Virtanen R, Jula A, Huikuri H, Kuusela T, Helenius H, Ylitalo A, Voipio-Pulkki L-M, Kauma H, Kesäniemi Y A, Airaksinen J
Department of Medicine, University of Turku, Turku, Finland.
J Hum Hypertens. 2004 Apr;18(4):247-52. doi: 10.1038/sj.jhh.1001661.
Although pulse pressure (PP), heart rate variability (HRV) and baroreflex sensitivity (BRS) have been shown to predict cardiovascular events and mortality in various populations, their relationships have not been clarified. We examined these associations in two separate population-based samples of healthy middle-aged subjects. In population 1, data were obtained from 149 subjects (71 men and 78 women) aged 35-64 (mean 47.7) years, and in population 2, from 214 subjects (88 men and 126 women) aged 40-62 (mean 50.5) years. Increased 24-h ambulatory PP was related to decreased cross-spectral BRS independent of age and gender (beta=-0.28, P<0.001 for population 1; beta=-0.22, P=0.003 for population 2). This association remained significant when 24-h ambulatory diastolic blood pressure, body mass index, smoking and alcohol intake were added as covariates in the multivariate analysis. Increased ambulatory PP was also associated with increased beat-to-beat systolic arterial pressure variability. Associations between ambulatory PP and HRV were not significant after controlling for age and gender. Our results suggest that elevated PP does not affect overall HRV, but it interferes with baroreflex-mediated control of the heart rate. This association may be due to a common denominator, such as arterial stiffness, for PP and BRS.
尽管脉压（PP）、心率变异性（HRV）和压力反射敏感性（BRS）已被证明可预测不同人群的心血管事件和死亡率，但其相互关系尚未明确。我们在两个基于人群的健康中年受试者样本中研究了这些关联。在人群1中，数据来自149名年龄在35 - 64岁（平均47.7岁）的受试者（71名男性和78名女性），在人群2中，数据来自214名年龄在40 - 62岁（平均50.5岁）的受试者（88名男性和126名女性）。24小时动态脉压升高与交叉谱压力反射敏感性降低相关，且不受年龄和性别的影响（人群1中β = -0.28，P < 0.001；人群2中β = -0.22，P = 0.003）。在多变量分析中加入24小时动态舒张压、体重指数、吸烟和饮酒量作为协变量后，这种关联仍然显著。动态脉压升高还与逐搏收缩期动脉压变异性增加有关。在控制年龄和性别后，动态脉压与心率变异性之间的关联不显著。我们的结果表明，升高的脉压并不影响整体心率变异性，但会干扰压力反射介导的心率控制。这种关联可能归因于脉压和压力反射敏感性的共同因素，如动脉僵硬度。
