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奥美帕替隆与厄贝沙坦/氢氯噻嗪对易卒中自发性高血压大鼠内皮功能和心肌肥厚的影响比较:性别差异

Comparison of the effects of omapatrilat and irbesartan/hydrochlorothiazide on endothelial function and cardiac hypertrophy in the stroke-prone spontaneously hypertensive rat: sex differences.

作者信息

Graham Delyth, Hamilton Carlene, Beattie Elisabeth, Spiers Angela, Dominiczak Anna F

机构信息

BHF Glasgow Cardiovascular Research Centre, Division of Cardiovascular and Medical Sciences, Western Infirmary, Glasgow, UK.

出版信息

J Hypertens. 2004 Feb;22(2):329-37. doi: 10.1097/00004872-200402000-00017.

Abstract

OBJECTIVE

The novel antihypertensive agent, omapatrilat, is both an inhibitor of neutral endopeptidase and angiotensin-converting enzyme. This study investigated the effects of omapatrilat in comparison with an angiotensin I-receptor antagonist/diuretic combination on blood pressure, endothelial function and cardiac hypertrophy in stroke-prone spontaneously hypertensive rats (SHRSP).

METHODS

Male and female SHRSP were treated orally with omapatrilat or irbesartan plus hydrochlorothiazide (I + H) or vehicle for 8 weeks. Systolic blood pressure was measured weekly by tail-cuff. Cardiac hypertrophy was monitored by echocardiography at 8, 12 and 16 weeks of age. Endothelial function [basal nitric oxide (NO) bioavailability and stimulated NO release] was examined in carotid arteries using organ bath pharmacology and in mesenteric resistance arteries using wire myography.

RESULTS

Compared with untreated controls, omapatrilat and I + H significantly attenuated hypertension [male control, 198.3 +/- 6.9 mmHg versus omapatrilat, 149.6 +/- 3.8 mmHg (F = 8.63 P < 0.0001), versus I + H, 145.6 +/- 5.1 mmHg (F = 7.38 P < 0.0001); female control, 170.3 +/-8.3 mmHg versus omapatrilat, 120.0 +/- 4.6 mmHg (F = 8.36, P < 0.0001), versus I + H, 112.2 +/- 2.9 mmHg (F = 9.08, P < 0.0001)] and left ventricular hypertrophy [male + female controls, 3.02 +/- 0.38 mg/g versus omapatrilat, 2.47 +/- 0.26 mg/g (P < 0.0001; 95% confidence interval, 0.27, 0.83), versus I + H, 2.49 +/- 0.21 mg/g (P < 0.0001; 95% confidence interval, 0.25, 0.83)]. Both treatments also significantly increased male carotid artery basal NO bioavailability relative to control [control, 0.62 +/- 0.17 g/g versus omapatrilat, 1.95 +/- 0.17 g/g (P < 0.0001; 95% confidence interval, -1.83, -0.36), versus I + H, 1.57 +/- 0.21 g/g (P < 0.026; 95% confidence interval, -1.31, -0.12)]. However, stimulated NO (EC50) was only improved in omapatrilat-treated males [controls, 0.19 +/- 0.06 micromol/l versus omapatrilat, 0.05 +/- 0.01 micromol/l (P = 0.05; 95% confidence interval, -1.16, -0.03)].

CONCLUSIONS

Omapatrilat treatment significantly reduced left ventricular hypertrophy and improved endothelial function in carotid arteries from male SHRSP by NO-dependent mechanisms. Despite equivalent antihypertensive and antihypertrophic actions, a similar improvement in endothelial function, specifically stimulated NO release, was not observed after treatment with I + H.

摘要

目的

新型抗高血压药物奥马曲拉既是中性内肽酶抑制剂,也是血管紧张素转换酶抑制剂。本研究比较了奥马曲拉与血管紧张素I受体拮抗剂/利尿剂联合用药对易卒中型自发性高血压大鼠(SHRSP)血压、内皮功能和心肌肥厚的影响。

方法

雄性和雌性SHRSP口服奥马曲拉、厄贝沙坦加氢氯噻嗪(I+H)或赋形剂,持续8周。每周用尾套法测量收缩压。在8、12和16周龄时通过超声心动图监测心肌肥厚情况。使用器官浴药理学方法在颈动脉以及使用线肌张力测定法在肠系膜阻力动脉中检测内皮功能[基础一氧化氮(NO)生物利用度和刺激后的NO释放]。

结果

与未治疗的对照组相比,奥马曲拉和I+H均能显著减轻高血压[雄性对照组,198.3±6.9 mmHg,奥马曲拉组为149.6±3.8 mmHg(F = 8.63,P < 0.0001),I+H组为145.6±5.1 mmHg(F = 7.38,P < 0.0001);雌性对照组,170.3±8.3 mmHg,奥马曲拉组为120.0±4.6 mmHg(F = 8.36,P < 0.0001),I+H组为112.2±2.9 mmHg(F = 9.08,P < 0.0001)]以及左心室肥厚[雄性和雌性对照组,3.02±0.38 mg/g,奥马曲拉组为2.47±0.26 mg/g(P < 0.0001;95%置信区间,0.27,0.83),I+H组为2.49±0.21 mg/g(P < 0.0001;95%置信区间,0.25,0.83)]。两种治疗方法还均能使雄性颈动脉基础NO生物利用度相对于对照组显著增加[对照组,0.62±0.17 g/g,奥马曲拉组为1.95±0.17 g/g(P < 0.0001;95%置信区间,-1.83,-0.36),I+H组为1.57±0.21 g/g(P < 0.026;95%置信区间,-1.31,-0.12)]。然而,仅在接受奥马曲拉治疗的雄性大鼠中刺激后的NO(EC50)得到改善[对照组,0.19±0.06 μmol/l,奥马曲拉组为0.05±0.01 μmol/l(P = 0.05;95%置信区间,-1.16,-0.03)]。

结论

奥马曲拉治疗可通过NO依赖机制显著减轻雄性SHRSP的左心室肥厚并改善颈动脉内皮功能。尽管具有同等的降压和抗肥厚作用,但I+H治疗后未观察到类似的内皮功能改善,尤其是刺激后的NO释放改善。

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