| Essential hypertension is very common in modern society and is one of the dangerous factors of causing cardiocerebrovascullar disease. The aetiology of hypertension is very complex, including heteridity, the increase of sympathetic nervous system tone, the abnomality of HAS and the vascular endothelial dysfunction. There are a lot of fac-tors which are unclear. Correcting vascular endothelial dysfunction is a new idea and a promising direction in studing antihypertension drug. Carvedilol is a nonselective (β - adrenoreceptor blocker, it can block αt - adrenoreceptor, βl - adrenoreceptor and β2 ~ adrenoreceptor completely. It has no the intrinsic sympathomimetic activity and it has Ca2+ -channel blockade activity at high dose. Its vasodilation effect mainly through α - adrenoreceptor blockade. Carvedilol has strong function of anti ?oxygen free radicals. It inhibits Liposuperoxidation, the injury of oxygen free radicals and the growth of vascular smooth muscle cell. It improves insulin resistance, decreases renal pressure without affecting renal blood flow. The aim of this experiment is to discuss the antihypertensive effect and the effect on the hypertension patients'plasma endothelium and nitric oxide of Carvedilol.Methods80 essential hypertension patients were double blind randomized assigned to two group - Carvedilol group ( a group) and Luode group ( b group). The original dose is 10 mg once a day. In a double blind control trial for eight weeks, the blood pressure and heart rate were re-cord once a week. The dose of Carvedilol was increased gradully when the blood pressure was not controlled to normal. We follow - up twice in the 8 th week. The venous blood were detected in 40 patients in the morning before and after the treatment. Plasma nitric oxide were de-tected by colorimeteric method, and plasma ET were detected by the radio - immunoassay(RIA) method. Plasma NO and ET were detec-ted in 10 normal control subjects.For categorical data, x2 test is used. For count data, such as blood pressure, heart rate, plasma NO and ET were analysized by t lest.ResultsCarvedilol had ideal antihypertensive effect (165. 28 ?1. 69/ 98.90 ?9. 95mmHg vs 142. 98 ?15. 87/85. 41 ?8. 22 mmHg in a group, P <0.01; 166.54 ?13.24/97.56 ?11.41 mmHg vs 140.77 ?12. 98/81.23 ?.58 mmHg, P <0. 01) ,total effective rate was 85% in a group and 84. 6% in b group respectively. Heart rate declined significantly (76.50 ?. 21bpm vs 66.03 ?. 27 bpm in a group, P <0.01;76.46?.04 bpm vs67.24?.64 bpm, P<0.01). Before treatment plasma nitric oxide in essential hypertension patients is lowerthan in normal control (61. 25 ?12. 21 umol/L vs 86. 21 ?20. 12 umol/L, P <0.05; 63. 38 ?15. 32 umol/L vs 86. 21 ?0.12 umol/ L;P<0. 05). After treatment, plasma nitric oxide increased signifi-cantly (76. 48 ?15.31 umol/L in a group, P <0. 05; 79. 21 ?14. 56 umol/L in b group, P<0.05). Before treatment plasma endothelium was higher in hypertension patients than in normal control (110.27 ?23. 17 pg/ml vs 54. 47 ?11. 10 in a group, P < 0. 01; 114. 38 ?31. 22pg/ml vs 54. 47 ?11. 10 in b group, P <0. 01). It decreases significantly after treatment (78. 49 ?15. 15 pg/ml in a group, P < 0.05; 74.71 ?3.39 pg/ml in b group, P <0.05) . Side effects in Cervedilol such as headache, dizziness, cough were slight, except that one patient discontinued the experiment because of eyeball con-junctiva congestion.DiscussionHypertension is very common in modem, society. It is one of the important and dangerous factors of causing cardiocerebrovascular dis-ease. Effectively controlling blood pressure can obviously decrease cardio - cerebral accidence. The result of the study indicate that the two native Carvedilol both have ideal antihypertensive effect. Total ef-fective rate of carvedilol and Luode group are 85.0% and 84. 6% re-spectively. The difference of the two groups has no statistic signifi-cance. These indicate that Carvedilol and Luode have ideal antihyper-tension effect. Carvedilol is a kind of nonselective (3 -... |
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