Cyclosporine-induced sympathetic activation and hypertension after heart transplantation.

TLDR: Cympathetic activity in patients with heart transplants or myasthenia gravis who were not being treated with cyclosporine was no different from that in Patients with essential hypertension or in normal controls, and cyclospora-induced hypertension is associated with sympathetic neural activation.

Abstract: Background. Hypertension is a frequent complication of cyclosporine-induced immunosuppression, but the underlying mechanism is unknown. In anesthetized animals, the administration of cyclosporine increases sympathetic-nerve discharge, which may contribute to hypertension. Methods. To determine whether cyclosporine-induced hypertension is accompanied by sustained sympathetic neural activation in patients, we recorded sympathetic action potentials using intraneural microelectrodes (in the peroneal nerve) in heart-transplant recipients receiving azathioprine and prednisone alone (n = 5) or in combination with cyclosporine (n = 14). We performed the same studies in eight patients with myasthenia gravis who were receiving cyclosporine and eight who were not, in five patients with essential hypertension, and in nine normal controls. Results. Heart-transplant recipients receiving cyclo-sporine had higher mean arterial blood pressure (±SE) than those not receiving cyclosporine (112±3 vs. 96±4 mm Hg; P<0....

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CYCLOSPORINE-INDUCED SYMPATHETIC
ACTIVATION AND HYPERTENSION AFTER
HEART-T$NSPLANTATION
Urs Scherrer
University of Texas Southwestern Medical Center at Dallas
Susan F. Vissing
University of Texas Southwestern Medical Center at Dallas
Barbara J. Morgan
University of Texas Southwestern Medical Center at Dallas
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The New England Journal of Medicine
Downloaded from nejm.org at VIRGINIA COMMONWEALTH UNIV on January 27, 2015. For personal use only. No other uses without permission.
Copyright © 1990 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine
Downloaded from nejm.org at VIRGINIA COMMONWEALTH UNIV on January 27, 2015. For personal use only. No other uses without permission.
Copyright © 1990 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine
Downloaded from nejm.org at VIRGINIA COMMONWEALTH UNIV on January 27, 2015. For personal use only. No other uses without permission.
Copyright © 1990 Massachusetts Medical Society. All rights reserved.