Wilson M F, Sung B H, Pincomb G A, Lovallo W R
Veterans Affairs Medical Center, Oklahoma City, Oklahoma 73104.
Am J Cardiol. 1990 Sep 15;66(7):731-6. doi: 10.1016/0002-9149(90)91139-w.
Normotensive persons at high risk of developing systemic hypertension have greater cardiovascular reactivity to mental and physical stressors. This study compared cardiovascular responses to exercise in normotensive men (aged 28 +/- 0.8 years [mean +/- standard error of the mean]) at high risk (positive parental history and high normal resting blood pressure [BP], n = 20) and at low risk (negative history, low normal BP, n = 15) of hypertension. All men had normal body weight and exercise tolerance. During graded supine bicycle exercise, 35% (7 of 20) of high-risk men had exaggerated BP responses (greater than or equal to 230/100 mm Hg) versus 0% of low-risk men, thus forming 3 groups (low risk, high-risk normal BP response, high-risk exaggerated response). Cardiac function was measured by nuclear cardiography. Cardiac index, peripheral resistance index, left ventricular ejection fraction and contractility index were measured at rest and during each exercise work load. High-risk exaggerated responders could not be distinguished from their high-risk normal-responding counterparts using resting BP or other cardiovascular variables. During exercise all 3 groups had equivalent increases in cardiac output. However, the high-risk exaggerated responders had blunting in peripheral resistance decline, resulting in excessive BP increases. This finding suggests an impaired capacity for exercise-induced vasodilation, indicating that the exaggerated response group may be at highest risk for future hypertension in these 3 groups.
有发展为系统性高血压高风险的血压正常者，对精神和身体应激源具有更强的心血管反应性。本研究比较了高血压高风险（有阳性家族史且静息血压处于正常高值，n = 20）和低风险（家族史阴性、血压处于正常低值，n = 15）的血压正常男性（年龄28±0.8岁[均值±均值标准误]）对运动的心血管反应。所有男性体重和运动耐量均正常。在分级仰卧位自行车运动期间，35%（20例中的7例）的高风险男性有血压反应过度（大于或等于230/100 mmHg），而低风险男性中这一比例为0%，由此形成3组（低风险、高风险正常血压反应、高风险过度反应）。通过核素心动图测量心功能。在静息状态及每个运动负荷期间测量心脏指数、外周阻力指数、左心室射血分数和收缩性指数。使用静息血压或其他心血管变量无法将高风险过度反应者与其高风险正常反应的同龄人区分开来。运动期间，所有3组的心输出量均有同等增加。然而，高风险过度反应者外周阻力下降减弱，导致血压过度升高。这一发现提示运动诱导的血管舒张能力受损，表明在这3组中，过度反应组未来发生高血压的风险可能最高。
