Hogarth A J, Burns J, Mackintosh A F, Mary D A S G
The Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
J Hum Hypertens. 2008 Aug;22(8):544-9. doi: 10.1038/jhh.2008.31. Epub 2008 May 8.
Sympathetic activation has been associated with the development and complications of hypertension. While the prevalence of hypertension and its cardiovascular risks in women are found to be less than in men and tend to become similar to men after the menopause, there have been no data on the level of sympathetic activation in postmenopausal women relative to men. Therefore, we planned to find out whether muscle sympathetic nerve hyperactivity of essential hypertension (EHT) in postmenopausal women is different from that in matched men. We quantified muscle sympathetic nerve activity (MSNA) as mean frequency of single units (s-MSNA) and multiunit bursts (b-MSNA) in 21 postmenopausal women with EHT (W-EHT) relative to 21 matched men with EHT (M-EHT), in comparison to two control groups of 21 normal women (W-NC) and 21 men (M-NC), respectively. The EHT groups had greater MSNA indices than NC groups. W-EHT had lower (P<0.05) s-MSNA (63+/-22.7 impulses per 100 cardiac beats) than M-EHT (78+/-11.2 impulses per 100 cardiac beats). W-NC had lower (P<0.05) s-MSNA (53+/-12.4 impulses per 100 cardiac beats) than M-NC (65+/-16.3 impulses per 100 cardiac beats). Similar results were obtained for b-MSNA. Postmenopausal women with EHT had lower level of central sympathetic hyperactivity than men. Similarly, normal postmenopausal women had lower MSNA than men. These findings suggest that postmenopausal women continue to have a lower sympathetic nerve activity than men even after the development of EHT, and that this could have implications for gender-specific management of hypertension.
交感神经激活与高血压的发生发展及并发症相关。虽然发现女性高血压的患病率及其心血管风险低于男性,且绝经后往往与男性相似,但关于绝经后女性相对于男性的交感神经激活水平尚无数据。因此,我们计划探究绝经后女性原发性高血压(EHT)的肌肉交感神经活动亢进是否与匹配的男性不同。我们将21名患有EHT的绝经后女性(W-EHT)与21名匹配的患有EHT的男性(M-EHT)的肌肉交感神经活动(MSNA)量化为单单位平均频率(s-MSNA)和多单位爆发频率(b-MSNA),并分别与21名正常女性(W-NC)和21名男性(M-NC)的两个对照组进行比较。EHT组的MSNA指数高于NC组。W-EHT的s-MSNA(每100次心跳63±22.7次冲动)低于M-EHT(每100次心跳78±11.2次冲动)(P<0.05)。W-NC的s-MSNA(每100次心跳53±12.4次冲动)低于M-NC(每100次心跳65±16.3次冲动)(P<0.05)。b-MSNA也得到了类似结果。患有EHT的绝经后女性的中枢交感神经活动亢进水平低于男性。同样,正常绝经后女性的MSNA也低于男性。这些发现表明,绝经后女性即使在发生EHT后,交感神经活动仍低于男性,这可能对高血压的性别特异性管理具有启示意义。