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肾素是否决定血压对钙通道阻滞剂的反应?

Does renin determine the blood pressure response to calcium entry blockers?

作者信息

Waeber B, Nussberger J, Brunner H R

出版信息

Hypertension. 1985 Mar-Apr;7(2):223-7. doi: 10.1161/01.hyp.7.2.223.

Abstract

Male Wistar rats with one-kidney, one clip renal hypertension were maintained on either a regular or a low salt diet for 3 weeks after clipping. At that time mean blood pressure in the unanesthetized rats was equally elevated in sodium-depleted (n = 17) and in sodium-replete rats (n = 19), but plasma renin activity was significantly higher in the former (p less than 0.05). Infusion of the calcium entry blocker verapamil at a rate of 0.05 mg/kg/minute decreased blood pressure within 60 minutes to a similar extent in rats kept on a salt-deficient diet and in rats fed a regular salt diet. In all rats taken as a group, there was a close, direct correlation (r = 0.87, p less than 0.001) between the magnitude of the blood pressure response to verapamil and the pretreatment blood pressure levels. Verapamil markedly accelerated heart rate and stimulated renin release in all rats. In additional groups of sodium-depleted (n = 8) and sodium-replete renal hypertensive rats (n = 7), nifedipine administration (4 micrograms/kg/min i.v.) within a 45-minute observation period caused a blood pressure fall (p less than 0.001) and heart rate acceleration (p less than 0.001) that were comparable in both groups. These findings suggest that in the rat with renal hypertension the short-term blood pressure response to the calcium antagonists verapamil and nifedipine is not influenced by the state of sodium balance and plasma renin activity. In this experimental model of hypertension, the magnitude of the blood pressure lowering effect of calcium entry blockers appears to be proportional to pretreatment blood pressure levels.

摘要

将单肾单夹型肾性高血压的雄性Wistar大鼠在夹闭后分别给予常规饮食或低盐饮食3周。此时,未麻醉大鼠的平均血压在低钠组(n = 17)和高钠组(n = 19)中同样升高,但前者的血浆肾素活性显著更高(p < 0.05)。以0.05 mg/kg/分钟的速率输注钙通道阻滞剂维拉帕米,在60分钟内使低盐饮食大鼠和常规盐饮食大鼠的血压下降程度相似。在所有大鼠中,维拉帕米引起的血压反应幅度与预处理血压水平之间存在密切的直接相关性(r = 0.87,p < 0.001)。维拉帕米使所有大鼠的心率明显加快并刺激肾素释放。在另外的低钠(n = 8)和高钠肾性高血压大鼠组(n = 7)中,在45分钟的观察期内静脉注射硝苯地平(4微克/千克/分钟)导致两组的血压下降(p < 0.001)和心率加快(p < 0.001)程度相当。这些发现表明,在肾性高血压大鼠中,钙拮抗剂维拉帕米和硝苯地平的短期血压反应不受钠平衡状态和血浆肾素活性的影响。在这个高血压实验模型中,钙通道阻滞剂的降压效果大小似乎与预处理血压水平成正比。

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