Arterial hypertension in heart transplant recipients trated with triple-drug immunosuppressive therapy

M. T. Olivari, A. Antolick, W. S. Ring

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

Arterial hypertension occurs in the majority of heart transplant recipients treated with high dosages of cyclosporine. The incidence of hypertension with lower loading and maintenance dosages of cyclosporine, as used with triple-drug immunosuppressive therapy is unknown. Fifty-six patients who had transplantation at the University of Minnesota, Minneapolis, from December 1983 through December 1986, received low loading (6 to 10 mg/kg) and maintenance dosages of cyclosporine in addition to azathioprine (2 to 2.5 mg/kg/day) and prednisone. Two weeks after transplantation 68% of the patients were hypertensive (blood pressure greater than 140/90 mm Hg) despite normal serum creatinine levels (1.14 ± 0.33 mg/dl). The number of patients requiring treatment for hypertension increased progressively, with 92% of the patients being hypertensive by 6 months. No correlation was found between blood pressure values, serum creatinine levels, and cyclosporine levels in the blood. Systemic vascular resistances were elevated 1 year after transplantation, whereas cardiac output and ventricular filling pressures were normal. Circulating norepinephrine levels, abnormally elevated before transplantation, normalized after operation. In 13 heart recipients in whom sequential measurements were obtained, plasma norepinephrine levels decreased within 2 weeks after transplantation. These data indicated that hypertension develops in almost all patients after heart transplantation despite the lower dosage of cyclosporine used with the triple-drug immunosuppressive therapy and the absence of significant renal impairment with this regimen, and probably it is not the result of activation of the sympathetic nervous system.

Original languageEnglish (US)
Pages (from-to)34-39
Number of pages6
JournalJournal of Heart Transplantation
Volume8
Issue number1
StatePublished - Jan 1 1989

ASJC Scopus subject areas

  • Transplantation

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