Tetrahydrobiopterin Ameliorates the Exaggerated Exercise Pressor Response in Patients with Chronic Kidney Disease: A Randomized Controlled Trial.

Tetrahydrobiopterin Ameliorates the Exaggerated Exercise Pressor Response in Patients with Chronic Kidney Disease: A Randomized Controlled Trial. Am J Physiol Renal Physiol. 2016 Mar 9;:ajprenal.00527.2015 Authors: Lin A, Liao P, Millson EC, Quyyumi AA, Park J Abstract Chronic kidney disease (CKD) patients have an exaggerated increase in blood pressure (BP) during rhythmic (RHG 20%) and static (SHG 30%) handgrip exercise. Nitric Oxide (NO) levels increase during exercise and help prevent excessive hypertension by both increasing vasodilation and reducing sympathetic nerve activity (SNA). Therefore, we hypothesized that tetrahydrobiopterin (BH4), an essential cofactor for nitric oxide synthase (NOS), would ameliorate the exaggerated exercise pressor response in CKD patients. In a randomized, double-blinded, placebo-controlled trial, we tested the effects of 12 weeks of sapropterin dihydrochloride (6R-BH4, N=18) versus placebo (N=14), on BP and muscle SNA (MSNA) responses during RHG 20% and SHG 30% in CKD patients. The 6R-BH4 group had a significantly lower systolic blood pressure (SBP, +6±1 vs. +13±2 mm Hg, p=0.002) and mean arterial pressure (MAP) response (+5±1 vs. +10±2 mm Hg, p=0.020) during RHG 20%, and a significantly lower SBP response (+19±3 vs. +28±3 mm Hg, p=0.043) during SHG 30%. Under baseline conditions, there was no significant difference in MSNA responses between the groups; however, when equalizing the BP respons...
Source: Am J Physiol Renal P... - Category: Urology & Nephrology Authors: Tags: Am J Physiol Renal Physiol Source Type: research