Phentolamine testing for alpha adrenergic participation in hypertensive patients: Independence from renin profiles
Phentolamine testing for alpha adrenergic participation in hypertensive patients: Independence from renin profiles
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高血压患者 α 肾上腺素能参与的酚妥拉明测试：独立于肾素谱
DOI：
10.1002/cpt1977223286
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发表时间：
1977
影响因子：
6.7
通讯作者：
J. H. Laragh
中科院分区：
文献类型：
--
作者：
J. Drayer;M. Weber;S. Atlas;J. H. Laragh
评价α肾上腺素能参与维持高血压患者的血压水平。酚妥拉明对30例坐位高血压病人静滴1 mg/min，20 min。诱导舒张压平均下降13.9 ± 9.2（SD）mm Hg：30例患者中有21例（70%）下降至少10%。收缩压下降7.8 ± 15.7 mm H g。与舒张压相比，降低幅度较小（P < 0.05）。输注期间心率增加36.2 ± 19.8 bpm，血浆肾素活性增加1.5 ± 2.6 ng/ml/hr。这些增加与诱发的血压变化无关。因此。推测反映了酚妥拉明的α阻断或β激动特性。当患者根据其肾素-钠指数细分时。高之间没有差异。正常和低肾素亚组之间的控制血浆肾素活性和收缩压或舒张压的诱导变化之间没有相关性。此外。24例分别接受血管紧张素转换酶抑制剂治疗的患者。替普罗肽其降压作用与酚妥拉明降压作用无关。在13例患者中，限制钠饮食刺激了肾素水平。对酚妥拉明的血压反应与对无限制钠饮食的研究相同。结果表明，α肾上腺素能因子可能经常参与维持高血压患者的血压。这种作用不依赖于肾素-血管紧张素系统和钠平衡状态。
To evaluate alpha adrenergic participation in sustaining blood pressure levels in hypertension. phentolanine. I mglmin for 20 min. was infUsed into 30 seated hypertensive patients. An average fall in diastolic blood pressure of 13.9 ± 9.2 (SD) mm Hg was induced: 21 of the 30 patients (70%) experienced a fall of at least 10%. Systolic blood pressure fell by 7.8 ± 15.7 mm H g. a decrement less (p < 0.05) than that for diastolic pressure. Heart rate increased by 36.2 ± 19.8 bpm and plasma renin activity increased by 1.5 ± 2.6 ng Iml Ihr during infusion. These increases did not correlate with the induced blood pressure changes and. thus. presumably reflected either the alpha blocking or perhaps beta agonistic properties of phentolamine. When patients were subdivided according to their renin‐sodium indices. there were no differences between the high. normal. and low renin subgroups in response to phentolamine and there was no correlation between control plasma renin activity and induced changes in systolic or diastolic blood pressure. Furthermore. in 24 patients who separately received an angiotensin‐converting enzyme inhibitor. teprotide. there was no relationship between the blood pressure decrements induced by it and those induced by phentolamine. In 13 patients in whom renin levels were stimulated by a restricted sodium diet. the blood pressure response to phentolamine was the same as that when they were studied on an unrestricted sodium diet. The results suggest that alpha adrenergic factors may often participate in sustaining blood pressure in hypertensive patients. This role is independent of the renin‐angiotensin system and of the state of sodium balance.