Department of Cardiology, Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK.
J Hypertens. 2011 Nov;29(11):2167-75. doi: 10.1097/HJH.0b013e32834b8014.
Hypertension and its subsequent cardiovascular complications have been associated with sympathetic neural activation, and their prevalence in women increases after the menopause. However, there have been no data on the level of sympathetic activation and its relationship to vascular blood flow following the menopause. Therefore, we planned to find out whether the behavior of muscle sympathetic nerve activity (MSNA) and calf blood flow (CBF) in women with and without essential hypertension (EHT) is changed following the menopause.
Peroneal nerve activity was measured as mean frequency of single units and of multiunit bursts with simultaneously measured CBF in two matched groups of postmenopausal women with and without EHT in comparison with two matched groups of premenopausal women with and without EHT.
As expected, nerve activity was greater in the hypertensive than in normotensive groups and in postmenopausal than in premenopausal normotensive groups. We found that single unit frequency in postmenopausal hypertensives (65 ± 3.9 impulses/100 cardiac beats) was not significantly different from that in postmenopausal normotensives (54 ± 2.2 impulses/100 cardiac beats) or in premenopausal hypertensives (57 ± 2.8 impulses/100 cardiac beats). Similar results were obtained for burst frequency. In addition, a statistically significant negative correlation between the frequency of nerve activity and CBF was found only in postmenopausal normotensive (at least r = -0.42, P < 0.04) and hypertensive women (at least r = -0.45, P < 0.03).
These findings suggest that sympathetic nerve hyperactivity in postmenopausal women may have greater vascular effects than in premenopausal women, and could have implications in the management of EHT in postmenopausal women.
高血压及其随后的心血管并发症与交感神经激活有关,女性绝经后其患病率增加。然而,关于绝经后交感神经激活水平及其与血管血流的关系尚没有数据。因此,我们计划了解绝经后有无原发性高血压(EHT)的女性的肌肉交感神经活动(MSNA)和小腿血流(CBF)行为是否发生变化。
在与绝经前有或无 EHT 的两组匹配女性中,同时测量腓神经活动作为单个单位和多单位爆发的平均频率以及同时测量 CBF,在有和无 EHT 的两组绝经后女性中进行测量。
正如预期的那样,高血压组的神经活动大于正常血压组,绝经后正常血压组大于绝经前正常血压组。我们发现,绝经后高血压组(65±3.9 脉冲/100 次心跳)的单个单位频率与绝经后正常血压组(54±2.2 脉冲/100 次心跳)或绝经前高血压组(57±2.8 脉冲/100 次心跳)无显著差异。爆发频率也得到了类似的结果。此外,仅在绝经后正常血压(至少 r =-0.42,P<0.04)和高血压女性(至少 r =-0.45,P<0.03)中发现神经活动频率与 CBF 之间存在统计学上显著的负相关。
这些发现表明,绝经后女性的交感神经活动过度可能比绝经前女性具有更大的血管作用,这可能对绝经后女性 EHT 的治疗有影响。