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黑人中异丙肾上腺素介导的血管舒张作用减弱。

Attenuation of isoproterenol-mediated vasodilatation in blacks.

作者信息

Lang C C, Stein C M, Brown R M, Deegan R, Nelson R, He H B, Wood M, Wood A J

机构信息

Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville 37232-6602, USA.

出版信息

N Engl J Med. 1995 Jul 20;333(3):155-60. doi: 10.1056/NEJM199507203330304.

Abstract

BACKGROUND

The mechanism of enhanced vascular reactivity in young blacks, which may play a part in the development of hypertension, has not been defined. To determine the contribution of blunted vasodilatation mediated by beta 2-adrenergic receptors to this phenomenon, we compared forearm blood-flow responses to isoproterenol in young black and white normotensive men.

METHODS

We used venous-occlusion plethysmography to measure the responses of blood flow in the forearm to the intraarterial administration of isoproterenol (10 to 400 ng per minute) in 9 normotensive black men (mean [+/- SD] age, 31.3 +/- 8.0 years) and 13 normotensive white men (mean age, 32.9 +/- 5.6 years). Sympathetic activity in the forearm was measured simultaneously by isotope-dilution techniques.

RESULTS

Base-line blood flow in the forearm was similar in blacks and whites, but the degree of vasodilatation in response to isoproterenol was markedly lower in blacks. Isoproterenol at an infusion rate of 400 ng per minute produced a 9-fold increase in blood flow in whites but only a 3.5-fold increase in blacks (P < 0.001). The base-line rate of norepinephrine spillover in the forearm was higher in blacks (2.0 +/- 1.3 ng per minute [11.8 +/- 7.7 nmol per minute]) than in whites (0.6 +/- 0.5 ng per minute [3.5 +/- 3.0 nmol per minute], P = 0.002), but there was no difference between the groups after isoproterenol stimulation.

CONCLUSIONS

Forearm blood-flow responses to isoproterenol were markedly attenuated in normotensive blacks, indicating a blunting of vasodilatation mediated by beta 2-adrenergic receptors. Sympathetic activity in the forearm was greater in blacks than in whites, but isoproterenol-stimulated presynaptic beta 2-adrenergic responses (which facilitated norepinephrine release) did not differ significantly between blacks and whites. Our findings suggest that the mechanisms responsible for blunted vasodilatation in response to the administration of isoproterenol may contribute to enhanced vascular reactivity in blacks and may play a part in the pathogenesis of hypertension in blacks.

摘要

背景

年轻黑人血管反应性增强的机制尚未明确,而这一机制可能在高血压的发生过程中起作用。为了确定β2 - 肾上腺素能受体介导的血管舒张功能减弱对这一现象的影响,我们比较了年轻黑人和白人正常血压男性前臂血流对异丙肾上腺素的反应。

方法

我们采用静脉阻断体积描记法,测量了9名正常血压黑人男性(平均年龄[±标准差]为31.3±8.0岁)和13名正常血压白人男性(平均年龄为32.9±5.6岁)前臂血流对动脉内注射异丙肾上腺素(每分钟10至400纳克)的反应。同时采用同位素稀释技术测量前臂的交感神经活动。

结果

黑人和白人的前臂基线血流相似,但黑人对异丙肾上腺素的血管舒张程度明显较低。每分钟输注400纳克异丙肾上腺素时,白人的血流增加了9倍,而黑人仅增加了3.5倍(P<0.001)。黑人前臂去甲肾上腺素溢出的基线速率(每分钟2.0±1.3纳克[每分钟11.8±7.7纳摩尔])高于白人(每分钟0.6±0.5纳克[每分钟3.5±3.0纳摩尔],P = 0.002),但异丙肾上腺素刺激后两组之间没有差异。

结论

正常血压黑人对异丙肾上腺素的前臂血流反应明显减弱,表明β2 - 肾上腺素能受体介导的血管舒张功能减弱。黑人前臂的交感神经活动高于白人,但异丙肾上腺素刺激的突触前β2 - 肾上腺素能反应(促进去甲肾上腺素释放)在黑人和白人之间没有显著差异。我们的研究结果表明,对异丙肾上腺素给药反应的血管舒张功能减弱的机制可能导致黑人血管反应性增强,并可能在黑人高血压的发病机制中起作用。

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