Agabiti-Rosei E, Alicandri C, Beschi M, Castellano M, Corea L, Beggi P, Motolese M, Muiesan G
Cardiology. 1983;70(6):308-16. doi: 10.1159/000173613.
The aim of this study was to examine the interrelationships between age, plasma catecholamines, plasma renin activity (PRA) and blood pressure in essential hypertensive (EH) patients. PRA, plasma noradrenaline (NA) and adrenaline (A) were measured in 76 consecutive EH patients (WHO stages 1-2, aged 24-66 years) and in 28 normotensive subjects (aged 25-64 years) studied at rest in supine position after 5 days of normal fixed sodium and potassium intake. Both plasma NA and A were slightly but significantly higher in EH patients (p less than 0.05). While no relationship was found between the various parameters in normotensive subjects, in EH patients, particularly those at WHO stage 2, plasma NA was directly related to mean blood pressure (MBP) (p less than 0.001) and PRA (p less than 0.01). Plasma A was weakly related to MBP (p less than 0.05); PRA was inversely related to age (p less than 0.01) but no relationship was found between NA or A and age. Partial correlation analysis confirmed all these relationships. In fact, NA was related to MBP also considering constant PRA (p less than 0.001) or age (p less than 0.001), and NA was related to PRA also considering constant MBP (p less than 0.01) or age (p less than 0.001). Acute pharmacological alpha- and beta-blockade, with labetalol 100 mg i.v., induced a reduction of MBP which was directly related to basal plasma NA (p less than 0.001). These results support the view that in EH the sympathetic nervous system might be in part responsible for PRA levels and for the severity of hypertension.
本研究旨在探讨原发性高血压（EH）患者的年龄、血浆儿茶酚胺、血浆肾素活性（PRA）与血压之间的相互关系。对76例连续的EH患者（WHO分期1 - 2期，年龄24 - 66岁）和28例血压正常的受试者（年龄25 - 64岁）进行了研究，这些受试者在正常固定钠和钾摄入5天后，仰卧位休息时测量了PRA、血浆去甲肾上腺素（NA）和肾上腺素（A）。EH患者的血浆NA和A均略有升高但差异有统计学意义（p < 0.05）。在血压正常的受试者中，未发现各参数之间存在相关性，但在EH患者中，尤其是WHO 2期患者，血浆NA与平均血压（MBP）直接相关（p < 0.001）和PRA（p < 0.01）。血浆A与MBP弱相关（p < 0.05）；PRA与年龄呈负相关（p < 0.01），但未发现NA或A与年龄之间存在相关性。偏相关分析证实了所有这些关系。事实上，在考虑恒定PRA（p < 0.001）或年龄（p < 0.001）时，NA也与MBP相关，在考虑恒定MBP（p < 0.01）或年龄（p < 0.001）时，NA也与PRA相关。静脉注射100 mg拉贝洛尔进行急性药理学α和β阻断，可使MBP降低，这与基础血浆NA直接相关（p < 0.001）。这些结果支持了这样一种观点，即在EH中，交感神经系统可能部分负责PRA水平和高血压的严重程度。
