The role of the alpha-adrenergic receptor in the leg vasoconstrictor response to orthostatic stress.
OBJECTIVE
The prompt increase in peripheral vascular resistance, mediated by sympathetic alpha-adrenergic stimulation, is believed to be the key event in blood pressure control during postural stress. However, despite the absence of central sympathetic control of the leg vasculature, postural leg vasoconstriction is preserved in spinal cord-injured individuals (SCI). This study aimed at assessing the contribution of both central and local sympathetically induced alpha-adrenergic leg vasoconstriction to head-up tilt (HUT) by including healthy individuals and SCI, who lack central sympathetic baroreflex control over the leg vascular bed.


METHODS
In 10 controls and nine SCI the femoral artery was cannulated for drug infusion. Upper leg blood flow (LBF) was measured bilaterally using venous occlusion strain gauge plethysmography before and during 30 degrees HUT throughout intra-arterial infusion of saline or the non-selective alpha-adrenergic receptor antagonist phentolamine respectively. Additionally, in six controls the leg vascular response to the cold pressor test was assessed during continued infusion of phentolamine, in order to confirm complete alpha-adrenergic blockade by phentolamine.


RESULTS
During infusion of phentolamine HUT still caused vasoconstriction in both groups: leg vascular resistance (mean arterial pressure/LBF) increased by 10 +/- 2 AU (compared with 12 +/- 2 AU during saline infusion), and 13 +/- 3 AU (compared with 7 +/- 3 AU during saline infusion) in controls and SCI respectively.


CONCLUSIONS
Effective alpha-adrenergic blockade did not reduce HUT-induced vasoconstriction, regardless of intact baroreflex control of the leg vasculature. Apparently, redundant mechanisms compensate for the absence of sympathetic alpha-adrenoceptor leg vasoconstriction in response to postural stress.
Kooijman
M
M
Department of Physiology and Institute of Fundamental and Clinical Movement Sciences, Radboud University Nijmegen Medical Centre, Geert Grooteplein Noord 21, Nijmegen, The Netherlands.
Rongen
G A
GA
Smits
P
P
van Kuppevelt
H J M
HJ
Hopman
M T E
MT
D000317:Adrenergic alpha-Antagonists; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010646:Phentolamine; D010991:Plethysmography; D011187:Posture / Q000502:physiology; D011942:Receptors, Adrenergic, alpha / Q000502:physiology*; D012039:Regional Blood Flow / Q000502:physiology; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014661:Vasoconstriction / Q000502:physiology*; D055815:Young Adult
D000317:Adrenergic alpha-Antagonists; D011942:Receptors, Adrenergic, alpha; D010646:Phentolamine