithelial sodium channel (ENaC), the thiazide-sensitive Na-Cl cotransporter (NCC), and the 70-kDa band of gamma-ENaC (Song J, Hu X, Khan O, Tian Y, Verbalis JG, and Ecelbarger CA. Am J Physiol Renal Physiol 287: F1076-F1083, 2004; Ecelbarger CA, Knepper MA, and Verbalis JG. J Am Soc Nephrol 12: 207-217, 2001). Here, we determine whether changes in these renal proteins and MAP require elevated aldosterone levels. We performed adrenalectomies (ADX) or sham surgeries on male Sprague-Dawley rats. Corticosterone and aldosterone were replaced to clamp these hormone levels. MAP was monitored by radiotelemetry. Rats were infused with 1-deamino-[8-D-arginine]-vasopressin (dDAVP) via osmotic minipumps (5 ng/h). At day 3 of dDAVP infusion, seven rats in each group were offered a liquid diet [water load (WL)] or continued on a solid diet (SD). Plasma aldosterone and corticosterone and urine aldosterone were increased by WL in sham rats. ADX-WL rats escaped, as assessed by early natriuresis followed by diuresis; however, urine volume and natriuresis were somewhat blunted. WL did not reduce the abundance or activity of 11-beta-hydroxsteroid dehydrogenase type 2. Furthermore, the previously observed increase in renal aldosterone-sensitive proteins and escape-associated increased MAP persisted in clamped rats. The densitometry of immunoblots for NCC, alpha- and gamma-70 kDa ENaC, respectively, were (% sham-SD): sham-WL, 159, 278, 233; ADX-SD, 69, 212, 171; ADX-WL, 116, 302, 161. However, clamping corticosteroids blunted the rise at least for NCC and gamma-ENaC (70 kDa). Overall, the increase in aldosterone observed in vasopressin escape is not necessary for the increased expression of NCC, alpha- or gamma-ENaC or increased MAP associated with "escape."

Topics: 11-beta-Hydroxysteroid Dehydrogenase Type 2; Adrenalectomy; Aldosterone; Animals; Blood Pressure; Corticosterone; Deamino Arginine Vasopressin; Diuresis; Drinking; Epithelial Sodium Channels; Gene Expression Regulation; Glomerular Filtration Rate; Hyperaldosteronism; Hypertension; Kidney Tubules, Collecting; Male; Natriuresis; Rats; Rats, Sprague-Dawley; Sodium Channels; Sodium Chloride Symporters; Vasopressins

Liddle's syndrome is a genetic form of hypertension linked to Na(+) retention caused by activating mutations in the COOH terminus of the beta or gamma subunit of the epithelial sodium channel (ENaC). In this study, we used the short-circuit current (I(sc)) method to investigate the effects of deamino-8-d-arginine vasopressin (dDAVP) on Na(+) and Cl(-) fluxes in primary cultures of cortical collecting ducts (CCDs) microdissected from the kidneys of mice with Liddle's syndrome carrying a stop codon mutation, corresponding to the beta-ENaC R(566) stop mutation (L) found in the original pedigree. Compared to wild-type (+/+) CCD cells, untreated L/+ and L/L CCD cells exhibited 2.7- and 4.2-fold increases, respectively, in amiloride-sensitive (Ams) I(sc), reflecting ENaC-dependent Na(+) absorption. Short-term incubation with dDAVP caused a rapid and significant increase (approximately 2-fold) in Ams I(sc) in +/+, but not in L/+ or L/L CCD cells. In sharp contrast, dDAVP induced a greater increase in 5-nitro-2-(3-phenylpropamino)benzoate (NPPB)-inhibited apical Cl(-) currents in amiloride-treated L/L and L/+ cells than in their +/+ counterparts. I(sc) recordings performed under apical ion substituted conditions revealed that the dDAVP-stimulated apical secretion of Cl(-), which was absent in cultured CCDs lacking CFTR, was 1.8-fold greater in L/+ and 3.7-fold greater in L/L CCD cells than in their +/+ CCD counterparts. After the basal membrane had been permeabilized with nystatin and a basal-to-apical Cl(-) gradient had been imposed, dDAVP also stimulated larger Cl(-) currents across L/L and L/+ CCD layers than +/+ CCD layers. These findings demonstrate that vasopressin stimulates greater apical CFTR Cl(-) conductance in the renal CCD cells of mice with Liddle's syndrome than in wild-type mice. This effect could contribute to the enhanced NaCl reabsorption observed in the distal nephron of patients with Liddle's syndrome.

Topics: Animals; Cells, Cultured; Chloride Channel Agonists; Chloride Channels; Chlorides; Codon; Cystic Fibrosis Transmembrane Conductance Regulator; Deamino Arginine Vasopressin; Electrophysiology; Epithelial Sodium Channels; Hypertension; Kidney Tubules, Collecting; Mice; Mice, Knockout; Nephrons; Nystatin; Organ Culture Techniques; Phenotype; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Sodium; Sodium Channels; Syndrome; Vasopressins

Topics: 3' Untranslated Regions; Activated Protein C Resistance; Aged; Anticoagulants; Arthroplasty, Replacement, Hip; Contraindications; Coronary Disease; Deamino Arginine Vasopressin; Factor V; Factor VIII; Female; Genetic Predisposition to Disease; Genotype; Heparin; Humans; Hypertension; Postoperative Complications; Prothrombin; Pulmonary Embolism; Thrombophilia; von Willebrand Diseases; von Willebrand Factor

We have shown that the capacity for local release of tissue-type plasminogen activator (tPA) from the vascular endothelium is impaired in patients with primary hypertension. Because this response is an important protective mechanism against intravascular clotting, we investigated whether this system is also defective in patients with advanced chronic kidney disease and hypertension. Nine nondiabetic nonsmoking men with chronic kidney disease (glomerular filtration rate 11 to 28 mL/min x 1.73 m2; aged 33 to 75 years) were compared with age-matched healthy controls. Intraarterial infusions of desmopressin, methacholine, and sodium nitroprusside were given locally in the brachial artery. Forearm blood flow was measured by venous occlusion plethysmography and blood collected repeatedly during the desmopressin infusion for determination of stimulated net and total cumulated release of tPA. The maximal release rate of active tPA (P<0.05) and the capacity for acute tPA release were markedly impaired in the renal patients as compared with healthy subjects (ANOVA, P=0.013). Accordingly, the accumulated release of tPA was 1905 (SEM 366) and 3387 (718) ng/L tissue, respectively (P<0.05). However, there were no significant differences in vasodilator responses between the groups. Thus, patients with advanced chronic kidney disease and hypertension have a markedly impaired capacity for acute release of tissue plasminogen activator, despite preserved endothelium-dependent vasodilation. This defect may contribute to a defective local defense against arterial thrombosis.

Topics: Adult; Aged; Brachial Artery; Deamino Arginine Vasopressin; Endothelium, Vascular; Forearm; Humans; Hypertension; Hypertension, Renovascular; Infusions, Intra-Arterial; Kidney Diseases; Male; Methacholine Chloride; Middle Aged; Nitroprusside; Plethysmography; Secretory Rate; Tissue Plasminogen Activator; Vasodilation

Topics: Biopsy, Needle; Computer Systems; Deamino Arginine Vasopressin; Female; Humans; Hypertension; Kidney; Male; Nephrotic Syndrome; Prone Position; Prospective Studies; Proteinuria; Renal Insufficiency; Supine Position; Ultrasonography

Topics: Adult; Case-Control Studies; Coronary Thrombosis; Deamino Arginine Vasopressin; Endothelium, Vascular; Fibrinolysis; Forearm; Hemostatics; Humans; Hypertension; Infusions, Intra-Arterial; Male; Methacholine Chloride; Middle Aged; Parasympathomimetics; Plasminogen Activator Inhibitor 1; Tissue Plasminogen Activator

The development of hypertension in the spontaneously hypertensive rat (SHR) is associated with renal dysfunction; the observed renal vasoconstriction may reflect an imbalance of constrictor and dilator systems. The present studies evaluated renal vascular reactivity to arginine vasopressin (AVP) and mediation by V1 and/or V2 receptors. Renal blood flow (electromagnetic flowmetry) was measured in water-loaded, 8-wk-old SHR, Wistar-Kyoto rats (WKY), and Munich-Wistar rats. Injection of AVP (2 and 5 ng) into the renal artery caused dose-dependent renal vasoconstriction. The maximum blood flow response was approximately twofold larger in SHR than both normotensive strains. The strain difference was largely unaffected by indomethacin administration, although the reduction in blood flow produced by 5 ng AVP was 4-6% larger in both SHR and WKY during cyclooxygenase inhibition. The V1 receptor antagonist, [D-(CH2)5,Tyr(Me)2,Tyr(NH2)9]Arg8-vasopressin, blocked up to 90% of the renal vasoconstriction elicited by AVP. Intrarenal injection of the V1-receptor agonist [Phe2,Ile3,Org8]vasopressin produced renal hemodynamic effects similar to AVP; this agonist reduced renal blood flow, with twofold larger responses in SHR (-40 vs. -18% for 10 ng). In contrast, similar doses of the V2-receptor agonist 1-desamino-8-D-arginine vasopressin had no effect. These results indicate that AVP-induced vasoconstriction is mediated predominantly by the V1 receptor in the rat kidney. The enhanced vascular reactivity in 8-wk-old SHR may reflect an increased V1 receptor density and/or affinity or postreceptor signaling pathways, largely independent of buffering by the vascular V2 receptor or vasodilator prostaglandin activity. The strain difference in the vascular response to AVP may contribute to the renal vasoconstriction observed during the development of genetic hypertension.

Topics: Animals; Arginine Vasopressin; Cyclooxygenase Inhibitors; Deamino Arginine Vasopressin; Dose-Response Relationship, Drug; Hemodynamics; Hypertension; Indomethacin; Prostaglandin Antagonists; Prostaglandins; Rats; Rats, Inbred SHR; Rats, Inbred Strains; Rats, Inbred WKY; Receptors, Vasopressin; Renal Agents; Renal Circulation; Vasoconstriction

Intravenous (i.v.) infusion of the selective vasopressin (V2) agonist 1-desamino-8-D-arginine vasopressin (DDAVP, Desmopressin) in humans causes a fall in blood pressure, an increase in heart rate, and a rise in plasma renin and noradrenaline. The present study was designed to demonstrate the vasodilatory properties of DDAVP in the renal circulation and to describe the effect of DDAVP on renin secretion. Seven male subjects (31-63 years) with hypertension, who showed no signs of renal parenchymal disease, received an i.v. infusion of DDAVP (400 ng/kg in 10 minutes). They were studied at the time they were undergoing renal vein renin sampling and renal angiography as part of the diagnostic work-up of their hypertension. 131I-Hippurate clearance was used to measure effective renal plasma flow (ERPF). True renal plasma flow was calculated as ERPF divided by the renal extraction ratio of 131I-hippurate. 125I-Thalamate clearance was used to measure glomerular filtration rate (GFR). Measurements were made before and 15-20 minutes after administration of DDAVP. Angiography was performed in the same session after the last blood samples had been collected. In all patients the renal arteries were normal and the extraction ratios of 131I-hippurate and 125I-thalamate (Ehip, Ethal) were not different for the left and right kidney, and in all seven patients a diagnosis of essential hypertension was made. After DDAVP systolic blood pressure decreased by 14.4 mmHg (2.0-26.8) (mean, 95% confidence interval, p < 0.05). Diastolic blood pressure decreased by 12.1 mmHg (2.9-21.7, p < 0.01). Heart rate increased by 17.5 bpm (11.7-23.2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Deamino Arginine Vasopressin; Hemodynamics; Humans; Hypertension; Iodine Radioisotopes; Iodohippuric Acid; Iothalamic Acid; Male; Middle Aged; Receptors, Vasopressin; Renal Circulation; Renal Plasma Flow, Effective; Renin

Topics: Animals; Antidiuretic Hormone Receptor Antagonists; Arginine Vasopressin; Blood Pressure; Brain; Deamino Arginine Vasopressin; Dogs; Heart; Hypertension; Injections, Intraventricular; Pressoreceptors; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Reflex; Species Specificity

To determine whether the paraventricular nucleus (PVN) contributes to the development of hypertension in spontaneously hypertensive rats (SHR), we compared cardiovascular responses to ganglionic blockade with hexamethonium or vasopressin antagonism with dPVAVP in sham-operated or PVN lesioned SHR and Wistar-Kyoto rats (WKY). Lesions were produced electrolytically when the rats were 5 weeks old. During the next 3 weeks, tail-cuff measurements showed that the development of hypertension in SHR was inhibited, while systolic pressure in WKY was unaffected. Mean pressures recorded directly from the femoral artery at 8 weeks of age were lower in lesioned than in sham-operated SHR (141 +/- 5 vs 110 +/- 3 mm Hg, P less than 0.05), but did not differ in corresponding WKY groups (110 +/- 4 vs 112 +/- 5 mm Hg). Depressor responses to ganglionic blockade induced by i.v. injection of hexamethonium (25 mg/kg) were significantly larger in sham-operated than in lesioned SHR (-41 +/- 4% vs -28 +/- 3%, P less than 0.05). By contrast, vasopressin antagonism with dPVAVP did not alter blood pressure in all rat groups. In 24-h urine samples, excretion of vasopressin was unaffected, but that of norepinephrine was significantly reduced in lesioned SHR. These findings suggest that the PVN contributes to the development of spontaneous hypertension by sympathetic activation without increasing vasopressin secretion.

Topics: Animals; Blood Pressure; Body Weight; Catecholamines; Deamino Arginine Vasopressin; Drinking; Ganglionic Blockers; Heart Rate; Hexamethonium Compounds; Hypertension; Male; Paraventricular Hypothalamic Nucleus; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Sympathetic Nervous System; Vasopressins

The role of vasopressin in the regulation of body water volume and its distribution to intravascular, interstitial and intracellular compartments, and the importance of particular body water compartments in the pathogenesis of DOCA-salt hypertension were studied in young Brattleboro rats. Vasopressin-deficient, vasopressin-synthesizing and vasopressin-deficient rats chronically supplemented with deamino-8-D-arginine vasopressin (dDAVP) were compared with water-drinking controls. The chronic DOCA-salt treatment caused a marked hypertension in vasopressin-synthesizing animals; in these animals body water was slightly increased due to the expansion of extra-cellular fluid volume whereas intracellular water tended to decrease, so that the ratio of extracellular fluid volume to intracellular water rose significantly. The development of DOCA-salt hypertension was attenuated in the vasopressin-deficient rats, which had a similar level of total body water, slightly increased intracellular water and significantly decreased extracellular fluid volume compared with the hypertensive vasopressin-synthesizing rats. Consequently, in the vasopressin-deficient rats, the ratio of extracellular fluid volume to intracellular water did not differ from that of controls. A vasopressin deficiency was associated with a failure to expand the interstitial fluid volume although plasma volume was increased. Unaltered total body water together with elevated plasma osmolality indicated an extracellular water deficiency in DOCA-salt-treated vasopressin-deficient rats. Chronic dDAVP supplementation restored the body fluid pattern and the hypertensive response of the DOCA-salt-treated vasopressin-deficient rats. In conclusion, the antidiuretic effects of vasopressin are necessary for the interstitial fluid volume expansion that is essential for a full development of DOCA-salt hypertension.

Topics: Animals; Body Water; Chronic Disease; Deamino Arginine Vasopressin; Desoxycorticosterone; Heterozygote; Homozygote; Hypertension; Nephrectomy; Rats; Rats, Brattleboro; Sodium Chloride; Vasopressins

The cardiovascular effects of centrally administered cholinomimetics were examined in conscious Long-Evans and Brattleboro rats. Carbachol (1 microgram/kg) or physostigmine (50 micrograms/kg) induced a long-lasting increase in blood pressure and a decrease in heart rate in Long-Evans rats whereas no bradycardia was observed in Brattleboro rats, and the pressor response was significantly less than that in Long-Evans rats. The cardiovascular responses to nicotine (30 micrograms/kg) in Brattleboro rats were not different from those in Long-Evans rats. Intravenous vasopressin antagonist, d(CH2)5Tyr(Me) arginine vasopressin, significantly attenuated the pressor response and eliminated the bradycardic response to carbachol in Long-Evans rats. However, the pressor response to carbachol in Brattleboro rats was still significantly less than that in Long-Evans rats treated with vasopressin antagonist. Intravenous phentolamine partially inhibited the pressor response to carbachol in Long-Evans rats and completely eliminated it in Brattleboro rats. Combined intravenous treatment with phentolamine and vasopressin antagonist completely eliminated the pressor response to carbachol in Long-Evans rats. Centrally administered methylatropine eliminated either the hypertensive or bradycardic response to carbachol in Long-Evans rats. These results indicate that the pressor and bradycardic response to carbachol or physostigmine is mediated by the central muscarinic receptor mechanism. Hypertensive response to intracerebroventricularly administered carbachol in normal rats is mediated both by an increase in central sympathetic outflow and in circulating vasopressin. The bradycardia seems to be mediated mainly by vasopressin.

Topics: Animals; Arginine Vasopressin; Atropine Derivatives; Autonomic Nervous System; Blood Pressure; Bradycardia; Carbachol; Cardiovascular Physiological Phenomena; Cardiovascular System; Deamino Arginine Vasopressin; Hypertension; Injections, Intraventricular; Male; Nicotine; Parasympatholytics; Phentolamine; Physostigmine; Rats; Rats, Brattleboro; Vasopressins

The deoxycorticosterone acetate (DOCA)-Na model of hypertension requires the presence of vasopressin for expression of high blood pressure. In the present study, the effects of vasopressin V2-receptor stimulation were examined in kidneys from rats receiving 1 wk of DOCA-Na or control (olive oil-tap water) treatment. The dose response to vasopressin (10(-10) to 10(-6) M) was tested in microdissected cortical collecting tubule (CCT) segments and adenosine 3',5'-cyclic monophosphate (cAMP) accumulation was significantly increased in segments from DOCA-Na rats vs. controls, confirming our previous study. In other experiments, kidneys from DOCA-Na and control rats were perfused with a modified Krebs-Henseleit buffer (37 degrees C, pH 7.4) and treated with either vehicle or 0.21-2.1 pM 1-desamino-8-D-arginine vasopressin (DDAVP). DDAVP caused significant (P less than 0.05) dose-related reductions in urine excretion (UV) and urinary sodium excretion (UNaV) in both DOCA-Na and control kidneys in the absence of changes in renal hemodynamics. However, DDAVP produced earlier and significantly greater reductions in UV and UNaV in kidneys from DOCA-Na vs. control rats. Percent fractional excretion of sodium was reduced significantly only in the DOCA-Na group (2.1 pM DDAVP). A small degree of antikaluresis was seen with DDAVP in both groups. Thus, DOCA-Na treatment augmented cAMP accumulation in the CCT, accompanied by a significant enhancement of DDAVP-stimulated urinary sodium and water reabsorption at the level of the intact kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Cyclic AMP; Deamino Arginine Vasopressin; Desoxycorticosterone; Electrolytes; Hypertension; Kidney; Male; Rats; Rats, Inbred Strains; Receptors, Angiotensin; Receptors, Vasopressin; Sodium

The aim of this study was to assess the cardiovascular and hormonal responses to 1-desamino-8,D-arginine vasopressin (DDAVP) in hypertensive patients before and after non-selective beta-blockade. We infused DDAVP at 400 ng/kg body weight for 10 min in nine subjects with mild essential hypertension before and 14 days after administration of nadolol at 80 mg/day. Blood pressure and heart rate were recorded, and blood was drawn at 0, 30 and 60 min for measurement of plasma renin activity, aldosterone, cortisol, noradrenaline, adrenaline and dopamine. Before the administration of nadolol, DDAVP induced a significant decrease in blood pressure, and significant increases in the heart rate, plasma renin activity, cortisol and noradrenaline; there were no changes in adrenaline or dopamine. After the administration of nadolol, baseline noradrenaline was significantly increased, while cortisol, adrenaline and dopamine remained unchanged. A second infusion of DDAVP did not significantly alter blood pressure, [corrected] heart rate, noradrenaline, adrenaline or dopamine, but plasma renin activity, aldosterone and cortisol still showed a significant increase. The blunted hypotensive effect of DDAVP after the administration of nadolol may be aspecific, due to lower basal blood pressure levels, or may indicate a mechanism of action common to both drugs. A similar post-DDAVP increase before and after beta-blockade suggests that the drug has a direct effect on the renin-secretory apparatus. An indirect effect, mediated by changes in intrarenal haemodynamics or by other factors with renin-stimulating activity, e.g. tissue plasminogen activator, can also be hypothesized.

Topics: Adult; Deamino Arginine Vasopressin; Female; Hemodynamics; Hormones; Humans; Hypertension; Male; Nadolol; Renin

A 24 year old man developed partial central diabetes insipidus with impaired thirst and an elevated osmotic threshold to the release of arginine vasopressin (AVP). Plasma AVP was present in inappropriately small concentrations despite severe hyperosmolality. In addition, marked hypertension accompanied this disorder and all abnormalities, including the hypertension, responded to 1-desamino-8-D-arginine vasopressin therapy. Several lines of evidence suggest this disorder may be a disturbance of hypothalamic function.

Topics: Adult; Arginine Vasopressin; Deamino Arginine Vasopressin; Diabetes Insipidus; Glucose; Humans; Hypernatremia; Hypertension; Infusions, Parenteral; Male; Radioimmunoassay; Sodium Chloride; Thirst; Water

The role of vasopressin as a pressor agent to the hypertensive process was examined. Vasopressin plays a major role in the pathogenesis of DOCA-salt hypertension, since the elevation of blood pressure was not substantial in the rats with lithium-treated diabetes insipidus after DOCA-salt treatment. Administration of DDAVP which has antidiuretic action but minimal vasopressor effect failed to increase blood pressure to the levels observed after administration of AVP. Furthermore, the pressor action of vasopressin appears to be important in the development of this model of hypertension, since the enhanced pressor responsiveness to the hormone was observed in the initial stage of hypertension. Increased secretion of vasopressin from neurohypophysis also promotes the function of the hormone as a pathogenetic factor in hypertension. An unproportional release of vasopressin compared to plasma osmolality may be induced by the absence of an adjusting control of angiotensin II forming and receptor binding capacity for sodium balance in the brain. However, the role of vasopressin remains to be determined in human essential hypertension.

Topics: Animals; Blood Pressure; Chlorides; Deamino Arginine Vasopressin; Desoxycorticosterone; Hypertension; Injections, Intravenous; Lithium; Lithium Chloride; Male; Rats; Receptors, Angiotensin; Salts; Vasopressins

Intravenous administration of 0.4 micrograms DDAVP/kg body weight in 16 normal controls, 34 patients with haemophilia A and 30 patients with von Willebrand's disease (vWd) was followed by an increase in FVIII: C from 230 to 410%, in FVIIIR:Ag from 160 to 260% and FVIIIR:RC of from 160 to 320%. Additionally, in the patients with vWd, a shortening of the bleeding time and improvement in platelet retention was observed. In 7 haemophiliacs with pretreatment levels of FVIII: C ranging from between 11 and 43% dental extractions were performed successfully after DDAVP whereas in 2 patients with FVIII: C levels of 5 and 6%, respectively, severe bleeding necessitated administration of factor VIII concentrates. In 8 haemophiliacs (FVIII: C between 6.5 and 50%) and 2 patients with vWd (FVIII: C 18 and 36%, respectively) DDAVP enabled minor surgery and successful therapy of spontaneous or traumatic bleeding complications. However, severe postoperative bleeding after stomach surgery in 2 haemophiliacs (FVIII: C 23 and 40%, respectively) and severe menstrual bleeding in one patient with vWd (FVIII: C 15%) required administration of factor VIII concentrates. At present DDAVP therapy should be restricted to minor surgery and non-life-threatening, spontaneous or traumatic bleeding complications in patients with pretreatment FVIII: C levels higher than 10%.

Topics: Arginine Vasopressin; Deamino Arginine Vasopressin; Factor VIII; Fatigue; Flushing; Hemophilia A; Hemorrhage; Humans; Hypertension; Surgical Procedures, Operative; Tooth Extraction; von Willebrand Diseases

Topics: Animals; Arginine Vasopressin; Blood Pressure; Deamino Arginine Vasopressin; Desoxycorticosterone; Diabetes Insipidus; Diet; Hypertension; Nephrectomy; Osmolar Concentration; Rats; Rats, Brattleboro; Rats, Mutant Strains; Sodium Chloride