本態性高血圧症のレニン分泌に対する交感神経β受容体の役割

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書誌事項

タイトル別名
  • The Role of Sympathetic Beta-Adrenergic Receptor on Renin Secrtion in Essential Hypertension
  • ホンタイセイ コウケツアツショウ ノ レニン ブンピ ニ タイスル コウカン

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説明

This study was undertaken to clarify the role of sympathetic beta-adrenergic receptor on renin secretion from juxta-glomerular apparatus in the kidney. Urinary norepinephrine excretion (u-NE) and epinephrine excretion (u-E) were determined in low, normal and high renin essential hypertension (n=93), and next isoproterenol was administrated intravenously, at a dose of 0.02μg/kg/min for 30 min, and blood pressure, pulse rate, plasma renin activity (PRA), plasma cyclic AMP (c-AMP) and plasma aldosterone concentration (PAC) were measured before (0'), during (5', 15', 30') and 30min after (60') the infusion in 6 normal subjects and 19 patients with essential hypertension (EH). u-NE was 16.5±11.8μg/day in low renin EH (LR-EH), 19.7±11.4μg/day in normal renin EH (NR-EH) and 20.2±9.8μg/day in high renin EH (HR-EH), respectively. u-E was 3.6±2.2μg/day in LR-EH, 6.3±5.8μg/day in NR-EH and 8.6±5.0μg/day in HR-EH, respectively. u-E in LR-EH was significantly lower than in NR-EH (p=0.05) and in HR-EH (p=0.01). In normal subjects, pulse rate markedly increased during isoproterenol infusion. PRA and c-AMP did increase, but PAC did not change signifi-cantly with the infusion of isopreterenol. In LR-, NR- and HR-EH pulse rate increased significantly. PRA in LR-EH inconsiderably increased (0': 0.25±0.17ng/ml/h, 5': 0.28±0.23ng/ml/h, 15': 0.31±0.19 ng/ml/h, 30': 0.31±0.14ng/ml/h) during the infusion. PRA in both NR-EH and HR-EH significantly increased during isoproterenol infusion. The increment of c-AMP was observed in LR-EH as well as in NR-EH. PAC did not change significantly during the infusion. These data suggest that the renin secretion after the stimulation of sympathetic nervous system is mediated by renal beta-adrenergic receptor, and that in low renin essential hypertension there may be not only the hypotonicity of sympatho-adrenomedullary system but also the hyporesponsiveness of renin secretion to exogeneous and/or endgeneuos catecholamines.

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