Role of sarcolemmal membrane sodium-calcium exchange in vascular smooth muscle tension.

A body of information obtained by experiments with intact tissues, isolated cells, and sarcolemmal vesicles indicates, beyond a reasonable doubt, that a specific Na(+)-Ca2+ exchange system exists in vascular smooth muscle. However, its role in the regulation of cytosolic free-Ca2+ concentration and cell tension under physiological conditions remains unclear. Under pharmacological conditions in which the Na(+)-K+ pump is inhibited either by digitalis glycosides or K(+)-free medium, Na(+)-Ca2+ exchange may be modulated by increases in cytosolic free Na+ to increase the cytosolic free-Ca2+ concentration and cell tension. Under pathological conditions in which the cytosolic Na+ concentration is increased as a result of inhibition of the Na(+)-K+ pump by endogenous ouabain or a digitalis-like factor, or activation of the Na(+)-H+ exchange or passive permeability of Na+, the Na(+)-Ca2+ exchange activity of vascular smooth muscle and the nerve terminal may play an important role in the development and/or maintenance of hypertension. These and other premises remain to be confirmed or discounted.