The relevance of prostaglandins in human hypertension.
The relevance of prostaglandins in human hypertension.
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发表时间：
1985
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通讯作者：
M. Dunn;H. Gröne
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作者：
M. Dunn;H. Gröne
在血压正常和高血压的人中，前列腺素，特别是 PGE2 和 PGI2，通过控制血管阻力、盐排泄、心输出量和肾素分泌来影响血压。大多数人类原发性高血压研究都记录了肾合成减少，从而导致尿中 PGE2 排泄减少。急性给予吲哚美辛会抑制前列腺素合成，增加总外周阻力和平均血压，同时导致心脏指数下降。 PGE2 和 PGI2 的重要血管舒张和利尿钠作用在接受抗高血压治疗的高血压患者中最为明显。在所有报告的使用吲哚美辛的研究中，同时使用非甾体抗炎药会削弱血压控制。因此，在高血压患者的治疗过程中应避免使用强效非甾体抗炎药，而阿司匹林可能是这些情况下最安全的非甾体抗炎药。有趣的数据正在积累关于多不饱和脂肪酸，特别是亚油酸和二十碳五烯酸作为降低血压的饮食手段的有益作用。所有报告的研究都记录了通过膳食补充这些脂肪酸以及将多不饱和脂肪酸与饱和脂肪酸的比例转化为统一，血压可小幅下降 5 至 10 毫米汞柱。
In normotensive and hypertensive humans, prostaglandins, particularly PGE2 and PGI2, affect blood pressure through control of vascular resistance, salt excretion, cardiac output, and renin secretion. The majority of studies of human essential hypertension have documented diminished renal synthesis and, hence, urinary excretion of PGE2. The acute administration of indomethacin inhibits prostaglandin synthesis and increases total peripheral resistance as well as mean blood pressure, with a countervailing decrease of cardiac index. The important vasodilatory and natriuretic roles of PGE2 and PGI2 are most apparent in hypertensive patients receiving antihypertensive therapy. The concomitant use of NSAID attenuates blood-pressure control in all reported studies using indomethacin. Consequently, potent NSAID should be avoided during treatment of hypertensive patients, and aspirin may be the safest NSAID in these circumstances. Interesting data are accumulating on the beneficial effects of polyunsaturated fatty acids, particularly linoleic acid and eicosapentaenoic acid, as dietary means to reduce blood pressure. All reported studies have documented small 5 to 10 mm Hg decrements of blood pressure with dietary supplementation with these fatty acids and conversion of the ratio of polyunsaturated to saturated fatty acids toward unity.