Acute hypertension impairs endothelium-dependent vasodilatation
Acute hypertension impairs endothelium-dependent vasodilatation
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DOI：
10.1042/cs0940601
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发表时间：
1998-06-01
期刊：
影响因子：
6
通讯作者：
Lind, L
中科院分区：
文献类型：
--
作者：
Millgård, J;Lind, L
1.以往的研究表明，高血压患者内皮依赖性血管舒张功能（EDV）受损。本研究的目的是调查血压急性升高到高血压水平是否会损害其他血压正常受试者的EDV。27名年轻、健康、血压正常的受试者进行了研究。其中8人进行了评价EDV和内皮非依赖性血管舒张（EIDV）的前臂血流测量在局部动脉内灌注乙酰甲胆碱（2和4 μ g/min）和硝普钠（5和10 μ g/min），之前和之后1小时的持续高血压，诱导去甲肾上腺素静脉注射。11名受试者在伴随局部动脉内输注去甲肾上腺素之前和期间进行了相同的测量，血压没有变化，8名受试者在盐水输注期间进行了研究。持续1小时的高血压（舒张压>95 mmHg）显著减弱了前臂血流（17.4 +/- 6.8 vs 27.4 +/- 6.8 ml）。min（-1）。100 ml（-1）组织，P < 0.05）和前臂血管阻力降低（3.2 +/- 0.87 vs 7.4 +/- 2.5单位，P < 0.05）。乙酰甲胆碱对血管舒张的抑制作用明显强于硝普钠（P <0.05）。相反，局部动脉内注射去甲肾上腺素对乙酰甲胆碱和硝普钠引起的血管舒张作用的抑制程度相似。盐水输注不会改变EDV或EIDV，4。因此，在血压正常的受试者中，去甲肾上腺素引起的血压急剧升高至高血压水平对EDV的损害大于EIDV，而局部去甲肾上腺素没有观察到这种选择性作用，这表明高血压损害了内皮血管扩张功能。
1. Previous investigations have demonstrated an impaired endothelium-dependent vasodilatation (EDV) in patients with hypertension. The present study aimed to investigate if an acute rise in blood pressure to hypertensive levels impairs EDV in otherwise normotensive subjects.2. Twenty-seven young, healthy, normotensive subjects were studied. Eight of these underwent evaluation of EDV and endothelium-independent vasodilatation (EIDV) by means of forearm blood flow measurements during local intra-arterial infusions of methacholine (2 and 4 mu g/min) and sodium nitroprusside (5 and 10 mu g/min), before and after 1 h of sustained hypertension, induced by noradrenaline given intravenously. Identical measurements were made in 11 subjects before and during concomitant local intra-arterial infusion of noradrenaline without change in blood pressure and eight subjects were studied during saline infusions.3. One hour of sustained hypertension (diastolic blood pressure >95 mmHg) significantly attenuated both forearm blood flow (17.4 +/- 6.8 versus 27.4 +/- 6.8 ml . min(-1) . 100 ml(-1) tissue at baseline, P < 0.05) and forearm vascular resistance decrease (3.2 +/- 0.87 versus 7.4 +/- 2.5 units at baseline, P < 0.05) during methacholine infusion. These attenuations were significantly more pronounced for methacholine than for sodium nitroprusside (P < 0,05), In contrast, local intra-arterial noradrenaline infusions impaired vasodilatation induced by methacholine and sodium nitroprusside to a similar extent. Saline infusions did not change either EDV or EIDV,4.Thus, an acute rise in blood pressure to hypertensive levels induced by noradrenaline impaired EDV more than EIDV in otherwise normotensive subjects, while no such selective effect of local noradrenaline was seen, suggesting that a high blood pressure impairs endothelial vasodilator function.