Rinaldi G, Cingolani H E
Acta Physiol Pharmacol Latinoam. 1986;36(2):105-16.
The acute effects of a single dose of nifedipine (NIF, 20 mg SL) on heart rate (HR), arterial pressure (AP), forearm blood flow (FBF) and forearm vascular resistance (FVR), were measured in 15 normotensive (NP) and 11 hypertensive (HP) patients. In NP, NIF increased HR (from 78 +/- 3 to 88 +/- 3 lat/min, P less than 0.05) and FBF (from 4.0 +/- 0.4 to 5.5 +/- 0.3 ml/min. 100 ml, P less than 0.05) and decreased AP (from 99 +/- 2 to 89 +/- 3 mmHg, P less than 0.05) and FVR (from 29 +/- 3 to 22 +/- 2.9 relative units, P less than 0.05). In HP the changes were (with the exception of HR, which did not vary significantly) much greater in magnitude, and directly correlated with pretreatment levels of AP. In vitro experiments in aortic rings from spontaneously hypertensive (SHR) and normotensive (NR) rats demonstrated a much greater sensitivity of SHR to the relaxant effect of NIF, while the relaxant effect of nitroglycerin was similar in NR and SHR. It is concluded that NIF, although acting preferentially in HP as a hypotensive drug, also exerts a slight but still significant effect in NP. The greater vasodilating effect in HP could be due to a supersensitivity of the smooth muscle cell to NIF, possibly located at the calcium influx level.
在15名血压正常(NP)和11名高血压(HP)患者中,测量了单剂量硝苯地平(NIF,20mg舌下含服)对心率(HR)、动脉压(AP)、前臂血流量(FBF)和前臂血管阻力(FVR)的急性影响。在血压正常者中,硝苯地平使心率(从78±3次/分钟增加到88±3次/分钟,P<0.05)和前臂血流量(从4.0±0.4ml/分钟·100ml增加到5.5±0.3ml/分钟·100ml,P<0.05)增加,使动脉压(从99±2mmHg降低到89±3mmHg,P<0.05)和前臂血管阻力(从29±3个相对单位降低到22±2.9个相对单位,P<0.05)降低。在高血压患者中,除心率无显著变化外,其他变化幅度更大,且与治疗前动脉压水平直接相关。在自发性高血压大鼠(SHR)和血压正常大鼠(NR)的主动脉环上进行的体外实验表明,SHR对硝苯地平的舒张作用更为敏感,而硝酸甘油在NR和SHR中的舒张作用相似。结论是,硝苯地平虽然在高血压患者中作为降压药优先起作用,但在血压正常者中也有轻微但仍显著的作用。在高血压患者中更大的血管舒张作用可能是由于平滑肌细胞对硝苯地平超敏,可能位于钙内流水平。