Mohandas Appesh, Suboc Tisha B, Wang Jingli, Ying Rong, Tarima Sergey, Dharmashankar Kodlipet, Malik Mobin, Widlansky Michael E
Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Vasc Med. 2015 Oct;20(5):401-8. doi: 10.1177/1358863X15584753. Epub 2015 May 15.
Prior work suggests blood pressure in African Americans is more sensitive to the effects of aldosterone than in Caucasians. This mechanism may relate to a negative response of the vascular endothelium to aldosterone, including reduced glucose-6-phosphate dehydrogenase (G6PD) activity. Thirty-three African Americans (11 hypertensives, 22 controls) without evidence of diabetes or metabolic syndrome completed the protocol. The protocol included measurement of in vivo microvascular endothelial function by digital pulse arterial tonometry and ex vivo measurement of endothelial function by videomicroscopy of arterioles obtained from these same subjects with and without exposure to aldosterone or spironolactone. Systemic and arteriolar G6PD activities were also measured. In vivo and ex vivo microvascular endothelial function were impaired in African Americans with hypertension. One-hour exposure with aldosterone impaired endothelium-dependent vasodilation in arterioles from normotensive subjects, while 1 hour of spironolactone exposure reversed endothelial dysfunction in arterioles from hypertensive subjects. G6PD activity was impaired in hypertensive arterioles. Aldosterone-related endothelial dysfunction may be responsible for at least a portion of the greater blood pressure sensitivity to aldosterone in African Americans. This may be in part related to vascular suppression of G6PD activity.
先前的研究表明，非裔美国人的血压对醛固酮的影响比白人更敏感。这种机制可能与血管内皮对醛固酮的负反应有关，包括葡萄糖-6-磷酸脱氢酶（G6PD）活性降低。33名无糖尿病或代谢综合征证据的非裔美国人（11名高血压患者，22名对照者）完成了该方案。该方案包括通过数字脉搏动脉张力测量法测量体内微血管内皮功能，以及通过对这些受试者在暴露于醛固酮或螺内酯前后获取的小动脉进行视频显微镜检查来测量离体内皮功能。还测量了全身和小动脉的G6PD活性。高血压非裔美国人的体内和离体微血管内皮功能受损。醛固酮暴露1小时会损害正常血压受试者小动脉的内皮依赖性血管舒张，而螺内酯暴露1小时可逆转高血压受试者小动脉的内皮功能障碍。高血压小动脉中的G6PD活性受损。醛固酮相关的内皮功能障碍可能至少部分导致了非裔美国人对醛固酮的血压敏感性更高。这可能部分与血管对G6PD活性的抑制有关。
