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盐敏感个体在精神应激期间迷走神经活动降低。

Reduced vagal activity in salt-sensitive subjects during mental challenge.

作者信息

Buchholz Konrad, Schächinger Hartmut, Wagner Miriam, Sharma Arya M, Deter Hans Christian

机构信息

Division of Psychosomatic Medicine, Benjamin Franklin Medical Center, Free University of Berlin, Berlin, Germany.

出版信息

Am J Hypertens. 2003 Jul;16(7):531-6. doi: 10.1016/s0895-7061(03)00905-1.

Abstract

BACKGROUND

Salt-sensitive normotensive men exhibit an enhanced pressor and heart rate (HR) response to mental stress. Stress-induced HR acceleration may result from sympathetic activation or vagal withdrawal. We studied the importance of vagal withdrawal for the increased stress responsiveness of salt-sensitive subjects.

METHODS

We studied cardiovascular reactivity to mental challenge in 17 salt-sensitive healthy white male students and 56 salt-resistant control subjects who were comparable with respect to age, body mass index, and physical fitness. Salt sensitivity was determined by a 2-week dietary protocol (20 mmol v 240 mmol sodium/day). Mental stress was induced by a computerized information-processing task (manometer test). Electrocardiogram and finger blood pressure (BP; Finapres, Ohmeda, Louisville, CO) were registered continuously to determine HR and interbeat-interval length. Time and frequency domain (spectral power) based measures of respiratory-related heart rate variability (HRV) were calculated to estimate vagal cardiac control; diastolic BP reactivity was assessed to estimate peripheral sympathetic effects.

RESULTS

Stress-induced increase in HR was higher in salt-sensitive than in salt-resistant subjects. Salt-sensitive subjects, in comparison to salt-resistant subjects, showed significantly reduced respiratory-related HRV during baseline and mental stress conditions (P <.01). The increase in diastolic BP during mental challenge was significantly greater in salt-sensitive subjects (P <.05).

CONCLUSIONS

Our findings suggest reduced vagal and increased sympathetic tone during mental challenge in salt-sensitive subjects. Altered autonomic nervous system function may contribute to later development of hypertension in salt-sensitive individuals.

摘要

背景

盐敏感的血压正常男性对精神应激表现出增强的升压和心率(HR)反应。应激诱导的心率加速可能源于交感神经激活或迷走神经撤离。我们研究了迷走神经撤离对盐敏感受试者应激反应性增加的重要性。

方法

我们研究了17名盐敏感的健康白人男性学生和56名盐抵抗对照受试者对精神挑战的心血管反应性,这些受试者在年龄、体重指数和身体素质方面具有可比性。盐敏感性通过为期2周的饮食方案(20 mmol对240 mmol钠/天)来确定。通过计算机化信息处理任务(压力计测试)诱导精神应激。连续记录心电图和手指血压(BP;Finapres,Ohmeda,路易斯维尔,科罗拉多州)以确定心率和心跳间期长度。计算基于时间和频域(频谱功率)的呼吸相关心率变异性(HRV)测量值以估计迷走神经对心脏的控制;评估舒张压反应性以估计外周交感神经效应。

结果

应激诱导的心率增加在盐敏感受试者中高于盐抵抗受试者。与盐抵抗受试者相比,盐敏感受试者在基线和精神应激条件下呼吸相关HRV显著降低(P<.01)。精神挑战期间盐敏感受试者的舒张压升高显著更大(P<.05)。

结论

我们的研究结果表明,盐敏感受试者在精神挑战期间迷走神经张力降低,交感神经张力增加。自主神经系统功能改变可能有助于盐敏感个体后期高血压的发展。

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