Impact of aldosterone receptor blockade compared with thiazide therapy on sympathetic nervous system function in geriatric hypertension.
Impact of aldosterone receptor blockade compared with thiazide therapy on sympathetic nervous system function in geriatric hypertension.
复制标题
醛固酮受体阻断与噻嗪类药物治疗对老年高血压交感神经系统功能的影响。
DOI：
10.1161/hypertensionaha.109.147058
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Supiano,MarkA
中科院分区：
文献类型：
--
作者：
Wray,DWalter;Supiano,MarkA
Aldosterone receptor blockade and thiazide therapy effectively lower blood pressure in geriatric hypertension. Their impact on sympathetic nervous system function has not been evaluated. In a double-blind, randomized study, 36 patients with stage 1 hypertension underwent 6 months of therapy with either aldosterone receptor blockade (spironolactone, n=19; 68±1 years) or hydrochlorothiazide (n=17; 68±2 years). Arterial blood pressure, [3H]-norepinephrine (NE) kinetics (extravascular NE release rate), and α-adrenergic responsiveness (forearm vasoconstriction to graded intrabrachial artery NE infusions) were evaluated at baseline, after a 4-week antihypertensive medication withdrawal, and after spironolactone or hydrochlorothiazide treatment. Arterial blood pressure decreased significantly with both spironolactone (160±3 to 134±2 mm Hg; 77±2 to 68±2 mm Hg) and hydrochlorothiazide (161±4 to 145±4 mm Hg; 78±2 to 73±2 mm Hg) treatment. Sympathetic nervous system activity was significantly reduced after spironolactone (plasma NE: 378±40 to 335±20 pg/mL,P=0.04; [3H]-NE release rate: 2.74±0.3 to 1.97±0.2 μg/min per meter squared,P=0.04) but not hydrochlorothiazide (plasma NE: 368±25 to 349±23 pg/mL,P=0.47; [3H]-NE release rate: 2.63±0.4 to 2.11±0.2 mg/min per meter squared,P=0.21). α-Adrenergic responsiveness was unchanged with either drug treatment. These findings demonstrate a beneficial effect of aldosterone receptor blockade on reducing sympathetic nervous system activity and blood pressure in hypertensive older patients.
