Imaizumi Yuki, Eguchi Kazuo, Hoshide Satoshi, Kario Kazuomi
Department of Medicine, Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi Prefecture, Japan.
Blood Press Monit. 2018 Apr;23(2):79-84. doi: 10.1097/MBP.0000000000000310.
The respiratory system is an important component in the control of the autonomic nervous system, and is a possible factor of blood pressure variability (BPV). We examined whether decreased respiratory function is associated with exaggerated BPV in hypertensives.
This is a substudy of the Japan Morning Surge-Home Blood Pressure Study and patients who underwent both spirometry and ambulatory blood pressure monitoring (ABPM) in the Japan Morning Surge-Home Blood Pressure study were analyzed. In 95 hypertensives without known clinical respiratory diseases, we performed ABPM and the respiratory function test.
Percent vital capacity (%VC), but not forced expiratory volume in 1 s as a percentage of forced vital capacity, was associated with the SD (r=-0.23, P<0.05) and coefficient of variation (r=-0.25, P<0.05) of daytime systolic blood pressure (SBP). Lower %VC was associated with higher SD of daytime SBP (P=0.049 for trend). After adjusting for covariates, %VC tended to be associated with SD of daytime SBP (β=-0.22, P=0.08) and was associated with coefficient of variation of daytime SBP (β=-0.26, P=0.04).
Decreased respiratory function was associated with exaggerated ambulatory BPV, especially in the daytime in hypertensives without respiratory diseases. This is the first study to show an association between respiratory function and increased BPV as assessed by ABPM. The results of our study indicate that low respiratory function could exaggerate BPV, and thus may be one of the mechanisms underlying the elevated cardiovascular risk in patients with decreased respiratory function.
呼吸系统是自主神经系统控制中的重要组成部分，且可能是血压变异性（BPV）的一个影响因素。我们研究了呼吸功能下降是否与高血压患者中过度的BPV相关。
这是日本晨峰-家庭血压研究的一项子研究，分析了在日本晨峰-家庭血压研究中同时进行了肺活量测定和动态血压监测（ABPM）的患者。在95例无已知临床呼吸系统疾病的高血压患者中，我们进行了ABPM和呼吸功能测试。
肺活量百分比（%VC），而非1秒用力呼气量占用力肺活量的百分比，与日间收缩压（SBP）的标准差（r = -0.23，P < 0.05）和变异系数（r = -0.25，P < 0.05）相关。较低的%VC与日间SBP的较高标准差相关（趋势P = 0.049）。在对协变量进行校正后，%VC倾向于与日间SBP的标准差相关（β = -0.22，P = 0.08），并与日间SBP的变异系数相关（β = -0.26，P = 0.04）。
呼吸功能下降与过度的动态BPV相关，尤其是在无呼吸系统疾病的高血压患者的日间。这是第一项显示呼吸功能与通过ABPM评估的BPV增加之间存在关联的研究。我们的研究结果表明，低呼吸功能可能会加剧BPV，因此可能是呼吸功能下降患者心血管风险升高的潜在机制之一。
