Hyperkinetic hemodynamic pattern in some borderline hypertension: differential responses to alpha and beta agonists.
Twenty eight male borderline hypertensive patients(BH), mean age of 19.72 +/- 2.80 years, were studied and matched with 28 normal controls (NC). Alpha-adrenergic responsiveness was estimated with DPD15 (the dosage of neosynephrine required for an increase of diastolic pressure of 15mmHg); beta-adrenergic responsiveness with CD25 (the dosage of isoproterenol required for an increase of heart rate of 25 beats/minute). Using CD25 of 1.0ug (mean of the NC), the BH could be subdivided into two specific types: 13 patients (46%) whose CD25 less than 1.0 ug, 0.50 +/- 0.24 (m +/- SD) had a hyperkinetic pattern; the remaining 15 patients (54%) whose CD25 greater than 1.0ug, 1.76 +/- 0.32 (m +/- SD), had a normokinetic one. Values of DPD15 of the two types were comparable. Cardiac index (CI, L/min/M2) and total peripheral resistance (TPR, dynes/sec/cm-5) of the two types manifested significant differences, both p less than 0.001. When plotting CI and TPR versus CD25, good correlations were obtained. In the BH group, the coefficient r was -0.73 between CI and CD25, + 0.70 between TPR and CD25; correlations were poor when plotting versus DPD15. Similar correlations also happened in the NC. The present study suggests that coexistence of two different hemodynamic patterns may be due to the imbalance resulted from the interaction between alpha-adrenergic responsiveness and beta-adrenergic responsiveness.
Yi
G
G
Department of Internal Medicine, Baogang Hospital, Shanghai 2nd Medical University, People's Republic of China.
Yang
Q
Q
Fan
J
J
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology*; D000318:Adrenergic beta-Agonists / Q000494:pharmacology*; D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D003971:Diastole; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007545:Isoproterenol / Q000494:pharmacology; D008297:Male; D010656:Phenylephrine / Q000494:pharmacology; D014655:Vascular Resistance
D000316:Adrenergic alpha-Agonists; D000318:Adrenergic beta-Agonists; D010656:Phenylephrine; D007545:Isoproterenol