Trap-Jensen J, Carlsen J E, Svendsen T L, Christensen N J
Eur J Clin Invest. 1979 Jun;9(3):181-3. doi: 10.1111/j.1365-2362.1979.tb00920.x.
The cardiovascular and adrenergic responses to cigarette smoking during acute selective and non-selective beta adrenoceptor blockade were studied in seven young healthy volunteers in a double blind cross-over fashion. Heart rate, arterial blood pressure, forearm blood flow and plasma levels of adrenaline and noradrenaline were determined before and during the terminal 5 min period of 15 min smoking test. During smoking, plasma concentrations of adrenaline increased markedly and evenly by approximately 0.3 ng/ml in all three experimental sessions. Plasma concentrations of noradrenaline remained unchanged. Propranolol, a non-selective beta blocker, caused a marked rise in diastolic and mean blood pressure and forearm vascular resistance during smoking. This response was not seen in the control series or after selective beta-1 blockage with atenolol. This difference is attributable to propranolol's blockade of adrenaline's vasodilating effect mediated by beta-2 receptors in the resistance vessels. Furthermore, atenolol attenuated the systolic blood pressure and tachycardiac responses induced by cigarette smoking by comparison with placebo. This study suggests that selective beta-1 blockers are preferable in the management of patients who are habitual smokers.
采用双盲交叉试验方法，对7名年轻健康志愿者在急性选择性和非选择性β肾上腺素能受体阻滞期间吸烟时的心血管和肾上腺素能反应进行了研究。在15分钟吸烟试验的最后5分钟期间，测定心率、动脉血压、前臂血流量以及肾上腺素和去甲肾上腺素的血浆水平。吸烟期间，在所有三个实验环节中，血浆肾上腺素浓度均显著且均匀地升高，约为0.3 ng/ml。去甲肾上腺素的血浆浓度保持不变。非选择性β受体阻滞剂普萘洛尔在吸烟期间导致舒张压和平均血压以及前臂血管阻力显著升高。在对照系列或用阿替洛尔进行选择性β-1受体阻滞之后未观察到这种反应。这种差异归因于普萘洛尔对阻力血管中由β-2受体介导的肾上腺素血管舒张作用的阻滞。此外，与安慰剂相比，阿替洛尔减轻了吸烟引起的收缩压和心动过速反应。本研究表明，在习惯性吸烟者的治疗中，选择性β-1受体阻滞剂更为可取。
