5-hydroxytryptamine and vascular disease.

The release of 5-hydroxytryptamine (5-HT) from aggregating platelets may trigger acute vasospastic episodes of larger arteries, which can lead to tissue ischemia, particularly in the coronary and cerebral circulations. In hypertensive humans and animals, 5-HT may play a role in the maintenance of the chronic increase in peripheral resistance. This is suggested by the observations that 1) in several models of chronic hypertension there is a specific increase in the responsiveness of the blood vessel wall to the vasoconstrictor properties of 5-HT and a delayed tachyphylaxis to the monoamine; 2) the ability of hypertensive animals to clear 5-HT from the blood is reduced, and the platelets of hypertensive patients take up less 5-HT than those of normotensive humans; their activation to release 5-HT is accelerated; and 3) ketanserin, a 5-HT2-serotonergic antagonist devoid of agonistic properties, lowers arterial blood pressure in hypertensive humans and animals.