Weber M A, Stokes G S, Gain J M
J Clin Invest. 1974 Dec;54(6):1413-9. doi: 10.1172/JCI107888.
Continuous 6-h infusions of the beta adrenergic blockers d,l-propranolol or oxprenolol significantly reduced plasma renin activity (PRA) and mean blood pressure in the resting rabbit and prevented the stimulatory effects of isoproterenol on renin release and heart rate. These actions were due to blockade of beta receptors, for the inactive isomer, d-propranolol, had no effect. Despite sustained high plasma concentrations of d,l-propranolol (0.2 mug/ml) in the unstimulated animal, PRA did not fall below 36% of control values, suggesting that basal renin secretion is maintained partly by factors other than beta adrenergic mechanisms.Prindolol, another beta blocker, also abolished the effects of isoproterenol on renin and on the heart, and reduced blood pressure in the resting animal. However, prindolol increased resting PRA and heart rate, and in animals already receiving d,l-propranolol, it raised PRA and heart rate without further altering blood pressure. This suggests that the effect on PRA of prindolol was due to its intrinsic sympathomimetic activity and not hypotension-mediated mechanisms. The observation that the blood pressure-lowering effect of prindolol was associated with a rise in PRA, while another beta antagonist, H 35/25, lowered PRA but had no effect on blood pressure, indicates that the hypotensive action of beta blockers is unrelated to their effects on renin release. In both unstimulated and isoproterenol-challenged animals, only blockers possessing beta-1 receptor affinity (d,l-propranolol, oxprenolol, prindolol, practolol, and metoprolol) affected heart rate, while effects on PRA were more prominent with agents possessing beta-2 activity (d,l-propranolol, oxprenolol, prindolol, and H 35/25). Thus, the changes in PRA caused by the beta adrenergic blockers appear to be dependent upon the summation of their direct effects, antagonistic or sympathomimetic, on beta-2 adrenergic receptors regulating renin release.
对家兔持续6小时输注β肾上腺素能阻滞剂d,l-普萘洛尔或氧烯洛尔,可显著降低其静息状态下的血浆肾素活性(PRA)和平均血压,并可防止异丙肾上腺素对肾素释放和心率的刺激作用。这些作用是由于β受体被阻断,因为无活性的异构体d-普萘洛尔没有效果。尽管在未受刺激的动物中d,l-普萘洛尔的血浆浓度持续维持在较高水平(0.2μg/ml),但PRA并未降至对照值的36%以下,这表明基础肾素分泌部分是由β肾上腺素能机制以外的因素维持的。另一种β阻滞剂吲哚洛尔也消除了异丙肾上腺素对肾素和心脏的作用,并降低了静息动物的血压。然而,吲哚洛尔增加了静息状态下的PRA和心率,并且在已经接受d,l-普萘洛尔的动物中,它升高了PRA和心率,但没有进一步改变血压。这表明吲哚洛尔对PRA的作用是由于其内在拟交感活性,而不是低血压介导的机制。吲哚洛尔的降压作用与PRA升高相关,而另一种β拮抗剂H 35/25降低了PRA但对血压没有影响,这一观察结果表明β阻滞剂的降压作用与其对肾素释放的影响无关。在未受刺激和受到异丙肾上腺素刺激的动物中,只有具有β-1受体亲和力的阻滞剂(d,l-普萘洛尔、氧烯洛尔、吲哚洛尔、醋丁洛尔和美托洛尔)会影响心率,而具有β-2活性的药物(d,l-普萘洛尔、氧烯洛尔、吲哚洛尔和H 35/25)对PRA的影响更为显著。因此,β肾上腺素能阻滞剂引起的PRA变化似乎取决于它们对调节肾素释放的β-2肾上腺素能受体的直接作用(拮抗或拟交感)的总和。