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新诊断未治疗的高血压患者在睡眠期间无血浆儿茶酚胺水平升高。

No elevated plasma catecholamine levels during sleep in newly diagnosed, untreated hypertensives.

机构信息

Department of Neuroendocrinology, University of Lübeck, Lübeck, Germany.

出版信息

PLoS One. 2011;6(6):e21292. doi: 10.1371/journal.pone.0021292. Epub 2011 Jun 17.

Abstract

The sympatho-adrenergic system is highly involved in regulating sleep, wake and arousal states, and abnormalities in this system are regarded as a key factor in the development and progression of arterial hypertension. While hypertension is associated with a hyperadrenergic state during wakefulness, the effect of hypertension on plasma-catecholamine levels during sleep is not yet known. Twelve young participants with newly diagnosed, untreated hypertension and twelve healthy controls slept for 7 hours in the sleep laboratory. Before and after sleep, subjects rested in a supine position for 3-h periods of wakefulness. We sampled blood at a fast rate (1/10 min) and monitored blood pressure and heart rate continuously. We show that plasma NE and E levels did not differ between hypertensives and normotensive during sleep as well as before and after sleep. Blood pressure was higher in hypertensives, reaching the largest group difference in the morning after sleep. Unlike in the normotensives, in the hypertensive participants the morning rise in blood pressure did not correlate with the rise in catecholamine levels at awakening. Our results suggest that hypertension in its early stages is not associated with a strong hyperadrenergic state during sleep. In showing a diminished control of blood pressure through sympatho-adrenergic signals in hypertensive participants, our data point towards a possible involvement of dysfunctional sleep-related blood pressure regulation in the development of hypertension.

摘要

交感神经系统在调节睡眠、觉醒和警觉状态方面起着重要作用,该系统的异常被认为是动脉高血压发展和进展的关键因素。虽然高血压在清醒时与高肾上腺素能状态有关,但高血压对睡眠期间血浆儿茶酚胺水平的影响尚不清楚。12 名新诊断、未经治疗的高血压年轻参与者和 12 名健康对照者在睡眠实验室中睡眠 7 小时。在睡眠前后,受试者在仰卧位休息 3 小时清醒期。我们以较快的速度(1/10 分钟)取样血液,并连续监测血压和心率。我们表明,在睡眠期间以及睡眠前后,高血压患者与正常血压者的血浆去甲肾上腺素和肾上腺素水平没有差异。高血压患者的血压较高,在睡眠后早晨达到最大组间差异。与正常血压者不同,在高血压患者中,血压的晨峰与觉醒时儿茶酚胺水平的升高没有相关性。我们的结果表明,高血压早期在睡眠期间并没有强烈的高肾上腺素能状态。我们的数据表明,高血压患者通过交感神经系统信号对血压的控制减弱,这可能表明与睡眠相关的血压调节功能障碍可能参与了高血压的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4434/3117886/f487e8fab918/pone.0021292.g001.jpg

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