Blau A, Battler A, Eldar M, Rath S, Neufeld H N, Kapuler S, Iaina A, Cohen D, Eliahou H E
J Clin Hypertens. 1986 Mar;2(1):13-20.
The hemodynamic effects of the slow release form of a calcium channel blocker, nifedipine retard, in essential hypertension patients after angiotensin II (AII) infusion were studied using nuclear ventriculography. Sublingual nifedipine lowered blood pressure that had been acutely raised by an infusion of AII to its baseline level. When used for 4 weeks, nifedipine retard maintained its blood-pressure-lowering effects without a change in heart rate, both when used alone and when used in addition to beta-adrenergic blockers. In the patients with untreated essential hypertension, nifedipine counteracted the lowering effect of AII on left ventricular ejection fraction (LVEF), which was 67.5 +/- 8.9% at recumbency, 61.2 +/- 6.6% (+/- SD) during AII infusion, and 72.1 +/- 7.5% 30 minutes after sublingual nifedipine. These acute effects seem to result from a marked reduction in total peripheral resistance (TPR) and are accompanied by a rise in cardiac index (CI). The TPR, in dynes/sec/cm-5, was 1376.9 +/- 275.8 at recumbency, 2000.7 +/- 358 during AII infusion, and 1228.6 +/- 289 30 minutes after sublingual nifedipine. The corresponding figures for CI in liters/M2 BSA, were 4.02 +/- 0.77, 3.03 +/- 0.64, and 4.32 +/- 0.79. In patients receiving beta-blocker therapy (propranolol or atenolol) with inadequate control of blood pressure, similar results were obtained in LVEF (69.7 +/- 8.87% at recumbency, 63.7 +/- 11.9% during AII infusion, and 72.2 +/- 6.05% 30 minutes after sublingual nifedipine). The initial TPR was much higher than that of untreated essential hypertensive patients. Nevertheless, the increase obtained during AII infusion was counteracted by sublingual nifedipine. CI was decreased by AII.(ABSTRACT TRUNCATED AT 250 WORDS)
采用核素心室造影术研究了钙通道阻滞剂缓释硝苯地平对血管紧张素II（AII）输注后原发性高血压患者的血流动力学影响。舌下含服硝苯地平可使因输注AII而急性升高的血压降至基线水平。硝苯地平缓释片使用4周时，无论单独使用还是与β - 肾上腺素能阻滞剂合用，均能维持其降压效果且心率不变。在未经治疗的原发性高血压患者中，硝苯地平可抵消AII对左心室射血分数（LVEF）的降低作用，平卧位时LVEF为67.5±8.9%，AII输注期间为61.2±6.6%（±标准差），舌下含服硝苯地平30分钟后为72.1±7.5%。这些急性效应似乎是由于总外周阻力（TPR）显著降低所致，并伴有心脏指数（CI）升高。以达因/秒/厘米⁻⁵为单位，平卧位时TPR为1376.9±275.8，AII输注期间为2000.7±358，舌下含服硝苯地平30分钟后为1228.6±289。以升/平方米体表面积为单位，CI的相应数值分别为4.02±0.77、3.03±0.64和4.32±0.79。在接受β受体阻滞剂治疗（普萘洛尔或阿替洛尔）但血压控制不佳的患者中，LVEF也得到了类似结果（平卧位时为69.7±8.87%，AII输注期间为63.7±11.9%，舌下含服硝苯地平30分钟后为72.2±6.05%）。初始TPR远高于未经治疗的原发性高血压患者。然而，AII输注期间的升高被舌下含服硝苯地平抵消。CI因AII而降低。（摘要截选至250词）
