Trap-Jensen J
Department of Clinical Physiology, Frederiksberg Hospital, Denmark.
Am Heart J. 1988 Jan;115(1 Pt 2):263-7. doi: 10.1016/0002-8703(88)90647-3.
Cigarette smoking increases heart rate, arterial blood pressure, and plasma catecholamine levels. In healthy subjects the increase in heart rate occurs in the absence of peripheral vasoconstriction. In the studies reported here, short-term beta-blockade increased peripheral vascular resistance during smoking, more so for the nonselective beta-blocker propranolol than for the beta 1-selective blocker atenolol. However, after 3 months of continuous treatment of hypertensive patients with beta-blockers, smoking produced similar increases in blood pressure for atenolol and propranolol. Smoking attenuated the beneficial blood pressure-lowering effect of beta-blockers. Short-term clinical studies with the nonselective alpha-inhibitor phentolamine have suggested that blockade of arteriolar alpha-receptors may eliminate the increase in blood pressure response to smoking. Treatment with alpha-inhibitors also increased coronary sinus blood flow in patients with atherosclerotic artery disease. For patients who smoke, alpha-inhibiting drugs may provide beneficial therapy for hypertension and other cardiovascular disorders.
吸烟会增加心率、动脉血压和血浆儿茶酚胺水平。在健康受试者中，心率增加发生在外周血管没有收缩的情况下。在本文报道的研究中，短期使用β受体阻滞剂会增加吸烟时的外周血管阻力，非选择性β受体阻滞剂普萘洛尔比β1选择性阻滞剂阿替洛尔更明显。然而，高血压患者连续使用β受体阻滞剂治疗3个月后，吸烟对阿替洛尔和普萘洛尔的血压升高作用相似。吸烟减弱了β受体阻滞剂有益的降压效果。非选择性α受体抑制剂酚妥拉明的短期临床研究表明，阻断小动脉α受体可能消除吸烟引起的血压升高反应。α受体抑制剂治疗还可增加动脉粥样硬化性疾病患者的冠状窦血流量。对于吸烟的患者，α受体抑制药物可能为高血压和其他心血管疾病提供有益的治疗。
