Department of Physiology, Jawaharlal Institute of Post-Graduate Medical Education and Research, Puducherry, India.
Clin Exp Hypertens. 2012;34(1):31-7. doi: 10.3109/10641963.2011.618208. Epub 2011 Oct 3.
Although recently the incidence of prehypertension has increased considerably, the pathophysiological mechanisms and the effects of gender in its causation have not yet been fully elucidated. Therefore, in this study body mass index (BMI), waist-hip ratio (WHR), basal heart rate (BHR), blood pressure (BP), rate pressure product (RPP), and spectral indices of heart rate variability (HRV) were reordered and analyzed in normotensive and prehypertensive males and females. It was observed that low frequency-high frequency (LF-HF) ratio, the sensitive indicator of sympathovagal imbalance (SVI), is significantly more (P < .001) in male prehypertensives compared with female prehypertensives. Although SVI in prehypertensives was found to be due to both sympathetic activation and vagal inhibition, contribution of vagal withdrawal was prominent in males. The LF-HF ratio was significantly correlated with BMI, WHR, BHR, BP, and RPP, which was more prominent in male prehypertensives and the degree of correlation was more for WHR and diastolic pressure. It was concluded that vagal inhibition plays an important role in critical alteration of SVI in the genesis of prehypertension, especially in males, and WHR could be a better indicator of SVI in prehypertensives. It was suggested that prehypertensives should improve their vagal tone to restore the sympathovagal homeostasis.
尽管近年来高血压前期的发病率显著升高，但该疾病的病理生理学机制及其与性别的相关性尚未完全阐明。因此，本研究旨在重新分析和比较正常血压者和高血压前期者的体质指数（BMI）、腰臀比（WHR）、基础心率（BHR）、血压（BP）、心率血压乘积（RPP）和心率变异性（HRV）的各项频谱指数。结果发现，交感-迷走神经失衡的敏感指标——低频/高频（LF/HF）比值在男性高血压前期者中显著高于女性高血压前期者（P<.001）。虽然高血压前期者的 SVI 升高既与交感神经兴奋有关，也与迷走神经抑制有关，但在男性高血压前期者中，迷走神经抑制的作用更为突出。LF/HF 比值与 BMI、WHR、BHR、BP 和 RPP 均显著相关，在男性高血压前期者中更为显著，与 WHR 和舒张压的相关性更强。由此得出结论，迷走神经抑制在高血压前期患者 SVI 的改变中发挥重要作用，尤其是在男性中，WHR 可能是高血压前期患者 SVI 的更好预测指标。本研究提示高血压前期者应改善迷走神经张力，以恢复交感-迷走神经平衡。
