Elliott H L
Department of Medicine and Therapeutics, Gardiner Institute, Western Infirmary, Glasgow, UK.
J Hypertens Suppl. 1993 Dec;11(6):S13-6.
Effects of calcium antagonists on pressor mechanisms: A number of differences have been reported in the variable extent to which calcium antagonists interfere with various pressor mechanisms. In theory, high lipid solubility, membrane-binding characteristics and a prolonged duration of action appear to be requirements for a calcium antagonist to affect mechanisms such as vasodilation, endogenous vasoconstrictor responses, hormone release and natriuretic activity. Reduction in peripheral vascular resistance: A reduction in peripheral vascular resistance is fundamental to the antihypertensive effect not only of calcium antagonists but also of angiotensin converting enzyme inhibitors and alpha 1-adrenoceptor antagonists. However, only the calcium antagonists interfere directly with the pressor responses mediated by both the adrenergic nervous system and the renin-angiotensin system. Mechanism of lacidipine effects: Preliminary results with the new dihydropyridine calcium antagonist lacidipine indicate that it not only has vasodilator activity but that it also interferes with both adrenergic and non-adrenergic endogenous vasoconstrictor mechanisms. This may provide additional potentially beneficial cardiovascular effects, particularly in relation to left ventricular hypertrophy and dysfunction.
据报道，钙拮抗剂对各种升压机制的干扰程度存在多种差异。理论上，高脂质溶解性、膜结合特性和较长的作用持续时间似乎是钙拮抗剂影响血管舒张、内源性血管收缩反应、激素释放和利钠活性等机制的必要条件。外周血管阻力降低：外周血管阻力降低不仅是钙拮抗剂降压作用的基础，也是血管紧张素转换酶抑制剂和α1-肾上腺素能受体拮抗剂降压作用的基础。然而，只有钙拮抗剂直接干扰由肾上腺素能神经系统和肾素-血管紧张素系统介导的升压反应。拉西地平的作用机制：新型二氢吡啶类钙拮抗剂拉西地平的初步结果表明，它不仅具有血管舒张活性，还能干扰肾上腺素能和非肾上腺素能内源性血管收缩机制。这可能会带来额外的潜在有益心血管效应，特别是与左心室肥厚和功能障碍相关的效应。
