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黑人血管肾上腺素能血管收缩增强和血管舒张减弱。导致血管反应性增强的叠加机制。

Increased vascular adrenergic vasoconstriction and decreased vasodilation in blacks. Additive mechanisms leading to enhanced vascular reactivity.

作者信息

Stein C M, Lang C C, Singh I, He H B, Wood A J

机构信息

Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennesee, USA.

出版信息

Hypertension. 2000 Dec;36(6):945-51. doi: 10.1161/01.hyp.36.6.945.

Abstract

Blood pressure reactivity is enhanced in young black subjects through mechanisms that are poorly understood. We compared alpha-adrenergic-mediated vasoconstrictor and ss-adrenergic vasodilator sensitivity and their relation to sympathetic activity in blacks and whites. Ten healthy black (age, 29.9+/-2.4 years) and 10 white (age, 28.3+/-1.9 years) men were studied. Forearm blood flow was measured with strain-gauge plethysmography after the intrabrachial artery administration of phenylephrine (1.25 to 20 microgram/min) and isoproterenol (60 and 400 ng/min) after application of lower-body negative pressure and after a cold pressor test. Forearm and systemic norepinephrine spillover were measured with a radioisotope dilution technique. alpha-Adrenergic vasoconstriction was markedly increased (ANOVA P=0.008) and ss-adrenergic vasodilation decreased (ANOVA P=0.02) in blacks. Phenylephrine (10 microgram/min) decreased forearm blood flow by 58.0+/-2.5% in blacks but only by 26.6+/-6.0% in whites (P<0.001). Vasoconstrictor response to endogenous norepinephrine, stimulated by a cold pressor test, resulted in a higher forearm vascular resistance in blacks than in whites (107.3+/-13 versus 64.8+/-13 mm Hg. mL(-)(1). 100 mL(-)(1), P=0.03). There were no significant ethnic differences in basal or stimulated forearm or systemic norepinephrine spillover. Increased vasoconstrictor and decreased vasodilator responses in blacks were not correlated. Increased sympathetically mediated vascular tone caused by enhanced vasoconstriction and attenuated vasodilation, effects that would be additive, and not increased sympathetic activity could enhance vascular reactivity and may play a role in the pathogenesis of hypertension in blacks.

摘要

年轻黑人受试者的血压反应性通过尚未完全了解的机制增强。我们比较了α-肾上腺素能介导的血管收缩和β-肾上腺素能血管舒张敏感性及其与黑人和白人交感神经活动的关系。研究了10名健康黑人男性(年龄29.9±2.4岁)和10名白人男性(年龄28.3±1.9岁)。在应用下体负压和冷加压试验后,经肱动脉给予去氧肾上腺素(1.25至20微克/分钟)和异丙肾上腺素(60和400纳克/分钟)后,用应变片体积描记法测量前臂血流量。用放射性同位素稀释技术测量前臂和全身去甲肾上腺素溢出量。黑人的α-肾上腺素能血管收缩明显增加(方差分析P=0.008),β-肾上腺素能血管舒张减少(方差分析P=0.02)。去氧肾上腺素(10微克/分钟)使黑人前臂血流量减少58.0±2.5%,而白人仅减少26.6±6.0%(P<0.001)。冷加压试验刺激内源性去甲肾上腺素引起的血管收缩反应导致黑人的前臂血管阻力高于白人(107.3±13对64.8±13毫米汞柱·毫升-1·100毫升-1,P=0.03)。基础或刺激后的前臂或全身去甲肾上腺素溢出量在种族上没有显著差异。黑人血管收缩增加和血管舒张减少的反应不相关。血管收缩增强和血管舒张减弱导致交感神经介导的血管张力增加,这些效应是相加的,而不是交感神经活动增加,可增强血管反应性,并可能在黑人高血压发病机制中起作用。

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