Hishikawa K, Nakaki T, Suzuki H, Kato R, Saruta T
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
J Hypertens. 1993 Jun;11(6):639-45. doi: 10.1097/00004872-199306000-00008.
The present study was designed to investigate the effect of L-arginine administration on patients with essential and secondary hypertension by measuring haemodynamic parameters, neuroendocrine hormones and indicators of nitric oxide (NO) release.
Ten patients with essential hypertension and six with secondary hypertension (three with renovascular hypertension and three with primary aldosteronism) were enrolled in the study.
L-Arginine was administered intravenously to the hypertensive patients. During L-arginine administration, blood pressure, heart rate, cardiac output and neuroendocrine hormones such as catecholamines, plasma renin activity and plasma aldosterone were measured. To examine whether L-arginine administration increases NO production, indicators of NO release in vivo such as plasma cyclic GMP, plasma citrulline and urinary excretion of nitrite and nitrate were measured simultaneously.
During administration, mean arterial pressure decreased, heart rate increased, cardiac output increased and total peripheral resistance decreased. The indicators of NO release increased simultaneously during administration. Catecholamine and plasma renin activity, rather than increasing in response to L-arginine-induced hypotension as expected, showed no significant changes except in patients with renovascular hypertension. In all patients plasma aldosterone levels decreased significantly in response to L-arginine administration, regardless of basal plasma renin activity and aldosterone levels.
These results suggest that exogenous L-arginine produces a vasodilatory effect by increasing NO production and that L-arginine, or released NO, modulates the release of neuroendocrine hormones in hypertensive subjects.
本研究旨在通过测量血流动力学参数、神经内分泌激素和一氧化氮（NO）释放指标，探讨给予L-精氨酸对原发性和继发性高血压患者的影响。
本研究纳入了10例原发性高血压患者和6例继发性高血压患者（3例肾血管性高血压患者和3例原发性醛固酮增多症患者）。
对高血压患者静脉给予L-精氨酸。在给予L-精氨酸期间，测量血压、心率、心输出量以及儿茶酚胺、血浆肾素活性和血浆醛固酮等神经内分泌激素。为了检测给予L-精氨酸是否会增加NO生成，同时测量体内NO释放指标，如血浆环磷酸鸟苷、血浆瓜氨酸以及尿中亚硝酸盐和硝酸盐的排泄量。
给药期间，平均动脉压下降，心率增加，心输出量增加，总外周阻力降低。给药期间，NO释放指标同时增加。儿茶酚胺和血浆肾素活性并未如预期那样因L-精氨酸诱导的低血压而增加，除肾血管性高血压患者外，均无显著变化。在所有患者中，无论基础血浆肾素活性和醛固酮水平如何，给予L-精氨酸后血浆醛固酮水平均显著下降。
这些结果表明，外源性L-精氨酸通过增加NO生成产生血管舒张作用，并且L-精氨酸或释放的NO可调节高血压患者神经内分泌激素的释放。
