Departments of Medicine and Pharmacology, Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Hypertension. 2013 Apr;61(4):915-20. doi: 10.1161/HYPERTENSIONAHA.111.00854. Epub 2013 Feb 11.
Blacks have increased hemodynamic responses to both physiological and pharmacological adrenergic stimulation compared with whites, and this may contribute to the greater prevalence of hypertension in this ethnic group. A small study suggested enhanced α1-adrenoreceptor-mediated arterial vasoconstriction in the forearm vasculature of blacks compared with whites, but it is unknown whether this reflects a generalized vascular phenomenon. The objective of this study was to examine the hypothesis that there are ethnic differences in venous α1-adrenoreceptor responsiveness. Using a linear variable differential transformer, we measured local dorsal hand vein responses to increasing doses of the selective α1-adrenoreceptor agonist, phenylephrine, in 106 subjects (64 whites and 42 blacks). There was wide interindividual variability in responses to phenylephrine. The dose that produced 50% of maximal constriction (ED50) ranged from 11 to 5442 ng/min, and maximal venoconstriction (Emax) ranged from 13.5% to 100%. Blacks (geometric mean ED50 =172 ng/min; 95% confidence interval, 115-256 ng/min) were more sensitive to phenylephrine than whites (310 ng/min; 95% confidence interval, 222-434 ng/min; unadjusted P=0.026; adjusted P=0.003). Median Emax was slightly higher in blacks (89%; interquartile range, 82% to 98%) compared with whites (85%; interquartile range, 75% to 95%; P=0.07). Taken together with previous findings in arterial vessels, our results suggest a generalized increased sensitivity to α1-adrenoreceptor-mediated vasoconstriction in blacks. Increased vascular α-adrenoreceptor sensitivity could predispose to hypertension, and future studies addressing the contribution of this mechanism to ethnic differences in the prevalence of hypertension will be of interest.
黑人对生理和药理肾上腺素刺激的血液动力学反应均高于白人,这可能导致该族裔人群中高血压更为普遍。一项小型研究表明,与白人相比,黑人前臂血管的α1-肾上腺素能受体介导的动脉血管收缩增强,但尚不清楚这是否反映了一种普遍的血管现象。本研究的目的是检验这样一种假说,即静脉 α1-肾上腺素能受体反应存在种族差异。我们使用线性变量差动变压器,测量了 106 名受试者(64 名白人,42 名黑人)对递增剂量选择性 α1-肾上腺素能受体激动剂苯肾上腺素引起的局部手背静脉反应。苯肾上腺素的反应个体间差异很大。引起最大收缩 50%的剂量(ED50)范围为 11 至 5442ng/min,最大静脉收缩(Emax)范围为 13.5%至 100%。与白人(ED50为 310ng/min;95%置信区间,222-434ng/min)相比,黑人(几何均数 ED50为 172ng/min;95%置信区间,115-256ng/min)对苯肾上腺素更敏感(未校正 P=0.026;校正后 P=0.003)。黑人的 Emax 中位数(89%;四分位间距,82%-98%)略高于白人(85%;四分位间距,75%-95%;P=0.07)。与先前在动脉血管中的发现相结合,我们的结果表明黑人对 α1-肾上腺素能受体介导的血管收缩的敏感性普遍增加。血管 α-肾上腺素能受体敏感性增加可能导致高血压,未来研究探讨这种机制对高血压流行率的种族差异的贡献将具有重要意义。