Martins D, Tareen N, Pan D, Norris K
Department of Medicine, Charles R. Drew University, 1731 East 120th Street MP11, Los Angeles, California 90059, USA.
Cell Mol Biol (Noisy-le-grand). 2003 Dec;49(8):1305-9.
Obesity is associated with high insulin and leptin levels. Studies also suggest that high levels of insulin and leptin increase sympathetic nervous system (SNS) activity and engender increased chronotropy, vasoconstriction and antinatriuresis that may contribute to the pathogenesis of obesity related hypertension. Sympathetic modulation of cardiovascular responses requires good baroreceptor sensitivity and optimal vascular compliance. The vascular changes associated with isolated systolic hypertension (ISH) have been shown to modify baroreceptor sensitivity and vascular compliance and may mitigate sympathetic modulation of cardiovascular responses and attenuate the hypertensive effect of obesity. The purpose of this study is to examine the differences in the relationship between body mass index, pulse rate (PR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) among participants with normal blood pressure and ISH using data from the third National Health and Nutrition Examination Survey. Data from 13,761 non-institutionalized adults 18 years and older not receiving antihypertensive therapy were analyzed. Results showed that PR, SBP and DBP increase with increasing BMI. The rise in PR, SBP and DBP with BMI is higher among participants with normal blood pressure than among those with ISH. We concluded that increasing level of obesity is associated with a rise in pulse rate and blood pressure but the effect of obesity on blood pressure and pulse rate might be weaker among participants with ISH.
肥胖与高胰岛素和瘦素水平相关。研究还表明,高胰岛素和瘦素水平会增加交感神经系统(SNS)的活动,并导致心率加快、血管收缩和钠排泄减少,这些可能有助于肥胖相关高血压的发病机制。心血管反应的交感神经调节需要良好的压力感受器敏感性和最佳的血管顺应性。与单纯收缩期高血压(ISH)相关的血管变化已被证明会改变压力感受器敏感性和血管顺应性,并可能减轻心血管反应的交感神经调节,减弱肥胖的高血压效应。本研究的目的是利用第三次全国健康和营养检查调查的数据,检验血压正常和ISH参与者在体重指数、脉搏率(PR)、收缩压(SBP)和舒张压(DBP)之间关系的差异。对13761名18岁及以上未接受抗高血压治疗的非机构化成年人的数据进行了分析。结果显示,PR、SBP和DBP随BMI的增加而升高。血压正常的参与者中,PR、SBP和DBP随BMI的升高幅度高于ISH参与者。我们得出结论,肥胖程度增加与脉搏率和血压升高有关,但肥胖对血压和脉搏率的影响在ISH参与者中可能较弱。