Strand Arne H, Gudmundsdottir Helga, Os Ingrid, Smith Gunnar, Westheim Arne S, Bjørnerheim Reidar, Kjeldsen Sverre E
Department of Cardiology, Ullevaal University Hospital, Oslo, Norway.
J Hypertens. 2006 May;24(5):905-13. doi: 10.1097/01.hjh.0000222761.07477.7b.
Increased sympathetic activity may be an underlying mechanism in cardiovascular disease. It has been hypothesized that the degree of left ventricular (LV) hypertrophy is partly related to the blood pressure level, and partly to neurohormonal factors. The aim of this study was to investigate predictors of LV mass, including arterial plasma noradrenaline as an index of sympathetic activity, with particular emphasis on subjects who developed hypertension over a period of 20 years.
In a 20-year prospective study of middle-aged men, sustained hypertensives (n = 22), new hypertensives (crossovers) (n = 17) and sustained normotensives (controls) (n = 17) were examined both at baseline and after 20 years of follow-up (at ages 42.1 +/- 0.5 and 62.3 +/- 0.6 years, respectively). Relationships between arterial plasma catecholamines, blood pressure and body mass index at baseline to left ventricular parameters by echocardiography at follow-up were investigated.
Groups were homogeneous regarding age, gender, race and body build. The group of sustained hypertensives had significantly more LV hypertrophy (P = 0.025) and diastolic dysfunction (P = 0.010). Among the crossovers, LV mass index was positively correlated to arterial plasma noradrenaline (r = 0.50, P = 0.043) and body mass index (BMI) (r = 0.51, P = 0.039) and showed a positive trend with systolic blood pressure (SBP) at baseline. Arterial plasma noradrenaline (beta = 0.47) was found to predict LV mass index after 20 years independently of BMI (beta = 0.45) and SBP (beta = 0.22) at baseline (R adjusted = 0.345, P = 0.037). Such a relationship was not found in the controls or in the sustained hypertensives, of which 16 were treated with antihypertensive drugs.
Arterial plasma noradrenaline at baseline, as an index of sympathetic activity, predicts LV mass at follow-up independently of systolic blood pressure and body build in middle-aged men who developed hypertension over a period of 20 years.
交感神经活动增强可能是心血管疾病的潜在机制。据推测，左心室（LV）肥厚程度部分与血压水平有关，部分与神经激素因素有关。本研究的目的是调查LV质量的预测因素，包括将动脉血浆去甲肾上腺素作为交感神经活动指标，尤其侧重于20年间发生高血压的受试者。
在一项针对中年男性的20年前瞻性研究中，对持续性高血压患者（n = 22）、新发高血压患者（转换者）（n = 17）和持续性血压正常者（对照组）（n = 17）在基线时和随访20年后（分别为42.1±0.5岁和62.3±0.6岁）进行了检查。研究了基线时动脉血浆儿茶酚胺、血压和体重指数与随访时超声心动图测量的左心室参数之间的关系。
各组在年龄、性别、种族和体型方面具有同质性。持续性高血压组的LV肥厚（P = 0.025）和舒张功能障碍（P = 0.010）明显更多。在转换者中，LV质量指数与动脉血浆去甲肾上腺素（r = 0.50，P = 0.043）和体重指数（BMI）（r = 0.51，P = 0.039）呈正相关，并且在基线时与收缩压（SBP）呈正相关趋势。发现动脉血浆去甲肾上腺素（β = 0.47）在独立于基线时的BMI（β = 0.45）和SBP（β = 0.22）的情况下可预测20年后的LV质量指数（调整后R = 0.345，P = 0.037）。在对照组或持续性高血压患者中未发现这种关系，其中16例持续性高血压患者接受了降压药物治疗。
作为交感神经活动指标，基线时的动脉血浆去甲肾上腺素可独立于收缩压和体型，预测20年间发生高血压的中年男性随访时的LV质量。
