Jensen J, Henik R A, Brownfield M, Armstrong J
Department of Medical Sciences, University of Wisconsin-Madison 53706, USA.
Am J Vet Res. 1997 May;58(5):535-40.
To determine plasma renin activity (PRA), angiotensin I (Ang I), and aldosterone (ALDO) values in clinically normal cats and hypertensive cats with renal disease, and the relation of renin-angiotensin-aldosterone activation in response to treatment with beta-blockers or angiotensin-converting enzyme inhibitors.
5 normotensive healthy control cats and 12 Untreated hypertensive cats with chronic renal disease.
Untreated hypertensive cats received either propanolol (n = 6) or enalapril (n = 6) as initial antihypertensive treatment. PRA and baseline plasma Ang I and ALDO concentrations were measured prior to treatment. The difference in Ang I values at 2 hours (Ang I generated) and at time 0 (baseline Ang I) was divided by 2 to give the PRA value. Values for PRA, Ang I, and ALDO were obtained from 5 clinically normal, normotensive cats, and compared with those of hypertensive cats.
Mean +/- SD PRA and baseline Ang I concentration were not significantly different between normotensive and hypertensive cats. Mean ALDO concentration was significantly (P = 0.0235) higher in hypertensive cats with renal disease (186.18 +/- 145.15 pg/ml), compared with that in normotensive controls (51.1 +/- 16.76 pg/ml). Eight hypertensive cats with ALDO concentration > 2 SD above the mean concentration in control cats had low (n = 3), normal (n = 4), or high (n = 1) PRA, suggesting variable activation of the renin-angiotensin-aldosterone axis in the hypertensive state. Overall, enalapril was effective long-term monotherapy in only 1 of 6 cats, and propranolol was ineffective as long-term monotherapy.
Evaluation of the renin-angiotensin-aldosterone system in cats with hypertension associated with renal disease may lead to greater understanding of the pathophysiologic mechanisms of this disorder. In addition, identification of biochemical markers in hypertensive cats may permit selection of appropriate antihypertensive drugs. Propranolol and enalapril were ineffective antihypertensive agents in most cats of this study.
测定临床正常猫和患有肾脏疾病的高血压猫的血浆肾素活性(PRA)、血管紧张素I(Ang I)和醛固酮(ALDO)值,以及肾素 - 血管紧张素 - 醛固酮系统在接受β受体阻滞剂或血管紧张素转换酶抑制剂治疗后的激活情况。
5只血压正常的健康对照猫和12只未经治疗的患有慢性肾脏疾病的高血压猫。
未经治疗的高血压猫接受普萘洛尔(n = 6)或依那普利(n = 6)作为初始抗高血压治疗。在治疗前测量PRA以及基线血浆Ang I和ALDO浓度。将2小时时的Ang I值(生成的Ang I)与0时(基线Ang I)的差值除以2得到PRA值。从5只临床正常、血压正常的猫获取PRA、Ang I和ALDO值,并与高血压猫的值进行比较。
血压正常和高血压猫之间的平均±标准差PRA和基线Ang I浓度无显著差异。患有肾脏疾病的高血压猫的平均ALDO浓度(186.18±145.15 pg/ml)显著高于(P = 0.0235)血压正常的对照组(51.1±16.76 pg/ml)。8只ALDO浓度高于对照猫平均浓度2个标准差以上的高血压猫,其PRA低(n = 3)、正常(n = 4)或高(n = 1),提示高血压状态下肾素 - 血管紧张素 - 醛固酮轴的激活情况各异。总体而言,依那普利仅对6只猫中的1只作为长期单一疗法有效,而普萘洛尔作为长期单一疗法无效。
评估患有与肾脏疾病相关高血压的猫的肾素 - 血管紧张素 - 醛固酮系统,可能有助于更深入了解该疾病的病理生理机制。此外,识别高血压猫中的生化标志物可能有助于选择合适的抗高血压药物。在本研究的大多数猫中,普萘洛尔和依那普利是无效的抗高血压药物。