Effect of acute administration of vitamin C on muscle sympathetic activity, cardiac sympathovagal balance, and baroreflex sensitivity in hypertensive patients.
BACKGROUND
Essential hypertension is characterized by both increased oxidative stress and sympathetic traffic. Experimental studies have shown that reactive oxygen species can modulate autonomic activity.


OBJECTIVE
The aim of this study was to determine whether acute administration of the antioxidant vitamin C modifies sympathetic nerve activity in essential hypertension.


METHODS
Thirty-two untreated patients with essential hypertension and 20 normotensive subjects received vitamin C (3 g intravenously in 5 min) or vehicle. Heart rate, noninvasive beat-to-beat blood pressure, and muscle sympathetic nerve activity (microneurography) were monitored at baseline and up to 20 min after the infusion. Spectral analysis of RR interval variability and spontaneous baroreflex sensitivity were also computed.


RESULTS
Vitamin C infusion significantly lowered blood pressure in hypertensive patients but not in normotensive subjects (maximal changes in systolic blood pressure: -4.9 ± 10.1 compared with -0.7 ± 4.0 mm Hg, respectively; P < 0.05). Moreover, muscle sympathetic nerve activity was significantly reduced after vitamin C infusion in hypertensive patients (from 53.3 ± 12.2 to 47.4 ± 11.5 bursts/100 heart beats; P < 0.01) but not in healthy subjects (from 42.0 ± 10.1 to 42.7 ± 11.8 bursts/100 heart beats; NS). On the contrary, in 16 hypertensive patients, sodium nitroprusside in equidepressor doses induced a significant increase in muscle sympathetic nerve activity compared with vitamin C (+10.0 ± 6.9 bursts/100 heart beats). Sympathovagal balance and spontaneous baroreflex sensitivity were restored during vitamin C infusion in hypertensive subjects.


CONCLUSIONS
These results indicate that acute administration of vitamin C is able to reduce cardiovascular adrenergic drive in hypertensive patients, which suggests that oxidative stress is involved in the regulation of sympathetic activity in essential hypertension.
Department of Internal Medicine, University Hospital of Pisa, Italy. rosam.bruno@gmail.com
Rosa M
RM
Bruno
Elena
E
Daghini
Lorenzo
L
Ghiadoni
Isabella
I
Sudano
Ilaria
I
Rugani
Maurizio
M
Varanini
Claudio
C
Passino
Michele
M
Emdin
Stefano
S
Taddei
D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage*; D017704:Baroreflex / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D016022:Case-Control Studies; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects* / Q000503:physiopathology; D009599:Nitroprusside / Q000008:administration & dosage; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000378:metabolism; D013564:Sympathetic Nervous System / Q000187:drug effects* / Q000503:physiopathology
D017382:Reactive Oxygen Species; D009599:Nitroprusside; D001205:Ascorbic Acid