Naslund T, Silberstein D J, Merrell W J, Nadeau J H, Wood A J
Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232.
Clin Pharmacol Ther. 1990 Jul;48(1):87-95. doi: 10.1038/clpt.1990.121.
To determine the contribution of altered beta-receptor function in the vasculature to the increased peripheral vascular resistance seen in hypertension, the effects of intra-arterial infusions of isoproterenol and epinephrine on forearm blood flow were determined in 11 male normotensive subjects and 11 male hypertensive subjects during 10 and 250 mmol/day sodium diets. Increased sodium intake from 10 to 250 mmol produced contrasting effects in the hypertensive and normotensive subjects. In the hypertensive subjects, sensitivity to isoproterenol decreased when sodium intake increased (median effective dose increased from 39 [95% confidence limits, 30 to 50] to 70 [95% confidence limits, 42 to 116] ng/min, p less than 0.05). On the other hand, in the normotensive subjects increased sodium intake resulted in an increased sensitivity to isoproterenol induced vasodilation (median effective dose decreased from 52 [38 to 71] to 29 [22 to 38] ng/min, p less than 0.01). No change occurred in sensitivity to epinephrine or in the maximum vasodilatory response to ischemia during dietary changes. Changes in beta-receptors on lymphocyte membranes paralleled the changes seen in vascular sensitivity so that the proportion of receptors exhibiting high affinity for agonists, a reflection of receptor adenylate cyclase coupling, decreased in the hypertensive subjects from 38.0% +/- 3.8% when they were receiving 10 mmol/day sodium to 29.6% +/- 2.7% when they were receiving 250 mmol/day sodium (p less than 0.01). However, the proportion increased from 32.4% +/- 3.7% for normotensive subjects receiving 10 mmol/day sodium to 47.1% +/- 7.8% for normotensive subjects receiving 250 mmol/day sodium (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定血管中β受体功能改变对高血压患者外周血管阻力增加的影响,在11名男性正常血压受试者和11名男性高血压受试者摄入10 mmol/天和250 mmol/天钠饮食期间,测定了动脉内输注异丙肾上腺素和肾上腺素对前臂血流量的影响。钠摄入量从10 mmol增加到250 mmol对高血压和正常血压受试者产生了相反的影响。在高血压受试者中,钠摄入量增加时对异丙肾上腺素的敏感性降低(半数有效剂量从39 [95%置信区间,30至50]增加到70 [95%置信区间,42至116] ng/分钟,p<0.05)。另一方面,在正常血压受试者中,钠摄入量增加导致对异丙肾上腺素诱导的血管舒张敏感性增加(半数有效剂量从52 [38至71]降低到29 [22至38] ng/分钟,p<0.01)。饮食改变期间,对肾上腺素的敏感性或缺血时的最大血管舒张反应没有变化。淋巴细胞膜上β受体的变化与血管敏感性的变化平行,因此,对激动剂表现出高亲和力的受体比例(反映受体腺苷酸环化酶偶联)在高血压受试者中从接受10 mmol/天钠时的38.0%±3.8%降至接受250 mmol/天钠时的29.6%±2.7%(p<0.01)。然而,在正常血压受试者中,该比例从接受10 mmol/天钠时的32.4%±3.7%增加到接受250 mmol/天钠时的47.1%±7.8%(p<0.05)。(摘要截短于250字)