Johncy Selvaraj Smilee, Karthik Challakere Subramanya, Bondade Suresh Yankanna, Jayalakshmi Malavar Kariyappa
J Basic Clin Physiol Pharmacol. 2015 Nov;26(6):531-7. doi: 10.1515/jbcpp-2014-0068.
A study was undertaken to analyze the nature and magnitude of autonomic dysregulation that starts early in the offspring of a hypertensive parent and also whether obesity in them add an additional risk for future hypertension.
Forty normotensive subjects aged 18-25 years with at least one hypertensive parent constitute the study group. The study group was divided into obese and non-obese depending on their body mass index (non-obese with BMI 18.50-24.99 kg/m2; obese with BMI≥30 kg/m2). Twenty age-matched normotensive, without parental history subjects constitute the control group. Anthropometric parameters, heart rate, systolic and diastolic pressures were recorded. Heart rate variability indices like total power, LF, HF, LF/HF, SDNN, RMSSD, and PNN50% were studied. One-way ANOVA was used for simultaneous multiple group comparison followed by post hoc Tukey's test for groupwise comparison. The Pearson correlation coefficient was used to assess the relationship between BMI and other variables.
Subjects who were obese with parental history of hypertension showed significantly higher heart rate, diastolic blood pressure, LF, LF/HF ratio and reduced total power, HF, SDNN, RMSSD, and PNN50% compared to the other groups with normal BMI. HF and all the time domain indices showed negative correlation and LF a positive correlation with BMI.
In the obese offspring of hypertensive parents, HRV markers, which represent a vagal dominance were reduced substantially, and indices of sympathetic activity were increased. So obesity in a normotensive offspring of a hypertensive parent is an additional risk factor for the future development of hypertension as it further dysregulates the autonomic control of the heart.
开展了一项研究，以分析高血压患者后代早期出现的自主神经调节异常的性质和程度，以及他们的肥胖是否会增加未来患高血压的额外风险。
40名年龄在18 - 25岁之间、至少有一位高血压父母的血压正常受试者构成研究组。根据体重指数将研究组分为肥胖组和非肥胖组（非肥胖组BMI为18.50 - 24.99 kg/m²；肥胖组BMI≥30 kg/m²）。20名年龄匹配、无家族高血压病史的血压正常受试者构成对照组。记录人体测量参数、心率、收缩压和舒张压。研究心率变异性指标，如总功率、低频功率、高频功率、低频/高频比值、标准偏差、相邻RR间期差值的均方根以及50%相邻RR间期差值大于50毫秒的心搏数百分比。采用单因素方差分析进行多组同时比较，随后进行组间比较的事后Tukey检验。使用Pearson相关系数评估BMI与其他变量之间的关系。
有高血压家族史的肥胖受试者与其他BMI正常的组相比，心率、舒张压、低频功率、低频/高频比值显著更高，而总功率、高频功率、标准偏差、相邻RR间期差值的均方根以及50%相邻RR间期差值大于50毫秒的心搏数百分比降低。高频功率和所有时域指标与BMI呈负相关，低频功率与BMI呈正相关。
在高血压患者的肥胖后代中，代表迷走神经优势的心率变异性标志物大幅降低，交感神经活动指标增加。因此，高血压患者的血压正常后代中的肥胖是未来发生高血压的一个额外危险因素，因为它进一步破坏了心脏的自主神经控制。
