Elsewhere in this issue (pp 1-7), Frohlich and his associates report on a disease which they have defined as the "Hyperdynamic β-Adrenergic Circulatory State." In careful studies they were able to identify, within the large population of patients with elevated blood pressures, a group of individuals who would respond dramatically to propranolol hydrochloride therapy. This important clinical designation was in part determined by the use of a pharmacologic diagnostic test, an infusion of isoproterenol hydrochloride. Patients with the disease "hyperrespond" to such an infusion demonstrating increased heart rates, increased cardiac output, and occasionally the symptoms of frank panic. This report raises many interesting questions about the role of the autonomic nervous system in arterial hypertension and about the locus of receptors to drugs whose action appears to be primarily upon autonomic nervous system function.
The efferent sympathetic division of the autonomic nervous system may be thought of as consisting of