Müller R, Steffen H M, Weller P, Kugel C, Freiheit T, Krone W
Medical Clinic II, University of Cologne, Germany.
J Cardiovasc Pharmacol. 1994 Sep;24(3):429-33. doi: 10.1097/00005344-199409000-00011.
Antihypertensive drugs influence the sympathetic nervous system in different ways that may cause adverse or beneficial effects. We treated 48 hypertensive patients with either nitrendipine (10-20 mg twice daily, b.i.d.) or captopril (25-50 mg b.i.d.) for 16 weeks to evaluate changes in plasma catecholamines, platelet alpha 2- and lymphocyte beta 2-adrenoceptors. Blood pressure (BP) decreased from 153/95 to 135/87 mm Hg with captopril and from 155/99 to 137/89 mm Hg with nitrendipine. Treatment with nitrendipine significantly stimulated plasma norepinephrine (NE) from 327 +/- 37 to 446 +/- 50 pg/ml, and treatment with captopril resulted in a significant reduction in platelet alpha 2-adrenoceptor density from 265 +/- 39 to 171 +/- 26 fmol/mg protein. Despite having equal BP-lowering properties, captopril and nitrendipine have different effects on the sympathetic nervous system. Stimulation of plasma NE during long-term treatment with nitrendipine may contribute to possible adverse effects, whereas reduction in alpha 2-adrenoceptors induced by captopril may contribute to the vasodilating effect of angiotensin-converting enzyme (ACE) inhibition.
抗高血压药物以不同方式影响交感神经系统，可能产生不良或有益的效果。我们用尼群地平（每日两次，每次10 - 20毫克）或卡托普利（每日两次，每次25 - 50毫克）治疗48例高血压患者16周，以评估血浆儿茶酚胺、血小板α2 - 肾上腺素能受体和淋巴细胞β2 - 肾上腺素能受体的变化。使用卡托普利治疗后血压从153/95毫米汞柱降至135/87毫米汞柱，使用尼群地平治疗后血压从155/99毫米汞柱降至137/89毫米汞柱。尼群地平治疗显著刺激血浆去甲肾上腺素（NE）从327±37皮克/毫升升至446±50皮克/毫升，而卡托普利治疗导致血小板α2 - 肾上腺素能受体密度从265±39飞摩尔/毫克蛋白显著降至171±26飞摩尔/毫克蛋白。尽管卡托普利和尼群地平具有同等的降压特性，但它们对交感神经系统有不同的影响。长期使用尼群地平治疗期间血浆NE的升高可能导致潜在的不良反应，而卡托普利诱导的α2 - 肾上腺素能受体减少可能有助于血管紧张素转换酶（ACE）抑制的血管舒张作用。
