Departments of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9174, USA.
Am J Physiol Heart Circ Physiol. 2011 Mar;300(3):H968-77. doi: 10.1152/ajpheart.01145.2010. Epub 2011 Jan 7.
In hypertension, the blood pressure response to exercise is exaggerated. We demonstrated previously that this heightened pressor response to physical activity is mediated by an overactive skeletal muscle exercise pressor reflex (EPR), with important contributions from its metaboreflex and mechanoreflex components. However, the mechanisms driving the abnormal blood pressure response to EPR activation are largely unknown. Recent evidence in humans suggests that the muscle metaboreflex partially mediates the enhanced EPR-induced pressor response via abnormally large changes in sympathetic nerve activity (SNA). Whether the muscle mechanoreflex induces similarly exaggerated alterations in SNA in hypertension remains unknown, as does the role of the mechanoreceptors mediating muscle reflex activity. To address these issues, the EPR was selectively activated by electrically inducing hindlimb muscle contraction in decerebrate normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Stimulation of the EPR evoked significantly larger increases in mean arterial pressure (MAP) and renal SNA (RSNA) in SHR compared with WKY (ΔRSNA from baseline: 140 ± 11 vs. 48 ± 8%). The mechanoreflex was stimulated by stretching hindlimb muscle which likewise elicited significantly greater elevations in MAP and RSNA in SHR than WKY (ΔRSNA from baseline: 105 ± 11 vs. 35 ± 7%). Blockade of mechanoreceptors in muscle with gadolinium significantly attenuated the MAP and RSNA responses to contraction and stretch in SHR. These data suggest that 1) the exaggerated pressor response to activation of the EPR and muscle mechanoreflex in hypertension is mediated by abnormally large reflex-induced augmentations in SNA and 2) this accentuated sympathetic responsiveness is evoked, in part, by stimulation of muscle mechanoreceptors.
在高血压中,运动时的血压反应会被夸大。我们之前已经证明,这种对体力活动的升压反应是由过度活跃的骨骼肌运动压反射(EPR)介导的,其代谢反射和机械反射成分都有重要贡献。然而,驱动 EPR 激活时异常血压反应的机制在很大程度上尚不清楚。最近在人类中的证据表明,肌肉代谢反射部分通过交感神经活动(SNA)的异常大幅变化来介导增强的 EPR 诱导的升压反应。在高血压中,肌肉机械反射是否会引起类似的 SNA 过度改变,以及介导肌肉反射活动的机械感受器的作用如何,仍然未知。为了解决这些问题,我们通过电刺激去大脑化的正常血压 Wistar-Kyoto(WKY)和自发性高血压(SHR)大鼠的后肢肌肉收缩来选择性地激活 EPR。EPR 的刺激引起 SHR 中的平均动脉压(MAP)和肾 SNA(RSNA)显著增加,与 WKY 相比增加幅度更大(从基线开始的 RSNA 变化:140±11 对 48±8%)。机械反射是通过伸展后肢肌肉来刺激的,这同样引起 SHR 中的 MAP 和 RSNA 显著升高,高于 WKY(从基线开始的 RSNA 变化:105±11 对 35±7%)。用钆阻断肌肉中的机械感受器会显著减弱 SHR 对收缩和伸展的 MAP 和 RSNA 反应。这些数据表明,1)高血压中 EPR 和肌肉机械反射激活时的升压反应过度是由反射诱导的 SNA 异常增加介导的,2)这种增强的交感反应是由肌肉机械感受器的刺激引起的。