Kardos A, Watterich G, de Menezes R, Csanády M, Casadei B, Rudas L
University Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital Oxford, United Kingdom.
Hypertension. 2001 Mar;37(3):911-6. doi: 10.1161/01.hyp.37.3.911.
Baroreflex sensitivity (BRS) by the spontaneous sequence technique has been widely used as a cardiac autonomic index for a variety of pathological conditions. However, little information is available on determinants of the variability of spontaneous BRS and on age-related reference values of this measurement in a healthy population. We evaluated BRS as the slope of spontaneous changes in systolic blood pressure (BP) and pulse interval from 10 minutes BP (Finapres) and ECG recordings in 1134 healthy volunteers 18 to 60 years of age. Measurement of BRS could be obtained in 90% of subjects. Those with unmeasurable spontaneous BRS had a slightly lower heart rate but were otherwise not different from the rest of the population. BRS was inversely related to age (lnBRS, 3.24-0.03xage; r(2)=0.23; P:<0.0001) in both genders. In addition, univariate analysis revealed a significant inverse correlation between BRS and heart rate, body mass index, and BP. Sedentary lifestyle and regular alcohol consumption were also associated with lower BRS. However, only age, heart rate, systolic and diastolic BP, body mass index, smoking, and gender were independent predictors of BRS in a multivariate model, accounting for 47% of the variance of BRS. The present study provides reference values for spontaneous BRS in a healthy white population. Only approximately half of the variability of BRS could be explained by anthropometric variables and common risk factors, which suggests that a significant proportion of interindividual differences may reflect genetic heterogeneity.
通过自发序列技术测定的压力反射敏感性（BRS）已被广泛用作多种病理状况下的心脏自主神经指标。然而，关于自发BRS变异性的决定因素以及健康人群中该测量指标的年龄相关参考值，目前所知甚少。我们对1134名年龄在18至60岁的健康志愿者进行了评估，通过10分钟的血压（Finapres）和心电图记录，将BRS作为收缩压（BP）自发变化与脉搏间期的斜率。90%的受试者能够获得BRS测量值。那些无法测量自发BRS的受试者心率略低，但在其他方面与其余人群并无差异。在两性中，BRS均与年龄呈负相关（lnBRS = 3.24 - 0.03×年龄；r² = 0.23；P < 0.0001）。此外，单因素分析显示BRS与心率、体重指数和血压之间存在显著的负相关。久坐的生活方式和经常饮酒也与较低的BRS相关。然而，在多变量模型中，只有年龄、心率、收缩压和舒张压、体重指数、吸烟和性别是BRS的独立预测因素，它们解释了BRS变异的47%。本研究提供了健康白人人群自发BRS的参考值。BRS变异性中只有约一半可由人体测量学变量和常见风险因素解释，这表明个体间差异的很大一部分可能反映了遗传异质性。
