Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
J Hypertens. 2010 Mar;28(3):543-50. doi: 10.1097/HJH.0b013e3283350ea4.
Recent evidence indicates that stress is associated with obesity, hypertension and metabolic abnormalities. Stress pathways, including both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, are activated in individuals with the metabolic syndrome. In order to gain some insight into the relation between sympathetic nervous system activation, metabolic profile and stress, we examined the pattern of sympathetic nervous firing in eight women and 17 men with the metabolic syndrome and elevated blood pressure (BP) in relation to their underlying psychological stress.
Both multiunit and single-unit muscle sympathetic nerve activity (MSNA) were recorded by using the technique of microneurography and psychological stress was assessed by Spielberger's State and Trait Anxiety scores and the Beck Depression Inventory II (BDI-II). Women had higher cholesterol levels, higher depressive symptom scores and similar multiunit MSNA compared with the men but displayed a disturbed firing pattern of sympathetic activity as indicated by a higher incidence of multiple spikes per burst (P < 0.05). In all individuals, regression analysis after adjustment for sex indicated that the single-unit sympathetic nerve-firing pattern did not correlate with any aspect of the metabolic profile; however it was significantly associated with anxiety state and trait and the affective component of the BDI scores. In particular, higher incidence of multiple firing (more than two spikes) during a sympathetic neural burst was associated with higher trait anxiety score (R = 0.557, P = 0.004) and higher affective depressive symptoms (R = 0.517, P = 0.008). Somatic symptoms bore no association with the sympathetic firing pattern.
These results suggest that chronic mental stress modulates the pattern of sympathetic activity, which, in turn, may confer greater cardiovascular risk on individuals with the metabolic syndrome and elevated BP.
最近的证据表明，压力与肥胖、高血压和代谢异常有关。代谢综合征患者的下丘脑-垂体-肾上腺轴和交感神经系统等应激途径被激活。为了深入了解交感神经激活、代谢特征和应激之间的关系，我们检查了 8 名女性和 17 名患有代谢综合征和高血压的男性的交感神经放电模式，以及他们潜在的心理应激。
通过微神经记录技术记录多单位和单单位肌肉交感神经活动（MSNA），并通过斯皮尔伯格状态和特质焦虑评分以及贝克抑郁量表第二版（BDI-II）评估心理应激。女性的胆固醇水平较高，抑郁症状评分较高，多单位 MSNA 与男性相似，但表现出交感活动放电模式紊乱，表现为爆发时多个尖峰的发生率较高（P < 0.05）。在所有个体中，调整性别后的回归分析表明，单单位交感神经放电模式与代谢特征的任何方面均无相关性；然而，它与焦虑状态和特质以及 BDI 评分的情感成分显著相关。特别是，交感神经爆发时多个尖峰的发生率较高（多于两个尖峰）与特质焦虑评分较高（R = 0.557，P = 0.004）和情感性抑郁症状较高（R = 0.517，P = 0.008）相关。躯体症状与交感神经放电模式无关。
这些结果表明，慢性精神应激调节交感神经活动模式，这反过来可能使代谢综合征和高血压患者面临更大的心血管风险。
