VASODILATION TO ACETYLCHOLINE IN PRIMARY AND SECONDARY FORMS OF HUMAN HYPERTENSION
VASODILATION TO ACETYLCHOLINE IN PRIMARY AND SECONDARY FORMS OF HUMAN HYPERTENSION
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DOI：
10.1161/01.hyp.21.6.929
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发表时间：
1993-06-01
期刊：
影响因子：
8.3
通讯作者：
SALVETTI, A
中科院分区：
文献类型：
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作者：
TADDEI, S;VIRDIS, A;SALVETTI, A
原发性高血压患者前臂对乙酰胆碱的内皮依赖性血管舒张作用降低。为了研究继发性高血压患者内皮依赖性血管舒张功能是否也降低，我们评估了臂内输注乙酰胆碱对原发性高血压（n=12）、原发性醛固酮增多症高血压（n=8）和肾血管性高血压（n = 8）患者和正常血压对照组（n=12）前臂血流（应变计静脉体积描记术）的影响。为了进一步评估环氧化酶依赖性内皮源性血管收缩物质的作用，我们在吲哚美辛存在的情况下重复输注乙酰胆碱。直接血管扩张剂硝普钠的效果也进行了检查。与血压正常者相比，原发性、原发性醛固酮增多症和肾血管性高血压患者对乙酰胆碱的血管舒张作用降低。相反，硝普钠诱导的血管舒张在所有患者组和对照组中相似。在吲哚美辛的存在下，乙酰胆碱的血管扩张作用在原发性高血压患者中增加，但在血压正常或继发性高血压个体中不增加。这些数据表明肾血管性和原发性醛固酮增多症高血压患者内皮依赖性血管舒张功能受损，并表明环氧合酶依赖性血管收缩机制参与了原发性高血压患者内皮依赖性血管舒张功能的减弱。
Endothelium-dependent vasodilatation to acetylcholine is reduced in the forearm of essential hypertensive patients. To investigate whether endothelium-dependent vasodilatation is reduced also in secondary hypertension, we evaluated the effects of an intrabrachial infusion of acetylcholine on forearm blood flow (strain-gauge venous plethysmography) in essential hypertensive (n=12), primary aldosteronism hypertensive (n=8), and renovascular hypertensive (n=8) patients and normotensive control subjects (n=12). To further evaluate the role of a cyclooxygenase-dependent endothelium-derived vasoconstrictor substance, we repeated the infusion of acetylcholine in the presence of indomethacin. The effect of the direct vasodilator sodium nitroprusside was also examined. The vasodilatation to acetylcholine was reduced in essential, primary aldosteronism, and renovascular hypertensive patients compared with normotensive subjects. In contrast, the vasodilatation induced by sodium nitroprusside was similar in all groups of patients and control subjects. In the presence of indomethacin, the vasodilator effect of acetylcholine was increased in essential hypertensive patients but not in normotensive or in secondary hypertensive individuals. These data demonstrate an impairment of endothelium-dependent vasodilation in renovascular and primary aldosteronism hypertensive patients and indicate that a cyclooxygenase-dependent vasoconstrictor mechanism participates in the blunting of endothelium-dependent vasodilation in essential hypertensive patients.