Nazzaro P, Manzari M, Merlo M, Pirrelli A
Centro universitario studio dello stress, Università di Bari.
Boll Soc Ital Biol Sper. 1991 Dec;67(12):999-1006.
Many studies, concerning cardiovascular reactivity in hypertensives, show contrasting data. The aim of the present study was to check, also measuring extracardiovascular variables, a procedure able to identify a peculiar characteristic of the prehypertensive phase. We studied 47 normotensives, who referred high blood pressure values, but that we did not find in our visit. The cardioneurovascular assessment was evaluated, by means of a non invasive, beat to beat technique, measuring SBP, DBP, HR, muscular contraction and skin conductance level (EMG, SCL), peripheric temperature (PT), during a psychophysiologic session. This was composed by 4 stressors (mental arithmetic and Sacks test, acoustic and electric stimulations), 5 minutes each, preceded and followed by an observation period of 10 minutes. After 18 month follow-up, we could distinguish 26 hypertensives (H), and 21 subjects maintained normal blood pressure values (N). The obtained findings showed, with statistical significance, 1) the hyperresponsiveness of SCL and PT; 2) the failed recovery, with consequent hyperdysreactivity, of SCL and PT; 3) the presence of both these phenomena in the H., while SBP, DBP and HR responses did not result a discriminative tool. These data seem 1) to reinforce the hypothesis that a hypersympathetic phase can characterize the prehypertensive stages of essential hypertension and 2) to suggest the psychophysiological approach as a useful method to diagnose prehypertension.
许多关于高血压患者心血管反应性的研究得出了相互矛盾的数据。本研究的目的是通过测量心血管外变量来检验一种能够识别高血压前期特殊特征的程序。我们研究了47名血压正常但自称血压值高的人,不过在我们的检查中未发现高血压。在一次心理生理测试期间,通过一种非侵入性的逐搏技术评估心脏神经血管功能,测量收缩压、舒张压、心率、肌肉收缩和皮肤电导率水平(肌电图、皮肤电导率)以及外周温度。该测试由4种应激源(心算和萨克斯测试、声音和电刺激)组成,每种应激源持续5分钟,前后各有10分钟的观察期。经过18个月的随访,我们区分出26名高血压患者(H组)和21名血压维持正常的受试者(N组)。所得结果具有统计学意义,表明:1)皮肤电导率和外周温度反应过度;2)皮肤电导率和外周温度未能恢复,从而出现反应过度;3)这些现象在高血压患者中均存在,而收缩压、舒张压和心率反应并非鉴别工具。这些数据似乎:1)强化了这样一种假设,即交感神经过度活跃阶段可能是原发性高血压前期的特征;2)表明心理生理学方法是诊断高血压前期的一种有用方法。