Rossi M, Taddei S, Fabbri A, Tintori G, Credidio L, Virdis A, Ghiadoni L, Salvetti A, Giusti C
II Clinica Medica, University of Pisa, Italy.
J Cardiovasc Pharmacol. 1997 Mar;29(3):406-11. doi: 10.1097/00005344-199703000-00015.
Endothelium-dependent vasodilation is reduced in the forearm of patients with essential hypertension. To evaluate whether endothelium-dependent vasodilation is also reduced in the skin microcirculation of patients with essential hypertension, we evaluated the effect of acetylcholine, an endothelium-dependent vasodilator, and sodium nitroprusside, an endothelium-independent vasodilator, on cutaneous and total forearm blood flow in normotensive subjects (n = 8) and matched patients with essential hypertension (n = 9). We infused acetylcholine (0.15, 0.45, 1.5, 4.5, and 15 microg/100 ml forearm tissue/min) and sodium nitroprusside (1, 2, and 4 microg/100 ml forearm tissue/min) into the brachial artery, and we measured cutaneous blood flow (laser Doppler flowmeter) and muscle blood flow (strain-gauge venous plethysmography) modifications. Both the cutaneous and muscle blood flow increases induced by acetylcholine were reduced in patients with essential hypertension as compared with normotensive controls, whereas the skin and muscle vasodilation induced by sodium nitroprusside was similar in the two groups of patients. These data confirm the impairment of endothelium-dependent vasodilation in the muscle vascular bed of patients with essential hypertension and demonstrate the presence of endothelial dysfunction in skin microcirculation.
原发性高血压患者前臂的内皮依赖性血管舒张功能降低。为评估原发性高血压患者皮肤微循环中的内皮依赖性血管舒张功能是否也降低，我们评估了内皮依赖性血管舒张剂乙酰胆碱和非内皮依赖性血管舒张剂硝普钠对血压正常受试者（n = 8）和相匹配的原发性高血压患者（n = 9）的皮肤及整个前臂血流量的影响。我们将乙酰胆碱（0.15、0.45、1.5、4.5和15微克/100毫升前臂组织/分钟）和硝普钠（1、2和4微克/100毫升前臂组织/分钟）注入肱动脉，并测量皮肤血流量（激光多普勒血流仪）和肌肉血流量（应变片静脉体积描记法）的变化。与血压正常的对照组相比，原发性高血压患者中由乙酰胆碱诱导的皮肤和肌肉血流量增加均减少，而两组患者中由硝普钠诱导的皮肤和肌肉血管舒张情况相似。这些数据证实原发性高血压患者肌肉血管床中内皮依赖性血管舒张功能受损，并证明皮肤微循环中存在内皮功能障碍。
