Hesse Christiane, Charkoudian Nisha, Liu Zhong, Joyner Michael J, Eisenach John H
Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Hypertension. 2007 Jul;50(1):41-6. doi: 10.1161/HYPERTENSIONAHA.107.090308. Epub 2007 May 14.
Patients with hypertension have a blunted sensitivity of baroreflex control of heart period. In these patients, baroreflex sensitivity is positively related to heart rate variability and inversely related to blood pressure variability. We hypothesized that this relationship would also be evident in healthy normotensive subjects and that individuals with higher baroreflex sensitivity would have lower ambulatory 24-hour blood pressure. Twenty-four-hour ambulatory blood pressure and heart rate were recorded in 50 healthy, normotensive, nonobese individuals (31 women and 19 men). The baroreflex was assessed using sequential bolus administration of sodium nitroprusside and phenylephrine, and baroreflex sensitivity was calculated as the slope of the relation between systolic blood pressure and R-R interval during the resulting blood pressure transients. Baroreflex sensitivity was inversely correlated to 24-hour average mean arterial pressure (R=0.49; P<0.001) and positively related to daytime heart rate variability (R=0.33; P=0.02). In contrast, no relationship was found between baroreflex sensitivity and 24-hour heart rate or blood pressure variabilities. We conclude that the relationship between baroreflex sensitivity and daytime heart rate variability was similar to that reported previously in hypertensive subjects. Furthermore, the inverse relation between baroreflex sensitivity and mean arterial pressure supports the idea that the baroreflex may exert longer-term effects on blood pressure than thought previously.
高血压患者压力反射对心动周期的控制敏感性降低。在这些患者中,压力反射敏感性与心率变异性呈正相关,与血压变异性呈负相关。我们推测这种关系在健康的血压正常受试者中也会明显,并且压力反射敏感性较高的个体24小时动态血压会较低。对50名健康、血压正常、非肥胖个体(31名女性和19名男性)记录24小时动态血压和心率。通过依次推注硝普钠和去氧肾上腺素评估压力反射,并将压力反射敏感性计算为血压瞬变期间收缩压与R-R间期关系的斜率。压力反射敏感性与24小时平均动脉压呈负相关(R = 0.49;P < 0.001),与日间心率变异性呈正相关(R = 0.33;P = 0.02)。相比之下,未发现压力反射敏感性与24小时心率或血压变异性之间存在关系。我们得出结论,压力反射敏感性与日间心率变异性之间的关系与先前在高血压受试者中报道的相似。此外,压力反射敏感性与平均动脉压之间的负相关支持了压力反射可能对血压产生比先前认为的更长时间影响的观点。