González-Trápaga J L, Nelesen R A, Dimsdale J E, Mills P J, Kennedy B, Parmer R J, Ziegler M G
Department of Medicine, University of California, San Diego, USA.
Life Sci. 2000 May 5;66(24):2383-92. doi: 10.1016/s0024-3205(00)00568-3.
Epinephrine (E) infusions raise blood pressure and there is an excess incidence of hypertension among males and blacks. However, reports of E levels by ethnicity, gender, and blood pressure status are inconsistent. Insensitive assays, variability in plasma E levels within individuals, and the small size of most studies have contributed to these conflicting reports. We measured plasma E levels in a large diverse sample of subjects, using a highly sensitive assay. A total of 361 individuals participated in the study: 61% were men and 39% women, 74% were normotensive and 26% hypertensive, 59% were white and 41% were black. Except for difference in blood pressure and body mass index between the normotensives and hypertensives, subjects had similar baseline characteristics and took no antihypertensive medications for at least five days prior to sampling. All blood samples were collected after resting for a least 30 minutes following the insertion of an indwelling i.v. catheter. Catecholamine levels were determined using a radioenzymatic assay (assay sensitivities for E and norepinephrine were 6 pg/ml and 10 pg/ml, respectively). An ethnicity by gender interaction was found (F(1,315) = 5.126, p = .024). Subsequent analysis revealed that white women had significantly lower basal plasma E levels than white men (p <0.001) and black women (p = 0.036). There were no significant differences in E levels between black men and women or between white men and black men. Uncorrected E levels were lower in normotensive than hypertensive subjects (p = .009) but this difference was not significant when corrected for body mass index (BMI). Uncorrected norepinephrine levels were higher in women than men (p = .03) but the difference was no longer significant when corrected for BMI. Plasma E levels were significantly lower among white women than men or black women. In contrast to prior studies, E levels were lower in hypertensives, but this may reflect obesity among hypertensives.
肾上腺素（E）输注会升高血压，并且男性和黑人中高血压的发病率过高。然而，关于按种族、性别和血压状态划分的E水平的报告并不一致。检测方法不灵敏、个体血浆E水平的变异性以及大多数研究样本量较小，这些因素导致了这些相互矛盾的报告。我们使用高灵敏度检测方法，在大量不同的受试者样本中测量了血浆E水平。共有361人参与了这项研究：61%为男性，39%为女性；74%血压正常，26%患有高血压；59%为白人，41%为黑人。除了血压正常者和高血压患者之间的血压和体重指数存在差异外，受试者具有相似的基线特征，并且在采样前至少五天未服用抗高血压药物。所有血样均在插入留置静脉导管后至少休息30分钟后采集。使用放射酶法测定儿茶酚胺水平（E和去甲肾上腺素的检测灵敏度分别为6 pg/ml和10 pg/ml）。发现了种族与性别之间的交互作用（F(1,315) = 5.126，p = .024）。后续分析显示，白人女性的基础血浆E水平显著低于白人男性（p <0.001）和黑人女性（p = 0.036）。黑人男性和女性之间或白人男性和黑人男性之间的E水平没有显著差异。未校正的E水平在血压正常者中低于高血压患者（p = .009），但在校正体重指数（BMI）后，这种差异并不显著。未校正的去甲肾上腺素水平女性高于男性（p = .03），但在校正BMI后，这种差异不再显著。白人女性的血浆E水平显著低于男性或黑人女性。与先前的研究相反，高血压患者的E水平较低，但这可能反映了高血压患者中的肥胖情况。
