Role of vasopressin in essential hypertension: Racial differences
Role of vasopressin in essential hypertension: Racial differences
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DOI：
10.1097/00004872-199715050-00011
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发表时间：
1997-05-01
影响因子：
4.9
通讯作者：
Gavras, H
中科院分区：
文献类型：
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作者：
Bakris, G;Bursztyn, M;Gavras, H
背景精氨酸加压素（AVP）除了是一种抗利尿激素外，还可能具有与高血压维持相关的加压作用。实验和临床研究结果表明，AVP的加压功能在低肾素高血压和盐负荷状态下更重要，在交感神经抑制下可能进一步发挥作用目的评价选择性加压素受体抑制是否能降低不同种族低肾素高血压患者的血压。（16名高加索人，23名非洲裔美国人）吃200 mmol/天的钠饮食，给予单次静脉注射剂量的选择性加压素受体拮抗剂，并在随后的3 h内持续监测他们的血压。结果54%的高血压患者进行了激素水平测定，非裔美国人高血压患者的血浆AVP水平高于白人（分别为1.13 +/- 0.05和0.37 +/- 0.06 pg/ml，P< 0.05），血浆肾素活性降低（分别为0.34 +/- 0.07和1.03 +/- 0.08 ng/ml/h，P< 0.05）。选择性血管加压素受体抑制剂降低了非裔美国人的平均动脉压，但对白人没有影响（非裔美国人降低28 +/- 4 mmHg，白人降低5 +/- 3 mmHg，P< 0.05）。结论AVP作为一种加压激素，在维持非裔美国人高血压患者动脉压升高中起着比白人更重要的作用。
Background Arginine vasopressin (AVP), in addition to being an antidiuretic hormone, might also have presser effects relevant to the maintenance of hypertension. Results from several experimental and clinical studies suggested that the presser function of AVP is more important in low-renin hypertension and in the salt-loaded state and that it might be further maximized under sympathetic suppression.Objective To assess whether selective vasopressin receptor inhibition lowers the blood pressure in a racially diverse group of low-renin hypertensive subjects.Methods Thirty-nine hypertensive subjects (16 Caucasian, 23 African-American) eating a 200 mmol/day sodium diet were administered a single intravenous dose of a selective vasopressin receptor antagonist and their blood pressure was monitored constantly for the ensuing 3 h. The protocol was repeated 3 days later after treatment with a single oral dose of 0.4 mg clonidine.Results Of these patients, 54% had their blood sampled for determination of hormone profiles, African-Americans with hypertension had higher baseline plasma AVP levels than did Caucasians (1.13 +/- 0.05 versus 0.37 +/- 0.06 pg/ml, respectively, P< 0.05), and lower plasma renin activity (0.34 +/- 0.07 versus 1.03 +/- 0.08 ng/ml per h, respectively, P< 0.05). Selective vasopressin receptor inhibition lowered the mean arterial pressure in African-Americans but not that in Caucasians (lowering by 28 +/- 4 mmHg in African-Americans versus lowering by 5 +/- 3 mmHg in Caucasians, P< 0.05). Moreover, vasopressin receptor blockade further reduced the arterial pressure in African-Americans but not that in Caucasians after pretreatment with clonidine.Conclusion AVP seems to play a more important role as a presser hormone in maintaining the elevation of arterial pressure in African-American hypertensives than it does in Caucasian hypertensives.