Mancia G, Grassi G, Parati G, Pomidossi G, Saino A, Malaspina D, Gregorini L, Zanchetti A
J Cardiovasc Pharmacol. 1986;8 Suppl 5:S82-8. doi: 10.1097/00005344-198608005-00016.
This article reviews observations made on reflex control of circulation in essential hypertension and in a few models of experimental hypertension. It is emphasized that a wide consensus exists on the fact that baroreceptor control of heart rate is impaired in essential hypertension and that this occurs not only in severe but also in mild and borderline hypertensive conditions. On the other hand, baroreceptor control of blood pressure is much less affected by chronic elevations in arterial blood pressure due to central or peripheral factors that differentially affect cardiac and vascular responses to the vagus and the sympathetic drive, respectively. Cardiopulmonary receptor control of peripheral circulation and renin release is also little affected by hypertension, and the suggestion has been made that its sensitivity may even be enhanced in early hypertensive stages and then undergoes a subsequent reduction as cardiac hypertrophy develops. Finally, the possible consequences of preservation of reflex control of circulation in hypertension are discussed. It is speculated that this phenomenon may be in part responsible for the similar percentage of blood pressure oscillations that can be observed in normotensive and borderline, moderate, and severe hypertensive subjects.
本文综述了在原发性高血压及几种实验性高血压模型中关于循环反射控制的观察结果。需要强调的是，目前已达成广泛共识：在原发性高血压中，压力感受器对心率的控制受损，且不仅在重度高血压中如此，在轻度和临界高血压状态下同样如此。另一方面，由于中枢或外周因素分别对心脏和血管对迷走神经及交感神经驱动的反应产生不同影响，动脉血压长期升高对压力感受器对血压的控制影响较小。心肺感受器对外周循环和肾素释放的控制也很少受高血压影响，有人提出，在高血压早期阶段其敏感性甚至可能增强，随后随着心脏肥大的发展而降低。最后，讨论了高血压中循环反射控制得以保留可能产生的后果。据推测，这种现象可能部分解释了在正常血压者以及临界、中度和重度高血压患者中观察到的血压波动百分比相似的原因。
