Effects of dopaminergic antagonists on dopamine-induced cardiovascular and insulin secretion actions in hypertensive patients.

P Forte, G Martin, A Luchsinger, O Hernandez, E Romero, M Velasco
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Abstract

A comparative study between two dopaminergic antagonists: metoclopramide and domperidone, was undertaken in nineteen (19) hypertensive patients at the Vargas Hospital, Caracas. The patients were pretreated with labetalol, 800-1,200 mg/day, orally, over a period of one week, after which they were divided into two groups: group A, a total of eleven patients were intravenously infused with dopamine hydrochloride 0.5-3 micrograms/kg/min, before and after treatment with metoclopramide (10 mg, i.v. as a bolus); group B (n = 8), was pretreated with domperidone, 20 mg b.i.d., p.o. over a period of one week and intravenously infused with dopamine hydrochloride, 0.5-3 micrograms/kg/min. In group A, dopamine induced a decrease of blood pressure from 171.9 +/- 6.35/103.6 +/- 3.12 to 152.7 +/- 7.55/93.8 +/- 2.97 mmHg (p < 0.001) without altering heart rate, and it increased plasma insulin levels from 8.29 +/- 0.70 microunits/ml to 12.09 +/- 1.83 microunits/ml (p < 0.01). Metoclopramide caused no changes of blood pressure or plasma insulin levels. However, hypotensive responses and plasma insulin rises due to dopamine were blocked by metoclopramide. In group B, domperidone also blocked dopamine-induced antihypertensive effect (from 170.0 +/- 9.23/102.8 +/- 3.80 to 160.2 +/- 9.84/95.5 +/- 2.50 mmHg) although it was less effective than metoclopramide. Domperidone also blocked dopamine-induced increase of plasma insulin levels from 9.65 +/- 4.50 microunits/ml to 11.78 microunits/ml. We conclude that a dopaminergic receptor may be involved in some cardiovascular responses and in modulating insulin secretion in man.

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多巴胺能拮抗剂对高血压患者多巴胺诱导的心血管和胰岛素分泌的影响。
对加拉加斯Vargas医院19例高血压患者进行了甲氧氯普胺和多潘立酮两种多巴胺能拮抗剂的比较研究。治疗前给予拉贝他洛尔800 ~ 1200mg /天,口服,为期一周,治疗后分为两组:a组11例患者,在甲氧氯普胺治疗前后静脉滴注盐酸多巴胺0.5 ~ 3微克/kg/min (10 mg,静脉滴注);B组(n = 8)给予多潘立酮预处理,20 mg b.d., p.o.,疗程1周,同时静脉滴注盐酸多巴胺,0.5 ~ 3微克/kg/min。在A组中,多巴胺诱导血压从171.9 +/- 6.35/103.6 +/- 3.12降至152.7 +/- 7.55/93.8 +/- 2.97 mmHg (p < 0.001),而不改变心率,血浆胰岛素水平从8.29 +/- 0.70 microrounits /ml升高至12.09 +/- 1.83 microrounits /ml (p < 0.01)。甲氧氯普胺没有引起血压或血浆胰岛素水平的变化。然而,多巴胺引起的降压反应和血浆胰岛素升高被甲氧氯普胺阻断。在B组,多潘立酮也阻断了多巴胺诱导的降压作用(从170.0 +/- 9.23/102.8 +/- 3.80降至160.2 +/- 9.84/95.5 +/- 2.50 mmHg),但效果不如甲氧氯普胺。多潘立酮还阻断了多巴胺引起的血浆胰岛素水平从9.65 +/- 4.50微微克/毫升增加到11.78微微克/毫升。我们得出结论,多巴胺能受体可能参与一些心血管反应和调节胰岛素分泌在人。
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