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早期卡维地洛治疗及撤药对高血压发生和肾血管狭窄的影响。

Effects of early carvedilol treatment and withdrawal on the development of hypertension and renal vascular narrowing.

作者信息

Kett Michelle M, Denton Kate M, Boesen Erika I, Anderson Warwick P

机构信息

Department of Physiology, PO Box 13F, Monash University, Victoria 3800, Australia.

出版信息

Am J Hypertens. 2004 Feb;17(2):161-6. doi: 10.1016/j.amjhyper.2003.09.013.

Abstract

BACKGROUND

The aims of this study were to examine whether combined blockade of alpha(1) and beta-adrenoceptors with carvedilol postweaning affected the development of hypertension and renal vascular narrowing in spontaneously hypertensive rats (SHR), and whether these effects on pressure and renal vascular changes persisted after treatment withdrawal.

METHODS

From 4 to 12 weeks of age male SHR were administered carvedilol in rat chow at 1.2 mg/g chow (low-dose) or 2.4 mg/g chow (high-dose), or were given normal chow. At 12 weeks of age, rats from each group either underwent experimentation or had treatment withdrawn and were studied at 20 weeks. On the experimental day, conscious mean arterial pressure (MAP) was measured and, as a functional test of renal vessel lumen characteristics, pressure-flow and pressure-glomerular filtration rate (pressure-GFR) relationships were determined in the maximally dilated kidney.

RESULTS

At 12 weeks of age, SHR on low and high-dose carvedilol had significantly lower MAP than that of untreated SHR (137 +/- 3, 134 +/- 1, 152 +/- 2 mm Hg, respectively; P <.001). The SHR treated with high-dose (but not low-dose) carvedilol demonstrated a steeper renal pressure-flow relationship (P <.001), and a leftward shifted (P <.01) and steeper (P <.001) pressure-GFR relationship compared with control SHR. Eight weeks after carvedilol withdrawal, there were no significant differences in MAP, pressure-flow, or pressure-GFR relationships between groups.

CONCLUSIONS

These results suggest that postweaning alpha(1) and beta-adrenoceptor blockade with high-dose carvedilol attenuated the development of hypertension and led to a preferential reduction in preglomerular resistance (increased lumen dimensions) independent of the effects on MAP. However, treatment of SHR from 4 to 12 weeks of age with high-dose carvedilol did not lead to persistent, long-term effects on arterial pressure or renal vascular narrowing after treatment withdrawal.

摘要

背景

本研究的目的是探讨断奶后使用卡维地洛联合阻断α₁和β肾上腺素能受体是否会影响自发性高血压大鼠(SHR)高血压和肾血管狭窄的发展,以及这些对血压和肾血管变化的影响在停药后是否持续存在。

方法

4至12周龄的雄性SHR在大鼠饲料中给予卡维地洛,剂量为1.2mg/g饲料(低剂量)或2.4mg/g饲料(高剂量),或给予正常饲料。12周龄时,每组大鼠要么进行实验,要么停药,并在20周时进行研究。在实验当天,测量清醒状态下的平均动脉压(MAP),并且作为肾血管腔特征的功能测试,在最大扩张的肾脏中测定压力-流量和压力-肾小球滤过率(压力-GFR)关系。

结果

12周龄时,低剂量和高剂量卡维地洛治疗的SHR的MAP显著低于未治疗的SHR(分别为137±3、134±1、152±2mmHg;P<.001)。与对照SHR相比,高剂量(而非低剂量)卡维地洛治疗的SHR表现出更陡峭的肾压力-流量关系(P<.001),以及左移(P<.01)和更陡峭(P<.001)的压力-GFR关系。卡维地洛停药8周后,各组之间的MAP、压力-流量或压力-GFR关系无显著差异。

结论

这些结果表明,断奶后高剂量卡维地洛阻断α₁和β肾上腺素能受体可减轻高血压的发展,并导致肾小球前阻力优先降低(管腔尺寸增加),而与对MAP的影响无关。然而,4至12周龄的SHR用高剂量卡维地洛治疗在停药后并未对动脉压或肾血管狭窄产生持续的长期影响。

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