Vancouver Initiative to Add Life To Years Research Group, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Aging Clin Exp Res. 2010 Feb;22(1):36-41. doi: 10.3275/6810. Epub 2010 Feb 5.
Carotid sinus hypersensitivity (CSH) is a common cause of fainting and falls in the older adult population and is diagnosed by carotid sinus massage (CSM). Previous work has suggested that age-related stiffening of blood vessels reduces afferent input from the carotid sinus leading to central upregulation of the overall arterial baroreflex response. We examined the differences in arterial stiffness and baroreflex function in older adults at high cardiovascular risk (advanced age, Type 2 diabetes, hypertension and hyperlipidemia) with and without CSH.
Forty-three older adults (mean age 71.4+/-0.7) with Type 2 diabetes, hyperlipidemia and hypertension were recruited. After resting supine for 45 minutes prior to the start of data collection, each subject had arterial stiffness measured by pulse wave velocity (PWV, Complior SD), followed by spontaneous baroreflex measures (Baroreflex sensitivity, BRS) and CSM.
Of the 43 subjects tested, 10 subjects met the criteria for CSH (8 pure vasodepressor and 2 mixed CSH). CSH subjects had higher measures of arterial stiffness when compared to normal subjects for both radial PWV (11.5+/-0.6 vs 9.6+/-0.4 m/s, p=0.043) and femoral PWV (13.4+/-0.9 vs 11.0+/-0.5 m/s, p=0.036). The CSH group demonstrated significantly lower BRS as compared to the normal group (BRS, 6.73+/-0.58 vs 10.41+/-0.85 ms/mmHg, p=0.038). These results were unchanged when the analysis was repeated with only the VD subjects.
Older adults with CSH have higher arterial stiffness and reduced arterial baroreflex sensitivity. There was no evidence to support upregulation of the arterial baroreflex in patients with CSH.
颈动脉窦敏感性（CSH）是老年人群中晕厥和跌倒的常见原因，通过颈动脉窦按摩（CSM）进行诊断。先前的研究表明，血管的年龄相关性僵硬会减少颈动脉窦的传入输入，从而导致整体动脉压力反射反应的中枢上调。我们研究了患有 2 型糖尿病、高血脂和高血压的高心血管风险的老年患者（年龄较大、2 型糖尿病、高血压和高血脂）中有无 CSH 时动脉僵硬和压力反射功能的差异。
共招募了 43 名患有 2 型糖尿病、高血脂和高血压的老年患者（平均年龄 71.4+/-0.7 岁）。在开始数据采集前，先让每位受试者仰卧休息 45 分钟，然后测量动脉僵硬度（脉搏波速度（PWV），Complior SD），随后进行自主压力反射测量（压力反射敏感性，BRS）和 CSM。
在 43 名接受测试的受试者中，有 10 名受试者符合 CSH 标准（8 名纯血管扩张性 CSH 和 2 名混合性 CSH）。与正常受试者相比，CSH 受试者的桡动脉 PWV（11.5+/-0.6 对 9.6+/-0.4 m/s，p=0.043）和股动脉 PWV（13.4+/-0.9 对 11.0+/-0.5 m/s，p=0.036）均更高。与正常组相比，CSH 组的 BRS 显著降低（BRS，6.73+/-0.58 对 10.41+/-0.85 ms/mmHg，p=0.038）。当仅分析 VD 受试者时，结果仍然不变。
患有 CSH 的老年患者动脉僵硬程度更高，动脉压力反射敏感性降低。没有证据表明 CSH 患者的动脉压力反射上调。
