Hutri-Kähönen N, Kähönen M, Tolvanen J P, Wu X, Sallinen K, Pörsti I
Medical School, University of Tampere, Finland.
Cardiovasc Res. 1997 Jan;33(1):188-95. doi: 10.1016/s0008-6363(96)00197-6.
Angiotensin-converting enzyme (ACE) inhibition has been shown to restore impaired endothelial function in hypertension, but the roles of different mediators in enhanced endothelium-dependent dilation have not been fully characterized.
The effects of ACE inhibition with ramipril (1 mg.kg-1.day-1) on relaxation responses of mesenteric arterial rings in vitro were studied in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY).
The 12-week-long therapy effectively reduced blood pressure in SHR. In noradrenaline (NA)-precontracted arterial rings, endothelium-dependent relaxations to acetylcholine (ACh) as well as endothelium-independent dilations to isoprenaline and nitroprusside were more pronounced in WKY and ramipril-treated SHR than in untreated SHR. The cyclo-oxygenase inhibitor, diclofenac, which reduces the synthesis of dilating and constricting prostanoids, clearly enhanced the relaxation to ACh in untreated SHR, but was without effect in the other groups. The nitric oxide (NO) synthase inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME), attenuated the relaxations to ACh more effectively in untreated SHR than in the ramipril-SHR and WKY groups. However, when endothelium-dependent hyperpolarization was prevented by precontracting the preparations with potassium chloride (KCl), no significant differences were found in relaxations to ACh between the study groups. In addition, in NA-precontracted rings the diclofenac- and L-NAME-resistant relaxations to ACh were partially prevented by glibenclamide and apamin, inhibitors of ATP-dependent and Ca(2+)-activated K+ channels, respectively.
Long-term ACE inhibition normalized blood pressure and enhanced arterial dilation in SHR. The improved endothelium-mediated relaxation following ramipril therapy could be attributed to reduced release of cyclo-oxygenase-derived constricting factors and augmented endothelium-dependent hyperpolarization in this type of experimental hypertension.
血管紧张素转换酶(ACE)抑制已被证明可恢复高血压患者受损的内皮功能,但不同介质在增强内皮依赖性舒张中的作用尚未完全明确。
在自发性高血压大鼠(SHR)和正常血压的Wistar-Kyoto大鼠(WKY)中,研究了雷米普利(1mg·kg⁻¹·d⁻¹)抑制ACE对肠系膜动脉环体外舒张反应的影响。
为期12周的治疗有效降低了SHR的血压。在去甲肾上腺素(NA)预收缩的动脉环中,WKY和雷米普利治疗的SHR对乙酰胆碱(ACh)的内皮依赖性舒张以及对异丙肾上腺素和硝普钠的非内皮依赖性舒张比未治疗的SHR更明显。环氧化酶抑制剂双氯芬酸可减少舒张和收缩性前列腺素的合成,在未治疗的SHR中可明显增强对ACh的舒张作用,但在其他组中无作用。一氧化氮(NO)合酶抑制剂N(G)-硝基-L-精氨酸甲酯(L-NAME)在未治疗的SHR中比在雷米普利-SHR和WKY组中更有效地减弱了对ACh的舒张作用。然而,当用氯化钾(KCl)预收缩制剂来防止内皮依赖性超极化时,研究组之间对ACh的舒张作用未发现显著差异。此外,在NA预收缩的环中,双氯芬酸和L-NAME抗性的对ACh的舒张作用分别被格列本脲和阿帕明部分阻断,它们分别是ATP依赖性和Ca²⁺激活的K⁺通道的抑制剂。
长期ACE抑制可使SHR血压正常化并增强动脉舒张。雷米普利治疗后内皮介导的舒张改善可能归因于环氧化酶衍生的收缩因子释放减少以及此类实验性高血压中内皮依赖性超极化增强。