Nagano M, Higaki J, Mikami H, Ogihara T
Department of Geriatric Medicine, Osaka University Medical School, Suita, Japan.
Blood Press Suppl. 1994;5:130-3.
Although the activity of the renin-angiotensin system is known to decrease with age, the antihypertensive efficacy of angiotensin-converting enzyme (ACE) inhibitors has been demonstrated in the elderly. To examine the role of the renin-angiotensin system in hypertension in the elderly, we evaluated the antihypertensive response to enalapril and to TCV-116, an angiotensin II type-1 receptor antagonist, in elderly patients with essential hypertension. A single oral dose of enalapril (10 mg) increased plasma renin activity (PRA) and reduced the angiotensin II concentration, whereas a single oral dose of TCV-116 (4 mg) increased both PRA and the angiotensin II concentration. Blood pressure was significantly reduced by these drugs from 4 h after administration. Basal levels of PRA and angiotensin II declined with age. However, the changes in blood pressure produced by either TCV-116 or enalapril did not correlate with age. These results suggest that the activity of the renin-angiotensin system in plasma declines with age, and that the extrarenal renin-angiotensin system may play a role in hypertension in the elderly.
虽然已知肾素 - 血管紧张素系统的活性会随年龄增长而降低，但血管紧张素转换酶（ACE）抑制剂在老年人中的降压疗效已得到证实。为了研究肾素 - 血管紧张素系统在老年高血压中的作用，我们评估了老年原发性高血压患者对依那普利和血管紧张素II 1型受体拮抗剂TCV - 116的降压反应。单次口服依那普利（10毫克）可增加血浆肾素活性（PRA）并降低血管紧张素II浓度，而单次口服TCV - 116（4毫克）则可增加PRA和血管紧张素II浓度。给药后4小时起，这些药物可显著降低血压。PRA和血管紧张素II的基础水平随年龄下降。然而，TCV - 116或依那普利引起的血压变化与年龄无关。这些结果表明，血浆中肾素 - 血管紧张素系统的活性随年龄下降，且肾外肾素 - 血管紧张素系统可能在老年高血压中起作用。
