Impaired Vasodilation and Nitric Oxide Synthase Activity in Glucocorticoid-Induced Hypertension

Brett M. Mitchell, R Clinton Webb

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Synthetic glucocorticoids are among the most widely prescribed medications by physicians. Although they have a vast array of beneficial effects such as immunosuppression and anti-inflammation, excess glucocorticoids can lead to iatrogenic Cushing’s syndrome, which includes hypertension and cardiovascular disease. The exact mechanism by which glucocorticoids elevate blood pressure is not completely understood, but it appears to be a complex pathology that involves increased responsiveness to vasoconstrictors and decreased vasodilator production. Nitric oxide is a vasodilator that plays a key role in blood pressure regulation, and previous studies have shown that a reduction in nitric oxide production or bioavailability contributes to hypertension. Tetrahydrobiopterin, a necessary cofactor for nitric oxide synthase activity, can affect nitric oxide production and bioavailability, with low levels causing decreased nitric oxide production. However, little is known about the interaction between glucocorticoids and tetrahydrobiopterin levels. In this review, the roles of nitric oxide and tetrahydrobiopterin in the pathogenesis of glucocorticoid hypertension will be discussed. Furthermore, the authors propose that glucocorticoids exert a genomic effect to decrease guanosine triphosphate cyclohydrolase I, the rate-limiting enzyme in the production of tetrahydrobiopterin. In the future, tetrahydrobiopterin supplementation in patients with iatrogenic Cushing’s syndrome may prove to be beneficial and decrease mortality attributed to cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)16-21
Number of pages6
JournalBiological Research for Nursing
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2002

Fingerprint

Vasodilation
Nitric Oxide Synthase
Glucocorticoids
Nitric Oxide
Hypertension
Cushing Syndrome
Vasodilator Agents
Biological Availability
Cardiovascular Diseases
Blood Pressure
Vasoconstrictor Agents
Guanosine Triphosphate
Immunosuppression
sapropterin
Pathology
Inflammation
Physicians
Mortality
Enzymes

Keywords

  • Cushing’s syndrome
  • glucocorticoids
  • hypertension
  • nitric oxide
  • tetrahydrobiopterin
  • vascular reactivity

ASJC Scopus subject areas

  • Research and Theory

Cite this

Impaired Vasodilation and Nitric Oxide Synthase Activity in Glucocorticoid-Induced Hypertension. / Mitchell, Brett M.; Webb, R Clinton.

In: Biological Research for Nursing, Vol. 4, No. 1, 01.01.2002, p. 16-21.

Research output: Contribution to journalArticle

@article{f1a952eec8c7478fb8f91712fae10b0b,
title = "Impaired Vasodilation and Nitric Oxide Synthase Activity in Glucocorticoid-Induced Hypertension",
abstract = "Synthetic glucocorticoids are among the most widely prescribed medications by physicians. Although they have a vast array of beneficial effects such as immunosuppression and anti-inflammation, excess glucocorticoids can lead to iatrogenic Cushing’s syndrome, which includes hypertension and cardiovascular disease. The exact mechanism by which glucocorticoids elevate blood pressure is not completely understood, but it appears to be a complex pathology that involves increased responsiveness to vasoconstrictors and decreased vasodilator production. Nitric oxide is a vasodilator that plays a key role in blood pressure regulation, and previous studies have shown that a reduction in nitric oxide production or bioavailability contributes to hypertension. Tetrahydrobiopterin, a necessary cofactor for nitric oxide synthase activity, can affect nitric oxide production and bioavailability, with low levels causing decreased nitric oxide production. However, little is known about the interaction between glucocorticoids and tetrahydrobiopterin levels. In this review, the roles of nitric oxide and tetrahydrobiopterin in the pathogenesis of glucocorticoid hypertension will be discussed. Furthermore, the authors propose that glucocorticoids exert a genomic effect to decrease guanosine triphosphate cyclohydrolase I, the rate-limiting enzyme in the production of tetrahydrobiopterin. In the future, tetrahydrobiopterin supplementation in patients with iatrogenic Cushing’s syndrome may prove to be beneficial and decrease mortality attributed to cardiovascular disease.",
keywords = "Cushing’s syndrome, glucocorticoids, hypertension, nitric oxide, tetrahydrobiopterin, vascular reactivity",
author = "Mitchell, {Brett M.} and Webb, {R Clinton}",
year = "2002",
month = "1",
day = "1",
doi = "10.1177/1099800402004001003",
language = "English (US)",
volume = "4",
pages = "16--21",
journal = "Biological Research for Nursing",
issn = "1099-8004",
publisher = "SAGE Publications Inc.",
number = "1",

}

TY - JOUR

T1 - Impaired Vasodilation and Nitric Oxide Synthase Activity in Glucocorticoid-Induced Hypertension

AU - Mitchell, Brett M.

AU - Webb, R Clinton

PY - 2002/1/1

Y1 - 2002/1/1

N2 - Synthetic glucocorticoids are among the most widely prescribed medications by physicians. Although they have a vast array of beneficial effects such as immunosuppression and anti-inflammation, excess glucocorticoids can lead to iatrogenic Cushing’s syndrome, which includes hypertension and cardiovascular disease. The exact mechanism by which glucocorticoids elevate blood pressure is not completely understood, but it appears to be a complex pathology that involves increased responsiveness to vasoconstrictors and decreased vasodilator production. Nitric oxide is a vasodilator that plays a key role in blood pressure regulation, and previous studies have shown that a reduction in nitric oxide production or bioavailability contributes to hypertension. Tetrahydrobiopterin, a necessary cofactor for nitric oxide synthase activity, can affect nitric oxide production and bioavailability, with low levels causing decreased nitric oxide production. However, little is known about the interaction between glucocorticoids and tetrahydrobiopterin levels. In this review, the roles of nitric oxide and tetrahydrobiopterin in the pathogenesis of glucocorticoid hypertension will be discussed. Furthermore, the authors propose that glucocorticoids exert a genomic effect to decrease guanosine triphosphate cyclohydrolase I, the rate-limiting enzyme in the production of tetrahydrobiopterin. In the future, tetrahydrobiopterin supplementation in patients with iatrogenic Cushing’s syndrome may prove to be beneficial and decrease mortality attributed to cardiovascular disease.

AB - Synthetic glucocorticoids are among the most widely prescribed medications by physicians. Although they have a vast array of beneficial effects such as immunosuppression and anti-inflammation, excess glucocorticoids can lead to iatrogenic Cushing’s syndrome, which includes hypertension and cardiovascular disease. The exact mechanism by which glucocorticoids elevate blood pressure is not completely understood, but it appears to be a complex pathology that involves increased responsiveness to vasoconstrictors and decreased vasodilator production. Nitric oxide is a vasodilator that plays a key role in blood pressure regulation, and previous studies have shown that a reduction in nitric oxide production or bioavailability contributes to hypertension. Tetrahydrobiopterin, a necessary cofactor for nitric oxide synthase activity, can affect nitric oxide production and bioavailability, with low levels causing decreased nitric oxide production. However, little is known about the interaction between glucocorticoids and tetrahydrobiopterin levels. In this review, the roles of nitric oxide and tetrahydrobiopterin in the pathogenesis of glucocorticoid hypertension will be discussed. Furthermore, the authors propose that glucocorticoids exert a genomic effect to decrease guanosine triphosphate cyclohydrolase I, the rate-limiting enzyme in the production of tetrahydrobiopterin. In the future, tetrahydrobiopterin supplementation in patients with iatrogenic Cushing’s syndrome may prove to be beneficial and decrease mortality attributed to cardiovascular disease.

KW - Cushing’s syndrome

KW - glucocorticoids

KW - hypertension

KW - nitric oxide

KW - tetrahydrobiopterin

KW - vascular reactivity

UR - http://www.scopus.com/inward/record.url?scp=0036652363&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036652363&partnerID=8YFLogxK

U2 - 10.1177/1099800402004001003

DO - 10.1177/1099800402004001003

M3 - Article

VL - 4

SP - 16

EP - 21

JO - Biological Research for Nursing

JF - Biological Research for Nursing

SN - 1099-8004

IS - 1

ER -