Bakke Espen F, Hisdal Jonny, Kroese Andries J, Jørgensen Jørgen J, Stranden Einar
Department of Vascular Diagnosis and Research, Aker University Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway.
Clin Physiol Funct Imaging. 2007 Mar;27(2):109-15. doi: 10.1111/j.1475-097X.2007.00720.x.
The purpose of this study was to compare the circulatory responses to isometric exercise in patients with peripheral atherosclerotic disease (PAD) with healthy controls.
Eleven patients with diagnosed PAD, a control group of eleven healthy young adults, and a control group of eleven healthy age-matched adults participated. Blood pressure, heart rate, stroke volume, cardiac output, blood velocity in the brachial artery, acral skin perfusion was continuously recorded and total peripheral resistance calculated before, during and after 2 min of 40% maximum voluntary contraction of the forearm.
At rest we found a consistently higher level of mean arterial pressure (MAP) and systolic pressure (SP) in the elderly, both PAD patients and elderly controls, compared with the young controls. We found no significant difference in diastolic blood pressure. Two minutes isometric handgrip exercise induced a similar increase in MAP in all three groups (patients 32.6 (17.9) mm Hg [mean (SD)], young control group 25.3 (8.9) mm Hg, age-matched control group 36.1 (10.6) mm Hg). No significant differences were found in the other measured cardiovascular variables during isometric handgrip. Increased TPR is the main factor contributing to the increase in blood pressure in all three groups.
Our study indicates that the pressor response continues to be well regulated with age, also when the cardiovascular system is altered by marked atherosclerosis. The consequence is that both PAD patients and elderly controls reach higher SP values during isometric exercise due to higher SP baseline values.
本研究的目的是比较外周动脉粥样硬化疾病（PAD）患者与健康对照者对等长运动的循环反应。
11例确诊为PAD的患者、11名健康年轻成年人组成的对照组以及11名年龄匹配的健康成年人组成的对照组参与了研究。在进行2分钟40%最大自主收缩的前臂运动前、运动期间和运动后，持续记录血压、心率、每搏输出量、心输出量、肱动脉血流速度、肢体皮肤灌注，并计算总外周阻力。
静息时，我们发现与年轻对照组相比，老年PAD患者和老年对照组的平均动脉压（MAP）和收缩压（SP）水平持续较高。我们发现舒张压无显著差异。2分钟的等长握力运动在所有三组中均引起类似的MAP升高（患者组为32.6（17.9）mmHg[均值（标准差）]，年轻对照组为25.3（8.9）mmHg，年龄匹配对照组为36.1（10.6）mmHg）。在等长握力运动期间，其他测量的心血管变量未发现显著差异。总外周阻力增加是所有三组血压升高的主要因素。
我们的研究表明，随着年龄增长，压力反应仍能得到良好调节，即使心血管系统因明显的动脉粥样硬化而改变。结果是，由于SP基线值较高，PAD患者和老年对照组在等长运动期间均达到较高的SP值。
