Freeman R H, Davis J O, Seymour A A
Fed Proc. 1982 Jun;41(8):2409-14.
An analysis is presented of volume and vasoconstrictor factors in experimental renovascular hypertension. Volume expansion and increased cardiac output produced by renal retention of salt and water are not essential for chronic renovascular hypertension to develop. When volume expansion and increased cardiac output do occur, however, it appears that the increased cardiac output contributes directly to the hypertensive process without triggering myogenic alterations in peripheral resistance predicted by the whole-body autoregulation theory of hypertension. Activation of the renin-angiotensin vasoconstrictor mechanism is not essential for either the development or the maintenance of chronic one-kidney renovascular hypertension in either the dog or the rat. In experimental two-kidney renovascular hypertension, a clear species difference is apparent. In the two-kidney hypertensive dog, the angiotensin pressor mechanism appears to play only a transient role lasting about 1 wk. In the two-kidney Goldblatt hypertensive rat, however, both the development and the maintenance of the hypertension are angiotensin-dependent, at least for a 4- to 6-wk period. When both the volume component and the renin-angiotensin vasoconstrictor component were deleted in one-kidney rats by sodium depletion and chronic SQ 14225 administration, renal artery stenosis failed to produce chronic renovascular hypertension. It is concluded that the pathogenesis of chronic renovascular hypertension requires either volume expansion produced by renal salt and fluid retention or expression of the renin-angiotensin vasoconstrictor mechanism.
本文对实验性肾血管性高血压中的容量和血管收缩因素进行了分析。肾潴留盐和水所导致的容量扩张及心输出量增加,并非慢性肾血管性高血压发展的必要条件。然而,当确实出现容量扩张和心输出量增加时,心输出量增加似乎直接促成了高血压进程,而未引发高血压全身自动调节理论所预测的外周阻力的肌源性改变。肾素 - 血管紧张素血管收缩机制的激活,对于犬或大鼠的慢性单肾肾血管性高血压的发生或维持均非必要条件。在实验性双肾肾血管性高血压中,明显存在物种差异。在双肾高血压犬中,血管紧张素升压机制似乎仅起短暂作用,持续约1周。然而,在双肾戈德布拉特高血压大鼠中,高血压的发生和维持均依赖血管紧张素,至少在4至6周期间如此。当通过钠耗竭和长期皮下注射SQ 14225使单肾大鼠的容量成分和肾素 - 血管紧张素血管收缩成分均缺失时,肾动脉狭窄未能引发慢性肾血管性高血压。结论是,慢性肾血管性高血压的发病机制需要肾潴留盐和液体所产生的容量扩张,或肾素 - 血管紧张素血管收缩机制的表达。