Abnormal renin short feedback loop in essential hypertension is reversible with converting enzyme inhibition.

The suppression of renin release by angiotensin II (AII) (the so-called short feedback loop) is blunted in essential hypertension. To determine whether this abnormality is reversible, renin release was assessed in sodium-restricted essential hypertensives and normal controls: (a) during the administration of captopril for varying intervals and (b) following the infusion of graded doses of AII (0.3-3 ng/kg per min) before and after plasma levels of AII had been chronically reduced with captopril (25-50 mg every 6 h) for 70 h. In control subjects, the maximal increment above control in plasma renin activity (PRA) after a single dose of captopril (11.9+/-3 ng/ml per h) was significantly (P < 0.02) greater than in hypertensives (8.1+/-1.7 ng/ml per h) despite similar reductions in AII levels and significantly greater decrements in diastolic blood pressure in the hypertensives. When captopril was continued for 70 h, the PRA increments above base line in hypertensive subjects (11.4+/-2.9 ng/ml per h) rose to levels seen in the controls (11+/-2.6 ng/ml per h); there were no significant differences in the AII or diastolic blood pressure decrements between the two groups. Compared with normotensive subjects, AII failed to suppress renin release in hypertensive subjects despite significantly greater diastolic blood increments and comparable AII levels achieved at each AII dose. After captopril treatment, AII now produced significant declines in PRA in the hypertensives; moreover, comparing declines pre- and postcaptopril, greater PRA decrements were seen either at comparable rises in levels of AII or diastolic blood pressure. Finally, the suppression of PRA by AII postcaptopril in hypertensives was now indistinguishable from that seen in normal controls. Thus, the impaired regulation of renin by AII is reversible with prolonged captopril treatment, suggesting that this abnormality is not due to a fixed structural defect but to a reversible lesion.

Calmodulin-like activity and calcium-dependent phosphodiesterase in purified cells of the rat zona glomerulosa and zona fasciculata.

We have studied calmodulin (CaM)-like activity and calcium (Ca++)-regulated phosphodiesterase (PDE) activity in cells from the rat adrenal zona glomerulosa (ZG) and zona fasciculata (ZF). Boiled cell sonicates from the ZG and ZF activated CaM-deficient PDE in a dose-dependent fashion by 2.0- to 2.3-fold. The properties of this stimulatory factor were similar to those of authentic CaM in a number of respects: 1) both activated CaM-deficient PDE at micromolar calcium concentrations; 2) both eluted at similar ionic strengths on DEAE-cellulose ion exchange chromatography; 3) the activation of CaM-dependent PDE activity was blocked by the CaM inhibitor trifluoperazine in both cases; and 4) Ca++-dependent activation of PDE was totally inhibited by an excess of EGTA. Boiled sonicates of cells from the ZG and ZF contained 366 +/- 53 and 882 +/- 69 ng/10(6) cells of CaM-like activity (P less than 0.01), respectively, as determined by comparison with activation of CaM-deficient PDE by a known amount of authentic rat CaM. The CaM contents of the ZG and ZF, determined by RIA, were 1050 +/- 35 and 1760 +/- 112 ng/10(6) cells, respectively (P less than 0.01). Under identical conditions, there were 4 times more cAMP and cGMP PDE activities in the ZG than in the ZF. EGTA (1 mM) or trifluoperazine (10(-4) M) inhibited 20% of PDE activity in ZG, and the addition of excess Ca++ (1.1 mM) restored about 50% of the EGTA-inhibited PDE activity. Maximal PDE activity in each cell type eluted at 0.25 M NaCl using DEAE-cellulose ion exchange chromatography. This activity was partially inhibited by EGTA. Moreover, each cell type contained CaM-like activity that migrated at 0.25 M NaCl. The ZF contained a second peak of CaM that migrated at 0.35 M NaCl. Boiled sonicates of the ZF and ZG, on the other hand, each had a single peak of CaM-like activity, which eluted from DEAE-cellulose at 0.28-0.29 M NaCl, similar to that of pure CaM from rat testes. Thus, these experiments demonstrate the presence of a heat-stable activator of CaM-dependent PDE activity in the ZG and ZF that is similar by a number of criteria to purified CaM. The presence of CaM and a Ca++-dependent PDE in the adrenal suggests that the effects of Ca++ on adrenal function might be mediated, in part, by this or other CaM-regulated enzymes.

Renal angiotensin receptor mapping in obese spontaneously hypertensive rats.

Obese spontaneously hypertensive rats (SHR) develop nephropathy with severe proteinuria, but lean littermates do not develop renal disease. Intrarenal angiotensin has been suggested to contribute to nephropathy in other experimental models. We examined the regulation of angiotensin receptors as a reflection of target tissue response to possible changes in the renin-angiotensin system. We visualized angiotensin receptors in kidneys of 6-8-month-old obese SHR and their lean littermates. Both obese and lean rats were hypertensive as determined by tail-cuff or by direct measurement. Histologic studies showed early glomerular sclerosis in obese but not lean rats. Autoradiographic visualization of angiotensin receptor binding sites in both obese and lean SHR showed glomeruli and medullary rays having the highest levels of binding with additional diffuse labeling in cortex and outer medulla. In obese rats, binding was reduced relative to lean littermates, particularly in the medulla, while intense binding in glomeruli was preserved. Loss of receptors did not reflect tissue damage, since the medulla showed no pathological changes. Biochemical assays of the binding of subtype-selective antagonists to 125I-angiotensin sites in intact sections showed that both losartan-sensitive and PD 123319-sensitive sites were decreased in nephrotic obese rats. We conclude that specific binding sites for angiotensin are decreased in obese SHR with early glomerular sclerosis, suggesting that angiotensin receptors may be regulated by pathogenic processes in this model of renal disease.

Refeeding hypertension in obese spontaneously hypertensive rats.

Very-low-calorie diets lower blood pressure acutely in obese humans and rats. However, refeeding after dietary restriction produces mild hypertension in rats. Refeeding hypertension was characterized in genetically obese spontaneously hypertensive rats (obese SHR, Koletsky rat), a model of genetic obesity and hypertension. Obese SHR were fed a restricted diet (Optifast) for 12 days, refed ad libitum for 28 days, dieted again for 12 days, and then refed 4 days and killed. Control obese SHR and lean SHR littermates were fed ad libitum continuously. Dietary restriction led to rapid weight loss followed by prompt regain to baseline weight after return to unrestricted food intake. Heart rate fell with institution of the low-calorie diet and returned to baseline on refeeding. Blood pressure became elevated during refeeding in dieted obese SHR relative to ad libitum fed obese SHR controls. The fall in blood pressure after ganglionic blockade with chlorisondamine was exaggerated in refed obese SHR, and cardiac beta-adrenergic receptors were downregulated. Both of these findings imply increased sympathetic tone. The left ventricular wall was thicker in the refed obese SHR than in the ad libitum fed obese SHR. Shorter cycles of weight loss and regain in lean SHR led to transient increases in blood pressure and heart rate. Cycles of dietary restriction and refeeding in obese SHR elicit sustained blood pressure elevation via sympathetic activation and exacerbate cardiac hypertrophy. Drastic fluctuations in nutrient intake may not be advantageous in hypertension.

Contribution of prostaglandins to the antihypertensive action of captopril in essential hypertension.

To determine whether prostaglandins contribute to the depressor response to the converting enzyme inhibitor, captopril, we measured the plasma prostaglandin levels by radioimmunoassy before and after captopril administration, and then examined the effect of prostaglandin synthetase inhibition on captopril's antihypertensive effect. When a single oral captopril dose (25-100 mg) was given to 31 sodium-restricted patients with essential hypertension, the levels of the stable transformation product of prostacyclin remained unmeasurable and that of thromboxane A2 did not change, while the metabolite of PGE2 (PGE-M) increased by 53% (34 +/- 4pg/ml pre-captopril, 52 +/- 5 pg/ml after; p less than 0.001). As expected, blood pressure (BP) and angiotension II (AII levels fell, and kinin levels rose (all changes p less than 0.001). We then blocked prostaglandin synthesis in 18 of these subjects for 24 hours with either indomethacin (n = 10) or aspirin (n = 8) before repeating the captopril dose, to assess the importance of these PGE-M increments. The PGE-M responses to captopril were effectively blocked in nine of 10 subjects receiving indomethacin and four of eight receiving aspirin. In these 13 patients, the depressor response to captopril was significantly blunted (-20 +/- 3mm Hg pre-synthetase inhibition vs - 13 +/- 2 mm Hg post; p less than 0.05). When these agents did not block the PGE-M response to captopril, the BP response was also unchanged (-15 +/- 4mm Hg pre, -18 +/- 5mm Hg post). Neither indomethacin nor aspirin changed the AII or kinin responses to captopril. We conclude that the prostaglandins may be important mediators of captopril's antihypertensive effect in the sodium-restricted state.

Effects of weight cycling on urinary catecholamines: sympathoadrenal role in refeeding hypertension.

OBJECTIVES: We sought to determine whether the sympathetic nervous system plays a role in the hypertensive response to refeeding from a very low-calorie diet (VLCD). DESIGN: Cycles of weight loss and regain were induced in the obese spontaneously hypertensive rat (SHROB) model of genetic obese hypertension. METHODS: A 12-day VLCD (1/6 of baseline calories) was alternated with 4-6 weeks of ad libitum chow refeeding for three cycles. Control SHROB ate chow ad libitum. Urine was collected for 24 h before and after each period of VLCD, and catecholamines were measured radioenzymatically. Tail cuff blood pressures and body weight were measured in parallel with urine collections. Kidneys were collected for assay of alpha2-adrenergic receptor density. RESULTS: VLCD induced rapid weight loss, but all the lost weight was regained during refeeding. Blood pressure fell during caloric restriction, but rose above baseline during refeeding. Urinary excretion of norepinephrine, epinephrine and dopamine changed several fold during weight cycling. Urinary catecholamines paralleled the changes in blood pressure, falling during caloric restriction and rebounding during refeeding. Dopamine showed the greatest decreases during weight loss and rises during weight regain, whereas epinephrine changed the least and norepinephrine was intermediate. Weight cycling elevated blood pressure above the initial baseline throughout the rapid weight gain phase of refeeding. The density of alpha2-adrenergic receptors was decreased in both the renal medulla and cortex of weight cycled SHROB, consistent with receptor down-regulation owing to overstimulation. CONCLUSIONS: The exacerbations of hypertension during weight regain in SHROB coincide with sustained activation of sympathoadrenal activity, as reflected in urinary catecholamine excretion and adrenergic receptor down regulation.

Simultaneous determination of plasma aldosterone, corticosterone, 11-deoxycorticosterone, 18-hydroxydeoxycorticosterone, cortisol, and 11-deoxycortisol. Methods and applications.

A method for the simultaneous determination of aldosterone, corticosterone (B), 11-deoxycorticosterone (DOC), 18-hydroxy-11-deoxycorticosterone (18-OH-DOC), cortisol, and 11-deoxycortisol in a single 1-ml sample of plasma is described. The method is applicable to both man and experimental animal. After extraction and purification by thin-layer chromatography (TLC), aldosterone was determined by radioimmunoassay (RIA) employing antibodies to aldosterone: B, DOC, cortisol and 11-deoxycortisol were determined by RIA employing antibodies to corticosterone; 18-OH-DOC was obtained colorimetrically using the Porter-Silber reagent. Recoveries after extraction and chromatography were: aldosterone 71% +/- 9.4 SD; B 81% +/- 10.2; DOC 73% +/- 8.4; cortisol 65% +/- 7.2; 11-deoxycortisol 74% +/- 6.3 using labeled steroids; 18-OH-DOC 82% +/- 8.7 using inert steroid. The method has a high specificity and is reproducible and accurate.

Molecular pathology in the obese spontaneous hypertensive Koletsky rat: a model of syndrome X.

The SHROB rat is a unique strain with genetic obesity, hypertriglyceridemia, hyperinsulinemia, renal disease with proteinuria, and genetically determined hypertension, characteristics paralleling human Syndrome X. The obese phenotype results from a single homozygous recessive trait, designated faK, and is allelic with the Zucker fatty trait (fa), but of distinct origin. The faK mutation is a premature stop codon in the extracellular domain of the leptin receptor, resulting in a natural receptor knockout. The SHROB are glucose intolerant compared to heterozygous or wild-type SHR, but retain fasting euglycemia even on a high sucrose diet, suggesting that diabetes requires polygenic interaction with additional modifier genes. Insulin-stimulated phosphorylation of tyrosine residues on the insulin receptor and on the associated docking protein IRS-1 are reduced in skeletal muscle and liver compared to SHR, due mainly to diminished expression of insulin receptor and IRS-1 proteins. Despite multiple metabolic derangements and severe insulin resistance, hypertension is not exacerbated in SHROB compared to SHR. Thus, insulin resistance and hypertension are independent in this model. Increased activity of the sympathetic nervous system may be a common factor leading by separate pathways to hypertension and to insulin resistance. We studied the chronic effects of sympathetic inhibition with moxonidine on glucose metabolism in SHROB. Moxonidine (8 mg/kg/day), a selective I1-imidazoline receptor agonist, not only reduced blood pressure but also ameliorated glucose intolerance. Moxonidine reduced fasting insulin by 47% and plasma free fatty acids by 30%. Moxonidine enhanced expression and insulin-stimulated phosphorylation of IRS-1 in skeletal muscle by 74 and 27%, respectively. Thus, central sympatholytic therapy not only counters hypertension but also insulin resistance, glucose tolerance, and hyperlipidemia in the SHROB model of Syndrome X.

Ventilation and metabolism among rat strains.

We examined ventilation and metabolism in four rat strains with variation in traits for body weight and/or blood pressure regulation. Sprague-Dawley [SD; 8 males (M), 8 females (F)], Brown Norway (BN; 10 M, 11 F), and Zucker (Z; 11 M, 12 F) rats were compared with Koletsky (K; 11 M, 11 F) rats. With the use of noninvasive plethysmography, frequency, tidal volume, minute ventilation (VE), O2 consumption, and CO2 production were derived at rest during normoxia (room air) and during the 5th minute of exposure to each of the following: hyperoxia (100% O2), hypoxia (10% O2-balance N2), and hypercapnia (7% CO2-balance O2). Statistical methods probed for strain and sex effects, with covariant analysis by body weight, length, and body mass. During resting breathing, strain effects were found with respect to both frequency (BN, Z > K, SD) and tidal volume (SD > BN, Z) but not to VE. Sex influenced frequency (F > M) alone. Z rats had higher values for O2 consumption, CO2 production, and respiratory quotient than the other three strains, with no independent effect by sex. During hyperoxia, frequency was greater in BN and Z than in SD or K rats; SD rats had a larger tidal volume than BN or Z rats; Z rats had a greater VE than K rats; and M had a larger tidal volume than F. Strain differences persisted during hypercapnia, with Z rats exhibiting the highest frequency and VE values. During hypoxic exposure, strain effects were found to influence VE (SD > K, Z), frequency (BN > K), and tidal volume (SD > BN, K, Z). Body mass was only a modest predictor of VE during normoxia, of both VE and tidal volume with hypoxia, hypercapnia, or hyperoxia, and of frequency during hypercapnia. We conclude that strain of rats, more than their body mass or sex, has major and different influences on metabolism, the pattern and level of ventilation during air breathing, and ventilation during acute exposure to hypercapnia or hypoxia.

Decreased transport of leptin across the blood-brain barrier in rats lacking the short form of the leptin receptor.

Leptin is produced in adipose tissue in the periphery, but its satiety effect is exerted in the CNS that it reaches by a saturable transport system across the blood-brain barrier (BBB). The short form of the leptin receptor has been hypothesized to be the transporter, with impaired transport of leptin being implicated in obesity. In Koletsky rats, the splice variant that gives rise to the short form of the leptin receptor contains a point mutation that results in marked obesity. We studied the transport of leptin across the BBB in Koletsky rats and found it to be significantly less than in their lean littermates. By contrast, Sprague-Dawley rats matched in weight to each of these two groups showed no difference in the blood-to-brain influx of leptin. HPLC showed that most of the leptin crossing the BBB in rats remained intact and capillary depletion showed that most of the leptin reached the parenchyma of the brain. The results indicate that the short form of the leptin receptor is involved in the transport of leptin across the BBB.

The I1-imidazoline receptor: from binding site to therapeutic target in cardiovascular disease.

OBJECTIVE: To review previous work and present additional evidence characterizing the I1-imidazoline receptor and its role in cellular signaling, central cardiovascular control, and the treatment of metabolic syndromes. Second-generation centrally-acting antihypertensives inhibit sympathetic activity mainly via imidazoline receptors, whereas first-generation agents act via alpha2-adrenergic receptors. The I1 subtype of imidazoline receptor resides in the plasma membrane and binds central antihypertensives with high affinity. METHODS AND RESULTS: Radioligand binding assays have characterized I1-imidazoline sites in the brainstem site of action for these agents in the rostral ventrolateral medulla. Binding affinity at I1-imidazoline sites, but not at other classes of imidazoline binding sites, correlates closely with the potency of central antihypertensive agents in animals and in human clinical trials. The antihypertensive action of systemic moxonidine is eliminated by the I1/alpha2-antagonist efaroxan, but not by selective blockade of alpha2-adrenergic receptors. Until now, the cell signaling pathway coupled to I1-imidazoline receptors was unknown. Using a model system lacking alpha2-adrenergic receptors (PC12 pheochromocytoma cells) we have found that moxonidine acts as an agonist at the cell level and I1-imidazoline receptor activation leads to the production of the second messenger diacylglycerol, most likely through direct activation of phosphatidylcholine-selective phospholipase C. The obese spontaneously hypertensive rat (SHR; SHROB strain) shows many of the abnormalities that cluster in human syndrome X, including elevations in blood pressure, serum lipids and insulin. SHROB and their lean SHR littermates were treated with moxonidine at 8 mg/kg per day. SHROB and SHR treated with moxonidine showed not only lowered blood pressure but also improved glucose tolerance and facilitated insulin secretion in response to a glucose load. Because alpha2-adrenergic agonists impair glucose tolerance, I1-imidazoline receptors may contribute to the multiple beneficial effects of moxonidine treatment. CONCLUSION: The I1-imidazoline receptor is a specific high-affinity binding site corresponding to a functional cell-surface receptor mediating the antihypertensive actions of moxonidine and other second-generation centrally-acting agents, and may play a role in countering insulin resistance in an animal model of metabolic syndrome X.

Fulminant Mycoplasma pneumoniae infection. Report of a fatal case, and a review of the literature.

Fatal Mycoplasma pneumoniae infection in a 30-yr-old woman is described. After 9 days of symptoms, the patient developed severe respiratory distress, rapidly progressive pneumonia, cardiovascular collapse, and acute renal failure. Death occurred 24 h after hospital admission. Postmortem examination demonstrated a diffuse membranous laryngotracheobronchitis, massive bilateral pneumonia, disseminated intravascular coagulation with widespread renal involvement, and hemorrhagic necrosis of the adrenal glands. Mycoplasma pneumoniae was isolated from the trachea, lungs, kidney, and brain, indicating hematogenous dissemination of the organism from its portal of entry in the respiratory tract.

Acceleration of renal disease in obese SHR by exacerbation of hypertension.

1. Obese SHR have lower blood pressures than lean littermates on ad libitum diets of standard rat chow and develop spontaneous progressive kidney disease with marked proteinuria, whereas lean SHR have only mild proteinuria. 2. On a high-salt diet, obese SHR show dramatic elevations in blood pressure accompanied by accelerated renal disease and mortality. Lean SHR are also salt sensitive but to a lesser degree. 3. Weight cycling elevates blood pressure in obese SHR to levels comparable to lean SHR littermates. This elevation in blood pressure is accompanied by an exacerbation of kidney disease relative to age-matched controls. 4. Ganglionic blockade reversed the elevation in blood pressure in obese SHR elicited by either high-salt diet or weight cycling. Therefore, excess sympathetic nervous activity contributes to the impact of these hypertensive stimuli. 5. Exacerbation of hypertension accelerates renal disease in obese SHR.

Dietary chloride modifies renin release in normal humans.

The effect of high and low chloride diets on the responses of plasma renin activity (PRA), angiotensin II (ANG II), and aldosterone (Aldo) to upright posture was studied in the same normal subjects in balance on constant sodium intake. Diet 1 consisted of 10 meq Na/day (low Na) and either 50 or 150 meq Cl/day. Diet 2 consisted of 200 meq Na/day (high Na) and either 20 or 200 meq Cl/day. The mean recumbent PRA level on the high Na-high Cl diet tended to be lower than on the high Na-low Cl diet but was not significantly different. However, the absolute peak upright PRA levels, 8.8 +/- 1.0 vs. 4.4 +/- 0.8 ng . ml-1 . h-1, and the incremental difference (delta PRA) between recumbent and peak upright PRA levels, 5.5 +/- 0.8 vs. 2.2 +/- 0.5 ng . ml-1 . h-1, were significantly less on the high Na-high Cl diet compared with the high Na-low Cl diet. Similar significant changes were seen in ANG II and Aldo levels. However, there were no significant changes in PRA, ANG II, and Aldo responses to upright posture on the low Na diet when the dietary Cl was varied. It is concluded that dietary Cl is another factor modifying renin release. However, Cl is probably less important than Na because Cl-induced changes in PRA were not seen in the low salt state.

Consequences of weight cycling in obese spontaneously hypertensive rats.

We mimicked human weight cycling in the obese spontaneously hypertensive rat (SHROB) model of genetic obesity. A 12-day very low calorie diet (VLCD; 16.7% of baseline calories) was alternated with 4-6 wk of ad libitum chow refeeding for three cycles. Control SHROB ate chow ad libitum. VLCD induced rapid weight loss, but during refeeding all the lost weight was regained. Final body weight was higher in cycled rats than in ad libitum controls (149 +/- 5 vs. 117 +/- 7% of initial baseline). Less weight was lost as a percent of starting body weight during each successive VLCD, which could not be explained by aging. At death, retroperitoneal fat pads were heavier in cycled SHROB than in ad libitum controls (62 +/- 3 vs. 44 +/- 4 g). During the first 2 days after each VLCD, cycled rats overate significantly relative to ad libitum controls (88 +/- 2 vs. 78 +/- 3 kcal/day), but cumulative food intake throughout the duration of the experiment did not differ (11.4 +/- 0.6 vs. 11.7 +/- 0.1 Mcal). Compared with ad libitum-fed rats, food efficiency (g body wt gain/kcal) was increased during each refeeding period. Weight cycling elevated blood pressure above the initial baseline throughout refeeding. Refeeding hypertension was abolished by ganglionic blockade with chlorisondamine. Thus weight cycling in SHROB exacerbates obesity, metabolic efficiency, abdominal fat accumulation, sympathetic activity, and hypertension.

Cortisol suppression test in patients with elevated adrenocorticotropic hormone levels.

Increased adrenocorticotropic hormone (ACTH) levels after bilateral adrenalectomy could be secondary to a pituitary tumor, under replacement with cortisol, or an abnormality in the hypothalamic-pituitary-adrenal feedback loop. To distinguish between these possibilities, ACTH levels were measured before and after cortisol infusion (20 mg/h for 4 hours) in five groups: normal volunteers; patients with idiopathic adrenal insufficiency; and with bilateral adrenalectomy for Cushing's syndrome with no roentgenographic evidence of pituitary tumor, with pituitary tumors, and with equivocal roentgenographic studies (suspect pituitary tumors). Control ACTH levels in all groups of patients were higher than in normal volunteers but there was overlapping. Cortisol infusion suppressed ACTH in all subjects but the reductions in the last two groups were less than in the first three. The cortisol suppression test appears to be useful in determining whether increased ACTH level after adrenalectomy is due to a pituitary tumor.

Characterization of retinal vascular abnormalities in lean and obese spontaneously hypertensive rats.

1. The obese SHR (Koletsky rat; SHR-k) is a unique animal model for the study of microvascular changes associated with genetic obesity, spontaneous hypertension, endogenous hyperlipidaemia, and hyperinsulinaemic, non-insulin dependent diabetes mellitus (Type II). 2. Lean and obese SHR-k exhibit retinal vascular changes which have not been previously characterized and are more severe than previously described in other animal models of experimental hypertension or non-insulin dependent diabetes. 3. Progressive retinal capillary dropout, capillary cell changes, vascular tortuosity and dilatation are severe. Vessels form elevated varicose vascular tortuosities which leak fluorescein dye and which are more frequent in the obese SHR-k. This study suggests that lean and obese SHR may be unique models for the study of multivariate factors in the pathogenesis of ischaemic neovascular proliferation.

Sympathetic nervous system in salt-sensitive and obese hypertension: amelioration of multiple abnormalities by a central sympatholytic agent.

Excess activity of the sympathetic nervous system (SNS) is linked to human obese hypertension and to salt-sensitive hypertension. Paradoxically, reduced SNS activity has been implicated as a contributor to obesity, particularly in animal models, and salt loading usually inhibits SNS activity. We have investigated the relationship between SNS activity, diet, and hypertension in the obese spontaneously hypertensive rat (SHROB), a model with a recessive obesity trait superimposed on a hypertensive background with multiple metabolic abnormalities resembling human syndrome X. We examined the role of SNS overactivity in the adverse impact of excess dietary salt and the possible beneficial effects of sympatholytic therapy. Mean blood pressure (MBP) was increased in SHROB and SHR fed a 4% NaCl diet. The pressor effect of dietary salt was abolished by ganglionic blockade, suggesting that increased SNS activity contributed to the pressor effect of the high-salt diet. Moxonidine, a second-generation central antihypertensive, controlled hypertension in both SHROB and SHR. Kidney damage in SHROB was accelerated by dietary salt and was reduced by moxonidine. Moxonidine elicited progressive weight loss in SHROB but not in SHR. Food intake in SHROB was reduced to the level of lean SHR. SHROB and SHR treated with moxonidine showed improved glucose tolerance. Additionally, SHROB showed reduced levels of triglycerides, cholesterol, and insulin following moxonidine therapy. Inhibition of the SNS, as with moxonidine therapy, may ameliorate multiple abnormalities and have therapeutic advantages in obese hypertensive syndromes.