Muszkat Mordechai, Sofowora Gbenga G, Wood Alastair J J, Stein C Michael
Division of Clinical Pharmacology, 560 RRB, Vanderbilt University School of Medicine, Nashville, Tenn 37232-6602, USA.
Hypertension. 2004 Jan;43(1):31-5. doi: 10.1161/01.HYP.0000103694.30164.C7. Epub 2003 Dec 1.
Black Americans have a reduced hypotensive response to the alpha2-adrenergic receptor agonist clonidine compared with whites, despite similar central sympathoinhibition. This reduced hypotensive response might be explained by greater postsynaptic vascular alpha2-adrenergic receptor vasoconstrictive response. However, clonidine has a low alpha2/alpha1 selectivity ratio. Therefore, to determine the role of altered alpha2-adrenergic receptor vascular sensitivity in ethnic differences in vascular response, we compared local vascular responses with the highly selective alpha2-adrenergic receptor agonist dexmedetomidine in healthy black (n=18) and white (n=19) subjects. Increasing doses of dexmedetomidine (0.001 to 1000 ng/min) were infused into a dorsal hand vein, and the local response was measured with a linear variable differential transformer. Dexmedetomidine caused pronounced venoconstriction, with an average (+/-SD) maximum response of 74.5+/-17.72% but with no difference between blacks and whites. There was substantial intersubject variability in the sensitivity to dexmedetomidine; the dose resulting in 50% (ED50) of maximum vasoconstriction ranged from 0.08 ng/min to 256 ng/min. The geometric mean ED50 was 2.28 ng/min (95% CI, 0.02 to 271.6 ng/min) in blacks and 1.58 ng/min (95% CI, 0.11 to 24.55 ng/min) in whites (P=0.59). Our data indicate that alpha2-adrenergic receptor-induced venoconstriction is similar in blacks and whites. These findings do not support the hypothesis that altered alpha2-adrenergic receptor sensitivity is the explanation for the decreased blood pressure response to systemic administration of clonidine in blacks. The response to dexmedetomidine provides a model that will allow further study of the regulation of alpha2-adrenergic receptor-mediated vascular responses
与白人相比,美国黑人对α2-肾上腺素能受体激动剂可乐定的降压反应减弱,尽管二者的中枢交感神经抑制作用相似。这种减弱的降压反应可能是由于突触后血管α2-肾上腺素能受体的血管收缩反应更强。然而,可乐定的α2/α1选择性比率较低。因此,为了确定α2-肾上腺素能受体血管敏感性改变在血管反应种族差异中的作用,我们比较了健康黑人(n = 18)和白人(n = 19)受试者对高选择性α2-肾上腺素能受体激动剂右美托咪定的局部血管反应。将递增剂量的右美托咪定(0.001至1000 ng/min)注入手背静脉,并用线性可变差动变压器测量局部反应。右美托咪定引起明显的静脉收缩,平均(±标准差)最大反应为74.5±17.72%,但黑人和白人之间无差异。受试者对右美托咪定的敏感性存在很大的个体差异;导致最大血管收缩50%(ED50)的剂量范围为0.08 ng/min至256 ng/min。黑人的几何平均ED50为2.28 ng/min(95%CI,0.02至271.6 ng/min),白人为1.58 ng/min(95%CI,0.11至24.55 ng/min)(P = 0.59)。我们的数据表明,α2-肾上腺素能受体诱导的静脉收缩在黑人和白人中相似。这些发现不支持以下假设,即α2-肾上腺素能受体敏感性改变是黑人对全身给予可乐定血压反应降低的原因。对右美托咪定的反应提供了一个模型,可用于进一步研究α2-肾上腺素能受体介导的血管反应的调节。