Vallès Prats M, Matas Serra M, Bronsoms Artero J, Matè Benito G, Torguet Escuder P, Mauri Nicolas J M
Hospital Doctor Josep Trueta, Girona, Catalunya, Spain.
Kidney Int Suppl. 1996 Jun;55:S104-6.
The effects of inhibition of the renin-angiotensin system with quinapril on adrenergic transmission were determined in 18 patients with moderate essential hypertension. Plasmatic renin activity, catecolamines, and aldosterone as well as vascular reactivity after norepinephrine and angiotensin II perfusion were determined before and after treatment with the ACE inhibitor quinapril up to 40 mg/day during four months. In the responder patients (patients with a casual diastolic blood pressure decrease > 5 mm Hg determined at the beginning of the second vascular reactivity study, (N = 9) a decrease of plasma norepinephrine and epinephrine and a slight increase of vascular reactivity was found. Non-responder patients (N = 9) did not show any significant changes in these parameters. These results demonstrate that the hypotensive effect of quinapril may be related not only to the inhibition of RAS, but also to the blockage of the adrenergic system.
在18例中度原发性高血压患者中,确定了用喹那普利抑制肾素 - 血管紧张素系统对肾上腺素能传递的影响。在四个月内,使用高达40mg/天的ACE抑制剂喹那普利治疗前后,测定了血浆肾素活性、儿茶酚胺、醛固酮以及去甲肾上腺素和血管紧张素II灌注后的血管反应性。在有反应的患者(在第二次血管反应性研究开始时测定的偶测舒张压下降>5mmHg的患者,N = 9)中,发现血浆去甲肾上腺素和肾上腺素减少,血管反应性略有增加。无反应的患者(N = 9)在这些参数上没有显示任何显著变化。这些结果表明,喹那普利的降压作用可能不仅与抑制肾素 - 血管紧张素系统有关,还与阻断肾上腺素能系统有关。