Taddei S, Virdis A, Mattei P, Ghiadoni L, Gennari A, Fasolo C B, Sudano I, Salvetti A
I Clinica Medica, University of Pisa, Italy.
Circulation. 1995 Apr 1;91(7):1981-7. doi: 10.1161/01.cir.91.7.1981.
Experimental data from normotensive and hypertensive animals indicate that aging is associated with impaired endothelium-dependent relaxations to acetylcholine, and this possibility appears to be confirmed in the human coronary artery. In the present study, we evaluated the effect of age on endothelial responsiveness in the forearm vessels of either normotensive control subjects or essential hypertensive patients.
Within the normotensive or hypertensive group (n = 53 and n = 57, respectively), subjects were selected with similar blood pressure, plasma cholesterol, and glucose values, and hypercholesterolemic subjects, diabetics, and smokers were excluded. We evaluated forearm blood flow (by strain-gauge plethysmography) modifications induced by intrabrachial acetylcholine (0.15, 0.45, 1.5, 4.5, and 15 micrograms/100 mL per minute), an endothelium-dependent vasodilator, and sodium nitroprusside (1, 2, and 4 micrograms/100 mL per minute), an endothelium-independent vasodilator. Acetylcholine caused a dose-dependent vasodilation that was significantly (P < .01) lower in essential hypertensive patients than in normotensive control subjects. However, a significant negative correlation was observed between acetylcholine-induced vasodilation and patient age in both normotensive (r = -.86, P < .001) and hypertensive (r = -.85, P < .001) patients. In contrast, vasodilation to sodium nitroprusside was similar in normotensive control subjects and essential hypertensive patients with a poorer inverse correlation with patient age (normotensive control subjects, r = -.37; hypertensive patients, r = -.36) compared with acetylcholine.
The present data indicate that there is a blunted response to acetylcholine with advancing age in both normotensive control subjects and essential hypertensive patients, suggesting that aging is associated with reduced endothelium-dependent vasodilation in humans.
来自正常血压和高血压动物的实验数据表明，衰老与对乙酰胆碱的内皮依赖性舒张功能受损有关，这种可能性似乎在人类冠状动脉中得到了证实。在本研究中，我们评估了年龄对正常血压对照受试者或原发性高血压患者前臂血管内皮反应性的影响。
在正常血压组或高血压组（分别为n = 53和n = 57）中，选择血压、血浆胆固醇和血糖值相似的受试者，并排除高胆固醇血症受试者、糖尿病患者和吸烟者。我们评估了由内皮依赖性血管舒张剂肱内注射乙酰胆碱（0.15、0.45、1.5、4.5和15微克/100毫升每分钟）和内皮非依赖性血管舒张剂硝普钠（1、2和4微克/100毫升每分钟）引起的前臂血流（通过应变片体积描记法）变化。乙酰胆碱引起剂量依赖性血管舒张，原发性高血压患者的这种舒张作用明显（P <.01）低于正常血压对照受试者。然而，在正常血压（r = -.86，P <.001）和高血压（r = -.85，P <.001）患者中，乙酰胆碱诱导的血管舒张与患者年龄之间均观察到显著的负相关。相比之下，正常血压对照受试者和原发性高血压患者对硝普钠的血管舒张作用相似，与乙酰胆碱相比，与患者年龄的负相关性较差（正常血压对照受试者，r = -.37；高血压患者，r = -.36）。
目前的数据表明，正常血压对照受试者和原发性高血压患者随着年龄增长对乙酰胆碱的反应均减弱，这表明衰老与人类内皮依赖性血管舒张功能降低有关。
