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比较血管紧张素转换酶抑制剂和血管紧张素II 1型受体拮抗剂治疗对高血压患者心血管变化影响的交叉研究。

Cross-over study comparing effects of treatment with an angiotensin converting enzyme inhibitor and an angiotensin II type 1 receptor antagonist on cardiovascular changes in hypertension.

作者信息

Gillies L K, Werstiuk E S, Lee R M

机构信息

Department of Anaesthesia, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Hypertens. 1998 Apr;16(4):477-86. doi: 10.1097/00004872-199816040-00009.

Abstract

OBJECTIVE

To compare the blood-pressure-lowering effects of an angiotensin converting enzyme inhibitor, perindopril, with those of an angiotensin II type 1 receptor antagonist, L-158,809, for adult spontaneously hypertensive rats.

DESIGN

A cross-over design was used, to treat adult spontaneously hypertensive rats with one drug for 10 weeks, and then with the other for 5 weeks.

METHODS

Adult, male spontaneously hypertensive rats (aged 15 weeks) were treated daily by gavage for 10 weeks with perindopril (P group) or L-158,809 (L group), then treatment was crossed over so that rats in the P group were treated with L-158,809 (P/L group) and rats in the L group were treated with perindopril (L/P group) for 5 weeks. Blood pressure was measured weekly. Plasma angiotensin converting enzyme activity, renal angiotensin receptor density, and arterial structure and functioning were measured after the single and crossover treatment periods.

RESULTS

Treatment lowered the blood pressure from 206 +/- 2 mmHg in rats in the control group, to 126 +/- 2 in rats in the P group and 150 +/- 2 in rats in the L group. After the cross-over period, blood pressure decreased further from 150 +/- 2 to 129 +/- 3 mmHg in rats in the L/P group, whereas blood pressure of spontaneously hypertensive rats in the P/L group increased from 126 +/- 2 to 148 +/- 2 mmHg. Perindopril treatment almost abolished plasma angiotensin converting enzyme activity, whereas L-158,809 treatment had no effect. Renal angiotensin II receptor density was decreased versus baseline in rats in the P and L groups. The affinity of binding was decreased versus baseline in rats in the L group. A positive correlation to blood pressure was found for mesenteric artery wall thickness and wall: lumen ratio. Concentration for half-maximal effect for the response of mesenteric arteries from rats in the P group to norepinephrine was lower than that of the control group rats. Angiotensin II potentiated the norepinephrine-stimulated contraction of arteries from rats in the control and P groups, but not that of arteries from rats in the groups treated with L-158,809.

CONCLUSION

Perindopril was more effective than was L-158,809 at lowering the blood pressure of adult spontaneously hypertensive rats, and at altering the structure and functioning of the arteries.

摘要

目的

比较血管紧张素转换酶抑制剂培哚普利与血管紧张素II 1型受体拮抗剂L-158,809对成年自发性高血压大鼠的降压效果。

设计

采用交叉设计,用一种药物治疗成年自发性高血压大鼠10周,然后换用另一种药物治疗5周。

方法

成年雄性自发性高血压大鼠(15周龄)每天经口灌胃给予培哚普利(P组)或L-158,809(L组),持续10周,然后交叉治疗,使P组大鼠接受L-158,809治疗(P/L组),L组大鼠接受培哚普利治疗(L/P组),持续5周。每周测量血压。在单次治疗期和交叉治疗期结束后,测量血浆血管紧张素转换酶活性、肾血管紧张素受体密度以及动脉结构和功能。

结果

治疗使对照组大鼠血压从206±2 mmHg降至P组大鼠的126±2 mmHg和L组大鼠的150±2 mmHg。交叉治疗期后,L/P组大鼠血压从150±2 mmHg进一步降至129±3 mmHg,而P/L组自发性高血压大鼠血压从126±2 mmHg升至148±2 mmHg。培哚普利治疗几乎消除了血浆血管紧张素转换酶活性,而L-158,809治疗无此作用。P组和L组大鼠的肾血管紧张素II受体密度较基线降低。L组大鼠的结合亲和力较基线降低。发现肠系膜动脉壁厚度和壁/腔比值与血压呈正相关。P组大鼠肠系膜动脉对去甲肾上腺素反应的半数最大效应浓度低于对照组大鼠。血管紧张素II增强了对照组和P组大鼠动脉对去甲肾上腺素刺激的收缩,但未增强L-158,809治疗组大鼠动脉的收缩。

结论

在降低成年自发性高血压大鼠血压以及改变动脉结构和功能方面,培哚普利比L-158,809更有效。

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