Mussalo Hanna, Vanninen Esko, Ikäheimo Risto, Laitinen Tomi, Laakso Markku, Länsimies Esko, Hartikainen Juha
Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P. O. Box 1777, 70211 Kuopio, Finland.
Clin Auton Res. 2002 Dec;12(6):465-71. doi: 10.1007/s10286-002-0069-z.
Baroreceptor reflex regulation has been shown to reset towards a higher blood pressure level and to operate with reduced sensitivity in hypertension. Whether this is secondary to elevated blood pressure or whether it plays a role in the development of hypertension is not known. In addition, only limited data exist on baroreflex sensitivity (BRS) in patients with long-lasting medically treated essential hypertension and in patients who have blood pressure elevation with similar severity, but of different etiology. The purpose of this study was to examine BRS in patients with different severity and forms of chronic, medically treated hypertension. Patients with renovascular hypertension (RVHT, n = 14), severe essential hypertension (SEHT, n = 36) and mild essential hypertension (MEHT, n = 29) as well as healthy age- and sex-matched control subjects were studied. BRS was measured with the phenylephrine method.BRS in the RVHT (3.7 +/- 0.6 ms/mmHg) and SEHT (7.6 +/- 0.8 ms/mmHg) groups did not differ from each other after age, gender and left ventricular mass index were taken into consideration. On the contrary, BRS in the RVHT (p = 0.008) and SEHT (p = 0.016) groups were lower than in the MEHT (8.5 +/- 1.2 ms/mmHg) group. BRS was also significantly reduced in the RVHT (P = 0.004) and SEHT groups (P = 0.006) when compared to the healthy age- and sex-matched controls. BRS in the MEHT group did not differ from the control subjects. In conclusion, BRS was equally impaired in patients with renovascular and severe essential hypertension, which was similar in severity but different in etiology. BRS in patients with long-lasting medically treated mild essential hypertension did not differ from the healthy subjects. Our study suggests that baroreflex dysfunction in hypertensive patients is related to the clinical severity of hypertension, rather than its etiology.
压力感受器反射调节已被证明会朝着更高的血压水平重新设定，并且在高血压患者中其敏感性降低。这是继发于血压升高还是在高血压的发展中起作用尚不清楚。此外，关于长期接受药物治疗的原发性高血压患者以及血压升高程度相似但病因不同的患者的压力反射敏感性（BRS）的数据有限。本研究的目的是检查不同严重程度和形式的慢性药物治疗高血压患者的BRS。研究了肾血管性高血压（RVHT，n = 14）、重度原发性高血压（SEHT，n = 36）和轻度原发性高血压（MEHT，n = 29）患者以及年龄和性别匹配的健康对照者。采用去氧肾上腺素法测量BRS。在考虑年龄、性别和左心室质量指数后，RVHT组（3.7±0.6 ms/mmHg）和SEHT组（7.6±0.8 ms/mmHg）的BRS彼此无差异。相反，RVHT组（p = 0.008）和SEHT组（p = 0.016）的BRS低于MEHT组（8.5±1.2 ms/mmHg）。与年龄和性别匹配的健康对照组相比，RVHT组（P = 0.004）和SEHT组（P = 0.006）的BRS也显著降低。MEHT组的BRS与对照者无差异。总之，肾血管性高血压和重度原发性高血压患者的BRS受损程度相同，它们的严重程度相似但病因不同。长期接受药物治疗的轻度原发性高血压患者的BRS与健康受试者无差异。我们的研究表明，高血压患者的压力反射功能障碍与高血压的临床严重程度有关，而非其病因。
