Cardiovascular Center, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
J Clin Hypertens (Greenwich). 2018 Feb;20(2):273-279. doi: 10.1111/jch.13180. Epub 2018 Jan 6.
We aimed to elucidate the role of autonomic dysfunction in the context of complex metabolic and cardiovascular changes in subjects with prehypertension. We identified 556 asymptomatic subjects without hypertension who underwent comprehensive cardiovascular exams. We obtained heart rate recovery (HRR) after peak exercise to quantitatively measure autonomic dysfunction. Of the 556 participants, 279 individuals had prehypertension and the remaining 277 had optimal BP. HRR was significantly lower in the prehypertension group (36.0 ± 14.5 bpm) than in the optimal BP group (39.3 ± 14.7 bpm, P = .009). The prehypertension group more frequently demonstrated features of metabolic disturbances and subclinical target organ damage. Among the various baseline cardiovascular and metabolic factors assessed, resting systolic BP and high-density lipoprotein cholesterol level were independent determinants of HRR (both P < .05). Autonomic dysfunction coexists with prehypertension and is closely linked to changes in systolic BP and lipid metabolism.
我们旨在阐明自主神经功能障碍在高血压前期患者复杂代谢和心血管变化背景下的作用。我们确定了 556 名无症状、无高血压的受试者，他们接受了全面的心血管检查。我们获得了峰值运动后的心率恢复（HRR），以定量测量自主神经功能障碍。在 556 名参与者中，279 人患有高血压前期，其余 277 人血压正常。高血压前期组的 HRR 明显低于血压正常组（36.0±14.5 bpm 比 39.3±14.7 bpm，P=.009）。高血压前期组更频繁地表现出代谢紊乱和亚临床靶器官损伤的特征。在评估的各种基线心血管和代谢因素中，静息收缩压和高密度脂蛋白胆固醇水平是 HRR 的独立决定因素（均 P<.05）。自主神经功能障碍与高血压前期并存，与收缩压和脂代谢变化密切相关。
