Nunes José Pedro
Instituto Farmacologia e Terapêutica Faculdade de Medicina do Porto 4200-319 Porto.
Rev Port Cardiol. 2003 Nov;22(11):1375-9.
Arterial hypertension is a very common disease, which acts as a risk factor for a number of other diseases. Experimental data in rats indicate that chronic arterial hypertension may be associated with a state of resistance to mortality from sepsis. Published data on human arterial hypertension and sepsis do not indicate that the former might act as a protective factor for the outcome of the latter, although precise data on this point have not yet been obtained. On the contrary, the presence of any of a variety of comorbid conditions, and perhaps also the combination of hypertension, old age and a higher prevalence of cardiac disease, may lead to worse outcomes in sepsis and septic shock. The prevalence of arterial hypertension in sepsis patients seems to be increasing while mortality may be decreasing, data consistent with a possible protective role for hypertension in sepsis patients. Black people in the Americas tend to have higher blood pressure than black people in Africa and than whites. If hypertension also acted as a state of resistance to mortality from sepsis in humans, it might provide part of the solution for the mystery of the high prevalence of hypertension in black people in the Americas, since blacks there may be descended from people heavily exposed to infectious diseases.
动脉高血压是一种非常常见的疾病，它是许多其他疾病的危险因素。大鼠实验数据表明，慢性动脉高血压可能与对败血症致死的抵抗状态有关。关于人类动脉高血压和败血症的已发表数据并未表明前者可能是后者预后的保护因素，尽管尚未获得关于这一点的确切数据。相反，各种合并症中的任何一种，以及高血压、老年和心脏病较高患病率的组合，可能导致败血症和感染性休克的预后更差。败血症患者中动脉高血压的患病率似乎在增加，而死亡率可能在下降，这些数据与高血压在败血症患者中可能起到的保护作用一致。美洲的黑人往往比非洲的黑人以及白人血压更高。如果高血压在人类中也表现为对败血症致死的抵抗状态，那么它可能为美洲黑人高血压高患病率之谜提供部分答案，因为那里的黑人可能是大量接触传染病人群的后裔。
