title: Adrenal medullary overactivity in lean, borderline hypertensive young men.
abstract: BACKGROUND
  There may be a link among stress, adrenal medullary activation, and the development of hypertension. Obesity is characterized by sympathetic activation and predisposes to hypertension, but may be associated with low or normal adrenal medullary activity. We hypothesized that plasma epinephrine (E) levels and adrenal medullary responsiveness to mental stress are lower in overweight than in lean borderline hypertensive subjects.
  
  
  METHODS
  We compared groups of lean (n = 62) and overweight (n = 29) borderline hypertensive young men as well as lean (n = 36) and overweight (n = 7) normotensive young men from the same population. Plasma catecholamines and heart rate (HR) were measured at rest during a hyperinsulinemic glucose clamp and during mental arithmetic-induced stress.
  
  
  RESULTS
  Plasma norepinephrine (NE) and E, HR, and responses to stress were increased in borderline hypertensive subjects. Our results showed that NE was increased only in lean borderline hypertensive subjects at rest, but in overweight subjects as well during stress, with DeltaNE being similar in lean and overweight subjects. We found that E was higher in lean than in overweight borderline hypertensive subjects at rest and during stress (both P <.001), as were DeltaE and DeltaHR (both P <.05). Independent of BP status, body mass index was negatively related to E during stress (P <.01) and waist circumference negatively related to resting E (P <.001) and DeltaHR (P =.02).
  
  
  CONCLUSIONS
  Sympathetic neural activity and responsiveness are increased in borderline hypertensive young men, but measures of overweight are independently related to lower plasma E and HR responses. We suggest that adrenal medullary activation in borderline hypertension mainly characterizes lean subjects.
authors.affiliation: Department of Cardiology, Ullevaal University Hospital, Oslo, Norway.
authors.forename: Henrik M
authors.initials: HM
authors.lastname: Reims
authors.forename: Eigil
authors.initials: E
authors.lastname: Fossum
authors.forename: Aud
authors.initials: A
authors.lastname: Høieggen
authors.forename: Andreas
authors.initials: A
authors.lastname: Moan
authors.forename: Ivar
authors.initials: I
authors.lastname: Eide
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
mesh_terms: D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000097:blood / Q000503:physiopathology*; D000313:Adrenal Medulla / Q000378:metabolism / Q000503:physiopathology*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology*; D007328:Insulin / Q000378:metabolism; D008297:Male; D009638:Norepinephrine / Q000097:blood; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000503:physiopathology; D012044:Regression Analysis; D012146:Rest; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000097:blood; D013851:Thinness / Q000097:blood / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D009638:Norepinephrine