Rilmenidine sympatholytic activity preserves mental stress, orthostatic sympathetic responses and adrenaline secretion
Rilmenidine sympatholytic activity preserves mental stress, orthostatic sympathetic responses and adrenaline secretion
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DOI：
10.1097/01.hjh.0000125453.28861.b8
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发表时间：
2004-08-01
影响因子：
4.9
通讯作者：
Lambert, G
中科院分区：
文献类型：
--
作者：
Esler, M;Lux, A;Lambert, G
背景：中枢交感神经流出增加在高血压中是常见的，导致高血压的发展，也可能导致并发症。急性交感神经激活被证实是不良心血管事件的触发因素。因此，抗高血压药物抑制交感神经外流在理论上是一个有吸引力的治疗选择。目的研究咪唑啉结合剂利美尼定在静息和反射性交感神经激活时的交感神经和降压活性。设计与方法我们采用随机、双盲、6周交叉研究，安慰剂磨合期为1周，两个2周的积极治疗间隔(利美尼定1 mg，每日2次或安慰剂)和干预1周的安慰剂冲洗。结果利美尼定使反映全身交感神经活动的去甲肾上腺素外溢率降低35%(P<0.05)。
Background Heightened central sympathetic nervous outflow is common in essential hypertension, contributing to hypertension development and possibly also to complications. Acute sympathetic nervous activation is a proven trigger for adverse cardiovascular events. Accordingly, antihypertensive drugs inhibiting sympathetic outflow represent a theoretically attractive therapeutic option.Objectives To study the sympatholytic and blood pressure-lowering activity of the imidazoline binding agent rilmenidine at rest and during reflex sympathetic activation.Design and methods We used a randomized, double-blind, 6-week cross-over study, with a 1-week placebo run-in period, two 2-week active treatment intervals (rilmenidine 1 mg twice daily or placebo) and intervening 1-week placebo washout. In 15 hypertensive patients, noradrenaline and adrenaline plasma kinetics and intra-arterial blood pressure measurements were performed at rest, after mental stress (difficult mental arithmetic) and during head-up tilting, at the end of the 2-week dosing periods.Results The noradrenaline spillover rate, indicative of whole body sympathetic activity, was reduced 35% by rilmenidine at rest (P