Goldstein D S, Eisenhofer G, Garty M, Sax F L, Keiser H R, Kopin I J
Hypertension-Endocrine Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892.
Clin Exp Hypertens A. 1989;11 Suppl 1:173-89. doi: 10.3109/10641968909045422.
Systemically infused tritiated norepinephrine (NE) was used to estimate total body NE spillover into arterial blood during mental challenge (playing a video game) in 18 young (mean age 35 years old) patients with essential hypertension and 20 normotensives of similar age. Arterial NE, epinephrine (E), and total body NE spillover at baseline did not differ between the groups. During the game, total body NE spillover increased significantly in both groups, with the increments related directly to the pressor responses. Mean increments in total body NE spillover, arterial E, and mean arterial pressure were larger in the hypertensives (204 vs 91 ng/min, 33 vs 9 pg/ml, and 16 vs 12 mm Hg). The hypertensives increased total peripheral resistance during the game, whereas the normotensive group did not. Intravenous administration of yohimbine was used to increase NE spillover. Pressor responses to yohimbine were related to responses of arterial NE. The hypertensive group had a larger mean increment in blood pressure and arterial NE than did the normotensive group during yohimbine, due to excessive responses in a subgroup of about 1/3 of the patients. Patients with essential hypertension can have excessive sympathoadrenomedullary responsiveness related to excessive pressor responses, even when sympathoadrenomedullary activity at rest is normal.
对18名年轻（平均年龄35岁）的原发性高血压患者和20名年龄相仿的血压正常者，使用全身输注氚标记去甲肾上腺素（NE）来评估在精神挑战（玩电子游戏）期间全身NE向动脉血中的溢出情况。两组在基线时的动脉NE、肾上腺素（E）和全身NE溢出无差异。游戏期间，两组的全身NE溢出均显著增加，且增加量与升压反应直接相关。高血压患者的全身NE溢出、动脉E和平均动脉压的平均增加量更大（分别为204对91 ng/分钟、33对9 pg/ml和16对12 mmHg）。高血压患者在游戏期间增加了总外周阻力，而血压正常组则没有。静脉注射育亨宾用于增加NE溢出。对育亨宾的升压反应与动脉NE的反应相关。由于约1/3的患者亚组反应过度，高血压组在使用育亨宾期间的血压和动脉NE平均增加量比血压正常组更大。原发性高血压患者即使静息时交感肾上腺髓质活动正常，也可能因过度的升压反应而出现过度的交感肾上腺髓质反应性。
