McCubbin J A, Bruehl S, Wilson J F, Sherman J J, Norton J A, Colclough G
Department of Behavioral Science and Anesthesiology, University of Kentucky College of Medicine, Lexington, USA.
Psychosom Med. 1998 Mar-Apr;60(2):227-31. doi: 10.1097/00006842-199803000-00020.
Laboratory experiments suggest that endogenous opioids inhibit blood pressure responses during psychological stress. Moreover, there seem to be considerable individual differences in the efficacy of opioid blood pressure inhibition, and these differences may be involved in the expression of risk for cardiovascular disease. To further evaluate the possible role of opioid mechanisms in cardiovascular control, the present study sought to document the effects of the long-lasting oral opioid antagonist naltrexone (ReVia, DuPont, Wilmington, DE) on ambulatory blood pressure responses during naturally occurring stress.
Thirty male volunteers participated in a laboratory stress study using naltrexone followed by ambulatory blood pressure under placebo and during the subsequent 24-hour period. Within-subject analyses were performed on ambulatory blood pressures under placebo and naltrexone conditions.
Laboratory results indicate no significant group effects of naltrexone on blood pressure levels or reactivity. Ambulatory results indicate that during periods of low self-reported stress, no effect of opioid blockade was apparent. In contrast, during periods of high stress, opioid blockade increased ambulatory blood pressure.
These findings suggest that naltrexone-sensitive opioid mechanisms inhibit ambulatory blood pressure responses during naturally occurring stress.
实验室实验表明,内源性阿片类物质在心理应激期间会抑制血压反应。此外,阿片类物质对血压的抑制效果似乎存在相当大的个体差异,这些差异可能与心血管疾病风险的表达有关。为了进一步评估阿片类机制在心血管控制中的可能作用,本研究试图记录长效口服阿片类拮抗剂纳曲酮(ReVia,杜邦公司,特拉华州威尔明顿市)对自然发生应激期间动态血压反应的影响。
30名男性志愿者参与了一项实验室应激研究,先使用纳曲酮,随后在安慰剂及之后的24小时内进行动态血压监测。对安慰剂和纳曲酮条件下的动态血压进行了受试者内分析。
实验室结果表明,纳曲酮对血压水平或反应性无显著的组间效应。动态血压监测结果表明,在自我报告的低应激期间,阿片类物质阻断没有明显效果。相反,在高应激期间,阿片类物质阻断会使动态血压升高。
这些发现表明,对纳曲酮敏感的阿片类机制在自然发生应激期间会抑制动态血压反应。