Stumpe K O, Vetter H, Hessenbruch V, Düsing R, Kolloch R, Krück F
Klin Wochenschr. 1975 Oct 1;53(19):907-11. doi: 10.1007/BF01468983.
Blood pressure (BP), plasma renin activity (PRA) and plasma concentration of aldosterone (PA) and cortisol (PC) were determined in essential hypertensive patients before and after beta-adrenergic blockade with propranolol and prindolol. Serial measurements of PRA, PA and PC at 30 min intervals (8 p.m. to 6 a.m.) were performed in 8 patients. Administration of propranolol (50 mg three times daily) over a period of 4 weeks was followed by a significant reduction in BP, PRA and PA. PC remained unaltered. The pattern of rhythmic secretion of renin was abolished whereas that of aldosterone persisted at a lower level. Prindolol (10 mg three times daily) had a similar effect on BP as propranolol but failed to lower PRA and PA. Rhythmic secretion of renin was also markedly altered with prindolol in the absence of any change in rhythmicity of PA and PC. The hypotensive action of prindolol was not mediated via inhibition of renin release. The dissociation between PRA and PA rhythmicity indicates that during beta-adrenergic blockade diurnal rhythm of aldosterone secretion is not regulated by the renin-angiotensin-system. Rhythmicity of PC was normal, indicating that also ACTH-secretion was unaltered. Thus, under beta-blockade unchanged diurnal rhythm of aldosterone may be due to normal ACTH-secretion.
在原发性高血压患者中，在使用普萘洛尔和吲哚洛尔进行β-肾上腺素能阻滞前后，测定了血压（BP）、血浆肾素活性（PRA）、醛固酮血浆浓度（PA）和皮质醇（PC）。对8例患者每隔30分钟（晚上8点至早上6点）进行PRA、PA和PC的系列测量。在4周内给予普萘洛尔（每日3次，每次50mg）后，BP、PRA和PA显著降低。PC保持不变。肾素的节律性分泌模式被消除，而醛固酮的节律性分泌在较低水平持续存在。吲哚洛尔（每日3次，每次10mg）对BP的作用与普萘洛尔相似，但未能降低PRA和PA。在PA和PC节律性没有任何变化的情况下，吲哚洛尔也显著改变了肾素的节律性分泌。吲哚洛尔的降压作用不是通过抑制肾素释放介导的。PRA和PA节律性之间的分离表明，在β-肾上腺素能阻滞期间，醛固酮分泌的昼夜节律不受肾素-血管紧张素系统调节。PC的节律性正常，表明促肾上腺皮质激素（ACTH）分泌也未改变。因此，在β-阻滞剂作用下，醛固酮昼夜节律不变可能是由于ACTH分泌正常。
