Post-traumatic stress disorder (PTSD) is an independent risk factor for the development of hypertension and cardiovascular disease. Patients with PTSD have heightened blood pressure and sympathetic nervous system reactivity; however, it is unclear if PTSD patients have exaggerated vasoconstriction in response to sympathetic nerve activation that could also contribute to increased blood pressure reactivity. Therefore, we hypothesized that patients with PTSD have increased sensitivity of vascular α₁ adrenergic receptors (α1AR), the major mediators of vasoconstriction in response to release of norepinephrine at sympathetic nerve terminals. To assess vascular α1AR sensitivity, we measured the degree of venoconstriction in a dorsal hand vein in response to exponentially increasing doses of the selective α1AR agonist phenylephrine (PE) in 9 patients with PTSD (age=59±2 years) and 10 age-matched controls (60±1 years). Individual dose-response curves were generated to determine the dose of PE that induces 50% of maximal venoconstriction (i.e. PE ED₅₀) reflective of vascular α1AR sensitivity. In support of our hypothesis, PE ED₅₀ values were lower in PTSD compared to controls (245±54 vs. 1995±459 ng/min, p=0.012), indicating increased vascular α₁AR sensitivity in PTSD. The PTSD group also had an increase in slope of rise in venoconstriction, indicative of an altered venoconstrictive reactivity to PE compared to controls (19.8±1.2% vs. 15.1±1.2%, p=0.009). Heightened vascular α₁AR sensitivity in PTSD may contribute to augmented vasoconstriction and blood pressure reactivity to sympathoexcitation and contribute to increased cardiovascular disease risk in this patient population.

中文翻译：

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患有创伤后应激障碍的老年人的血管 Alpha-1 肾上腺素能受体敏感性增加。

创伤后应激障碍（PTSD）是高血压和心血管疾病发展的独立危险因素。PTSD 患者的血压和交感神经系统反应性升高；然而，尚不清楚 PTSD 患者是否因交感神经激活而加剧血管收缩，这也可能导致血压反应性升高。因此，我们假设 PTSD 患者对血管 α _{1的敏感性增加}肾上腺素能受体 (α1AR)，是响应交感神经末梢释放去甲肾上腺素而引起血管收缩的主要介质。为了评估血管 α1AR 敏感性，我们测量了 9 名 PTSD 患者（年龄 = 59±2 岁）和 10 名年龄匹配的患者手背静脉收缩程度，以响应呈指数增加的选择性 α1AR 激动剂去氧肾上腺素 (PE) 剂量对照（60±1 岁）。生成个体剂量反应曲线以确定诱导 50% 的最大静脉收缩（即 PE ED ₅₀）反映血管 α1AR 敏感性的 PE 剂量。为支持我们的假设，PTSD 患者的 PE ED ₅₀值低于对照组（245±54 对比 1995±459 ng/min，p=0.012），表明血管 α _1增加PTSD 中的 AR 敏感性。PTSD 组的静脉收缩上升斜率也有所增加，表明与对照组相比，对 PE 的静脉收缩反应性发生了变化（19.8±1.2% 对 15.1±1.2%，p=0.009）。PTSD 中增加的血管 α ₁ AR 敏感性可能有助于增强血管收缩和血压对交感神经兴奋的反应性，并有助于增加该患者人群的心血管疾病风险。