© 1999 by European Society of Cardiology
Copyright © 1999, European Society of Cardiology
The role of corticosteroids in the regulation of vascular tone
Department of Medicine, Medical University of South Carolina, Clinical Sciences Building 829, 171 Ashley Avenue, Charleston, SC 29425, USA
* Tel.: +843-792-4122; fax: +843-792-8399; e-mail: ullianme@musc.edu
Received 11 February 1998; accepted 30 June 1998
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1 Introduction |
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Disease states resulting from excesses of circulating (adreno)corticosteroids include primary hyperaldosteronism, renal artery stenosis, ACTH-secreting tumors, and administration of glucocorticoids for treatment of other diseases. Hypertension is commonly associated with these diseases. Although renal sodium retention and intravascular volume overload contribute to the attendant hypertension, especially early in the course of the disease, a non-renal mechanism (increase in peripheral vascular resistance) is involved in the development and maintenance of hypertension. The concept of non-renal actions of corticosteroids in the development of hypertension stems from a seminal report in which Langford and Snavely [1]demonstrated that deoxycorticosterone acetate raised blood pressure in dogs and rats devoid of renal mass. In addition, corticosteroids in lesser amounts are essential for the maintenance of peripheral vascular resistance in healthy persons. This review details the proposed mechanisms by which corticosteroids maintain and, in excess, enhance vascular tone.
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2 Corticosteroid receptors in vascular smooth muscle |
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If corticosteroids indeed regulate vascular tone, vascular smooth
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3 Potentiation of vasoconstrictor action by corticosteroids |
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3.1
-Adrenergic agonists3.2 Angiotensin II
3.3 Others vasoconstrictors
3.4 Differences in corticosteroid effects in regional vasculature
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4 Mechanisms of potentiation of vasoconstrictor action by corticosteroids: upregulation of vasoconstrictor receptors in vascular smooth muscle |
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4.1 Corticosteroid effects on receptors for
-adrenergic agonists4.2 Corticosteroid effects on receptors for angiotensin II
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5 Potentiation of vasoconstrictor action by corticosteroids: non-receptor mechanisms |
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5.1 Corticosteroid targets external to the VSMCs
5.2 Corticosteroid targets within VSMCs
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6 Acute vascular actions of corticosteroids |
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7 Vascular hypertrophy |
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8 Summary and integrated approach to the problem |
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