White M, Fourney A, Leenen F H
Division of Cardiology, University of Ottawa Heart Institute, Ontario, Canada.
Clin Pharmacol Ther. 1998 Jun;63(6):663-71. doi: 10.1016/S0009-9236(98)90090-X.
To evaluate the effects of hypertension on heart rate and left ventricular responses to beta-agonist in young and older subjects, as well as the modulating effect of the arterial baroreflex on these responses.
Isoproterenol (INN, isoprenaline) alone was infused in 14 young normotensive subjects (mean age, 30 +/- 2 years), 18 older normotensive subjects (mean age, 60 +/- 2 years), 11 young hypertensive subjects (mean age, 36 +/- 1 years), and 17 older hypertensive subjects (mean age, 59 +/- 1 years); isoproterenol combined with ganglionic blockade (trimethaphan [INN, trimetaphan]) was administered to eight young normotensive subjects and eight young hypertensive subjects. Isoproterenol was infused at three to four incremental rates, each rate for 8 minutes. Left ventricular responses were assessed by echocardiography.
Isoproterenol caused similar increases in heart rate in all four groups. With ganglionic blockade, heart rate responses were enhanced but were similar in the young normotensive and hypertensive subjects. In young subjects, hypertension did not affect left ventricular responses to isoproterenol alone, whereas older hypertensive subjects showed some blunting of left ventricular responses compared with older normotensive subjects. With ganglionic blockade, young hypertensive subjects also showed mild blunting of left ventricular responses.
These results show that, in humans, hypertension does not lead to a decrease in chronotropic responses to infusion of the beta-agonist isoproterenol and causes only a modest decrease in left ventricular responses.
评估高血压对年轻和老年受试者心率及左心室对β-激动剂反应的影响,以及动脉压力反射对这些反应的调节作用。
单独向14名年轻血压正常受试者(平均年龄30±2岁)、18名老年血压正常受试者(平均年龄60±2岁)、11名年轻高血压受试者(平均年龄36±1岁)和17名老年高血压受试者输注异丙肾上腺素(国际非专利药品名称,异丙肾上腺素);向8名年轻血压正常受试者和8名年轻高血压受试者给予异丙肾上腺素联合神经节阻断剂(三甲硫吩[国际非专利药品名称,曲美芬])。以三到四个递增速率输注异丙肾上腺素,每个速率持续8分钟。通过超声心动图评估左心室反应。
异丙肾上腺素使所有四组受试者的心率出现相似程度的增加。使用神经节阻断剂时,心率反应增强,但年轻血压正常和高血压受试者的反应相似。在年轻受试者中,高血压单独并不影响左心室对异丙肾上腺素的反应,而老年高血压受试者与老年血压正常受试者相比,左心室反应出现一定程度的减弱。使用神经节阻断剂时,年轻高血压受试者的左心室反应也出现轻度减弱。
这些结果表明,在人类中,高血压不会导致对β-激动剂异丙肾上腺素输注的变时反应降低,只会使左心室反应出现适度降低。