Pal G K, Pal Pravati, Nanda Nivedita, Lalitha V, Dutta T K, Adithan C
Department of Physiology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry 605 006, India.
Int J Hypertens. 2011;2011:263170. doi: 10.4061/2011/263170. Epub 2011 Oct 23.
Objective. Though prehypertension has strong familial predisposition, difference in pathophysiological mechanisms in its genesis in offspring of both parents and single parent hypertensive have not been elucidated. Methods. Body mass index (BMI), waist-hip ratio (WHR), basal heart rate (BHR), blood pressure (BP), HR and BP response to standing, deep breathing difference, BP response to handgrip and spectral indices of heart rate variability (HRV) were analyzed in normotensive offspring of two parents hypertensive (Group I), normotensive offspring of one parent hypertensive (Group II), prehypertensive offspring of two parents hypertensive (Group III) and prehypertensive offspring of one parent hypertensive (Group IV). Results. Sympathovagal imbalance (SVI) in prehypertensive offspring was observed due to increased sympathetic and decreased vagal activity. In group III, SVI was more prominent with greater contribution by vagal withdrawal. LF-HF ratio, the marker of SVI was correlated more with diastolic pressure, 30 : 15 ratio and E : I ratio in prehypertensives and the degree of correlation was more in group III prehypertensives. Conclusion. Vagal withdrawal plays a critical role in development of SVI in prehypertensive offspring of hypertensive parents. The intensity of SVI was more in offspring of two parents hypertensive compared to single parent hypertensive.
目的。虽然高血压前期具有很强的家族易感性,但双亲高血压患者和单亲高血压患者后代发病的病理生理机制差异尚未阐明。方法。对双亲高血压患者的血压正常后代(I组)、单亲高血压患者的血压正常后代(II组)、双亲高血压患者的高血压前期后代(III组)和单亲高血压患者的高血压前期后代(IV组)的体重指数(BMI)、腰臀比(WHR)、基础心率(BHR)、血压(BP)、心率和血压对站立的反应、深呼吸差异、血压对手握力的反应以及心率变异性(HRV)的频谱指数进行分析。结果。高血压前期后代出现交感迷走失衡(SVI),原因是交感神经活动增加和迷走神经活动减少。在III组中,SVI更为突出,迷走神经撤离的贡献更大。SVI的标志物低频与高频比值(LF-HF ratio)与高血压前期患者的舒张压、30∶15比值和E∶I比值的相关性更强,且在III组高血压前期患者中的相关程度更高。结论。迷走神经撤离在高血压患者的高血压前期后代SVI的发生中起关键作用。与单亲高血压患者的后代相比,双亲高血压患者的后代SVI强度更大。