Hirawa N, Uehara Y, Numabe A, Kawabata Y, Gomi T, Ikeda T, Ohnishi T, Ishii M, Omata M
Division of Nephrology, Kohsaikai Asahi Hospital, Yokohama, Japan.
Am J Hypertens. 1997 May;10(5 Pt 2):102S-106S.
Angiotensin II (Ang II) progresses to remodeling of the cardiovascular system through nonhemodynamic as well as hemodynamic effects. There have been few data in vivo on whether subpressor concentration of Ang II is exerted to injure directly the cardiovascular system in hypertension. To test this hypothesis, we investigated, using Dahl salt-sensitive (Dahl S) rats, whether subpressor dose of Ang II progresses to cardiovascular injury observed in salt-induced hypertension. Recent studies have provided evidence that renin-angiotensin inhibition protects against renovascular injury in human hypertension as well as in experimental animals. Particularly in the case of Dahl salt-sensitive rats, a genetic model of volume-dependent hypertension in humans, they are likely to develop more severe arterial and renal injuries than those seen in spontaneously hypertensive rats with similar blood pressure levels. The mechanism of the susceptibility to hypertensive injuries is uncertain; however, renin-angiotensin inhibition significantly improved morphologic and functional injuries in the kidney of Dahl S rats. Conversely, subpressor dose of Ang II infusion exacerbated renal function and progressed to glomerulosclerotic lesions. Alterations of Ang II concentration in physiologic range influenced morphologic and functional injuries in Dahl S rats. Multivariate analysis revealed that activity of the renin-angiotensin system is an independent risk factor to glomerular injury in salt-induced hypertension. These data are in favor of the therapeutic strategy in human hypertension that inhibition of renin-angiotensin system is of value to produce beneficial effects of blood pressure reduction on organ injuries.
血管紧张素II(Ang II)通过非血流动力学以及血流动力学效应导致心血管系统重塑。关于在高血压中,低于升压浓度的Ang II是否直接对心血管系统造成损伤,体内相关数据较少。为验证这一假设,我们使用 Dahl 盐敏感(Dahl S)大鼠,研究低于升压剂量的Ang II是否会导致盐诱导性高血压中出现的心血管损伤。最近的研究表明,肾素 - 血管紧张素抑制可预防人类高血压以及实验动物的肾血管损伤。特别是对于 Dahl 盐敏感大鼠这种人类容量依赖性高血压的遗传模型,它们可能比血压水平相似的自发性高血压大鼠出现更严重的动脉和肾脏损伤。对高血压损伤易感性的机制尚不确定;然而,肾素 - 血管紧张素抑制可显著改善 Dahl S 大鼠肾脏的形态和功能损伤。相反,输注低于升压剂量的Ang II会使肾功能恶化并进展为肾小球硬化病变。生理范围内Ang II浓度的改变影响了 Dahl S 大鼠的形态和功能损伤。多变量分析显示,肾素 - 血管紧张素系统的活性是盐诱导性高血压中肾小球损伤的独立危险因素。这些数据支持在人类高血压治疗策略中,抑制肾素 - 血管紧张素系统对于降低血压对器官损伤产生有益作用具有重要价值。