Hirooka Y, Imaizumi T, Masaki H, Ando S, Harada S, Momohara M, Takeshita A
Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hypertension. 1992 Aug;20(2):175-80. doi: 10.1161/01.hyp.20.2.175.
Animal studies suggest that some angiotensin converting enzyme inhibitors augment endothelium-dependent vasorelaxation. We aimed to determine if captopril augments endothelium-dependent vasodilation in middle-aged hypertensive patients. By using strain-gauge plethysmography, forearm vasodilation evoked with intra-arterial acetylcholine (4, 8, 16, and 24 micrograms/min) or nitroprusside (0.2, 0.4, 0.8, and 1.2 micrograms/min) was examined before and after captopril administration (25 mg per os). Before captopril, forearm vasodilation with acetylcholine was less in hypertensive patients (n = 12) than in age-matched (n = 7) or young (n = 7) normotensive subjects, but forearm vasodilation with nitroprusside did not differ among the three groups. Captopril improved forearm vasodilation in hypertensive patients (n = 7) with acetylcholine but nitroprusside did not. In contrast, nifedipine (10 mg per os) did not alter forearm vasodilation with acetylcholine or nitroprusside in hypertensive patients (n = 5). The decreases in mean blood pressure caused by captopril and nifedipine in hypertensive subjects were comparable. Captopril did not alter forearm vasodilation with acetylcholine or nitroprusside in young normotensive subjects (n = 7). These results suggest that captopril in hypertensive patients may acutely improve impaired endothelium-dependent forearm vasodilation that does not result from reduction in blood pressure per se.
动物研究表明，某些血管紧张素转换酶抑制剂可增强内皮依赖性血管舒张。我们旨在确定卡托普利是否能增强中年高血压患者的内皮依赖性血管舒张。通过使用应变片体积描记法，在口服卡托普利（25毫克）前后，检测动脉内注射乙酰胆碱（4、8、16和24微克/分钟）或硝普钠（0.2、0.4、0.8和1.2微克/分钟）所诱发的前臂血管舒张情况。在服用卡托普利之前，高血压患者（n = 12）中乙酰胆碱诱发的前臂血管舒张程度低于年龄匹配的正常血压受试者（n = 7）或年轻正常血压受试者（n = 7），但硝普钠诱发的前臂血管舒张在三组之间并无差异。卡托普利可改善高血压患者（n = 7）中乙酰胆碱诱发的前臂血管舒张，但对硝普钠诱发的前臂血管舒张无此作用。相比之下，硝苯地平（口服10毫克）对高血压患者（n = 5）中乙酰胆碱或硝普钠诱发的前臂血管舒张无影响。高血压受试者中卡托普利和硝苯地平引起的平均血压下降程度相当。卡托普利对年轻正常血压受试者（n = 7）中乙酰胆碱或硝普钠诱发的前臂血管舒张无影响。这些结果表明，高血压患者服用卡托普利可能会急性改善受损的内皮依赖性前臂血管舒张，这并非由血压本身降低所致。
