AJP - Regu Watch the video to learn how APS reaches out to developing nations.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


Am J Physiol Regul Integr Comp Physiol 294: R1575-R1576, 2008. First published March 19, 2008; doi:10.1152/ajpregu.00179.2008
0363-6119/08 $8.00
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
294/5/R1575    most recent
00179.2008v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ray, C. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ray, C. A.

EDITORIAL FOCUS

ENVIRONMENTAL, EXERCISE AND RESPIRATORY PHYSIOLOGY

New insights into orthostatic hypotension

Chester A. Ray

Heart and Vascular Institute, Department of Cellular and Molecular Physiology, General Clinical Research Center, Pennsylvania State University College of Medicine, Hershey, Pennsylvania

WE ARE APPROACHING THE 50TH anniversary of manned spaceflight, which began in 1961 when Yuri Gagarin and Alan Shepard flew into space within a month of each other; much has been learned about the health risks associated with microgravity. One of the first indications that space travel could have adverse health consequences was in the U.S.A. Mercury program, when an astronaut experienced a near-syncopal episode upon return to Earth after only 34 h in space (4). In subsequent 14-day Gemini missions, postflight head-up tilt tests were aborted due to presyncopal symptoms of hypotension (2). The etiology of postflight orthostatic hypotension is multifactorial and may include blood volume loss, cardiac dysfunction, diminished baroreflex sensitivity, altered vestibular-autonomic function, and increased vascular compliance or decreased vasoconstrictor responsiveness. The relative contribution of each of these factors to orthostatic intolerance may vary within each individual (3) and may vary as a function of various factors, such as flight duration and gender (8, 12).

Although much work has been done to understand the causes and underlying mechanisms of postflight orthostatic hypotension, there are still considerable gaps in our knowledge regarding possible mechanisms contributing to this phenomenon. One such gap is the possible role of the splanchnic circulation. Vasoconstriction of the splanchnic circulation is normally responsible for ~33% of the decrease in total vascular conductance needed for the maintenance of arterial pressure during an orthostatic stress (11), and the mesenteric circulation is one of three arterial branches that make up the splanchnic circulation (10).

The focus of the work by Colleran et al. (5), published in this edition of the American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, was to investigate the possible role of the mesenteric circulation in the cardiovascular deconditioning that is associated with spaceflight and bed rest in humans. To accomplish this goal, these investigators used the tail-suspended hindlimb-unloaded rat, which exhibits many of the hallmarks of cardiovascular deconditioning that are evident in humans, including resting and exercise tachycardia (7), diminished maximal aerobic capacity (9), and orthostatic hypotension (13). Two significant findings were presented in this study. First, they found that the rate of norepinephrine-induced vasoconstriction of mesenteric resistance arteries is diminished in hindlimb-unloaded rats. Other studies have reported the effects of hindlimb unloading on the maximal response and sensitivity to vasoconstrictor stimuli in various conduit and resistance arteries. However, this study is the first to describe a slower rate of constriction, which may be physiologically significant in terms of the need to rapidly elevate peripheral vascular resistance in order to maintain cerebral perfusion pressure during standing. Second, the investigators tested various vasoconstrictor responses working through different signaling pathways to discern the mechanism for the diminished adrenergic vasoconstriction. The results indicated that hindlimb unloading impaired an intracellular Ca2+-release mechanism associated with the sarcoplasmic reticulum in the smooth muscle cells. This conclusion was further supported by the findings of diminished ryanodine-2 receptor mRNA and protein expression in mesenteric arteries from unloaded rats. Hence, this study is the first to fully describe the effects of hindlimb unloading on the adrenergic vasoconstrictor dynamics of mesenteric arteries and the first to describe the impairment of the Ca2+ release mechanism in the dysfunction of the vasoconstrictor response.

One of the unique features of the mesenteric circulation is that this vascular bed is not subjected to altered blood flow and pressure gradients that occur in many tissues when a cephalic fluid shift is induced by the hindlimb unloading treatment (6, 7, 13). In the absence of changes in mesenteric perfusion or intravascular pressure, it is unclear what the stimulus for the change in mesenteric vasoconstrictor dynamics might be. Previous work from this laboratory has suggested that alterations in the concentrations of circulating hormones associated with the fluid shift, such as atrial and brain natriuretic peptides, may play a role in altering vasoconstrictor responses in arteries and veins, and possibly smooth muscle contraction in lymphatic vessels and uterine tissue as well (1). These observations may serve as the basis for future investigation and insight into the problem of orthostatic hypotension associated with spaceflight and bed rest in humans.

FOOTNOTES


Address for reprint requests and other correspondence: C. A. Ray, Penn State College of Medicine, The Milton S. Hershey Medical Center, Heart & Vascular Institute H047, 500 Univ. Dr., Hershey, PA 17033-2390 (e-mail: caray{at}psu.edu)

REFERENCES

  1. Behnke BJ, Zawieja DC, Gashev AA, Ray CA, Delp MD. Diminished mesenteric vaso- and venoconstriction and elevated plasma ANP and BNP with simulated microgravity. J Appl Physiol In press.
  2. Berry CA, Catterson AD. Pre-Gemini medical predictions vs. Gemini flight results. In: Gemini Summary Conference. Washington DC: Government Printing Office, p. 197–281, 1967.
  3. Buckey JC Jr, Lane LD, Levine BD, Watenpaugh DE, Wright SJ, Moore WE, Gaffney FA, Blomqvist CG. Orthostatic intolerance after spaceflight. J Appl Physiol 81: 7–18, 1996.[Abstract/Free Full Text]
  4. Catterson AD, McCutcheon EP, Minners HA, Pollard RA. Aeromedical observations. In: Mercury Project Summary Including Results of the Fourth Manned Orbital Flight May 15 and 16, 1963. Washington, DC: NASA, p. 299–326, 1963.
  5. Colleran PN, Behnke BJ, Wilkerson MK, Donato AJ, Delp MD. Simulated microgravity alters rat mesenteric artery vasoconstrictor dynamics through an intracellular Ca2+ release mechanism. Am J Physiol Regul Integr Comp Physiol (March 19, 2008). doi:10.1152/ajpregu. 00084.2008.
  6. Delp MD, Colleran PN, Wilkerson MK, McCurdy MR, Muller-Delp J. Structural and functional remodeling of skeletal muscle microvasculature is induced by simulated microgravity. Am J Physiol Heart Circ Physiol 278: H1866–H1873, 2000.[Abstract/Free Full Text]
  7. McDonald KS, Delp MD, Fitts RH. Effect of hindlimb unweighting on tissue blood flow in the rat. J Appl Physiol 72: 2210–2218, 1992.[Abstract/Free Full Text]
  8. Meck JV, Reyes CJ, Perez SA, Goldberger AL, Ziegler MG. Marked exacerbation of orthostatic intolerance after long- vs. short-duration spaceflight in veteran astronauts. Psychosom Med 63: 865–873, 2001.[Abstract/Free Full Text]
  9. Overton JM, Woodman CR, Tipton CM. Effect of hindlimb suspension on VO2max and regional blood flow responses to exercise. J Appl Physiol 66: 653–659, 1989.[Abstract/Free Full Text]
  10. Rogers AI, David S. Intestinal blood flow and diseases of vascular impairment. In: Bockus Gastroenterology (5th ed.), edited by Haubrich WS, Schaffner F, Berk JE., Philadelphia: WB Saunders, 1994, p. 1212–1234.
  11. Rowell LB, Detry JM, Blackmon JR, Wyss C. Importance of the splanchnic vascular bed in human blood pressure regulation. J Appl Physiol 32: 213–220, 1972.[Free Full Text]
  12. Waters WW, Ziegler MG, Meck JV. Postspaceflight orthostatic hypotension occurs mostly in women and is predicted by low vascular resistance. J Appl Physiol 92: 586–594, 2002.[Abstract/Free Full Text]
  13. Wilkerson MK, Lesniewski LA, Golding EM, Bryan RM, Amin A, Wilson E, Delp MD. Simulated microgravity enhances cerebral artery vasoconstriction and vascular resistance through an endothelial nitric oxide mechanism. Am J Physiol Heart Circ Physiol 288: H1652–H1661, 2005.[Abstract/Free Full Text]




This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
294/5/R1575    most recent
00179.2008v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ray, C. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ray, C. A.


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Visit Other APS Journals Online
Copyright © 2008 by the American Physiological Society.