Middeke M
Medizinische Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-Universität München.
Z Kardiol. 1992;81 Suppl 2:55-8.
Circadian blood pressure rhythm exhibits a typical biphasic pattern in normotensives and in patients with primary hypertension. It is, however, disturbed in patients with secondary hypertension. There is ample evidence suggesting a major role for the sympatho-adrenergic system in regulating this rhythm. In order to investigate this relationship more accurately, the sympatho-adrenergic activity was studied in 20 patients with normal blood pressure, 20 patients with primary hypertension, and in patients with several diseases characterized by an abnormal catecholamine secretion, e.g. two pheochromocytomas, one adrenomedullary hyperplasia, and two Shy-Drager syndromes. Catecholamine concentrations were measured in plasma and urine, cAMP concentrations in plasma or in lymphocytes, and beta-adrenoceptor density and affinity on lymphocytes, and 24-h blood pressure monitoring was conducted. The data shows synchronicity of the circadian blood pressure rhythm and the sympatho-adrenergic activity both in normotensives and in patients with primary hypertension with normal circadian rhythm, and in abnormal catecholamine secretion with an abnormal circadian blood pressure curve. It is concluded that sympatho-adrenergic mechanisms play an important role in controlling and regulating circadian blood pressure.
昼夜血压节律在血压正常者和原发性高血压患者中呈现典型的双相模式。然而,在继发性高血压患者中,这种节律会受到干扰。有充分证据表明交感 - 肾上腺素能系统在调节这种节律中起主要作用。为了更准确地研究这种关系,对20名血压正常的患者、20名原发性高血压患者以及患有几种以儿茶酚胺分泌异常为特征的疾病的患者(例如2例嗜铬细胞瘤、1例肾上腺髓质增生和2例Shy - Drager综合征)的交感 - 肾上腺素能活性进行了研究。测定了血浆和尿液中的儿茶酚胺浓度、血浆或淋巴细胞中的环磷酸腺苷(cAMP)浓度以及淋巴细胞上的β - 肾上腺素能受体密度和亲和力,并进行了24小时血压监测。数据显示,在血压正常者、昼夜节律正常的原发性高血压患者以及昼夜血压曲线异常且儿茶酚胺分泌异常的患者中,昼夜血压节律和交感 - 肾上腺素能活性是同步的。得出的结论是,交感 - 肾上腺素能机制在控制和调节昼夜血压中起重要作用。