Amaral Josária Ferraz, Borsato Diana de Medeiros Andrade, Freitas Isabelle Magalhães Guedes, Toschi-Dias Edgar, Martinez Daniel Godoy, Laterza Mateus Camaroti
Universidade Federal de Juiz de Fora (UFJF) Juiz de Fora, MG - Brazil.
Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo São Paulo, SP - Brazil.
Arq Bras Cardiol. 2018 Feb;110(2):166-174. doi: 10.5935/abc.20180006. Epub 2018 Feb 19.
Individuals with a family history of systemic arterial hypertension (FHSAH) and / or prehypertension have a higher risk of developing this pathology.
To evaluate the autonomic and vascular functions of prehypertensive patients with FHSAH.
Twenty-five young volunteers with FHSAH, 14 normotensive and 11 prehypertensive subjects were submitted to vascular function evaluation by forearm vascular conductance(VC) during resting and reactive hyperemia (Hokanson®) and cardiac and peripheral autonomic modulation, quantified, respectively, by spectral analysis of heart rate (ECG) and systolic blood pressure (SBP) (FinometerPRO®). The transfer function analysis was used to measure the gain and response time of baroreflex. The statistical significance adopted was p ≤ 0.05.
Pre-hypertensive individuals, in relation to normotensive individuals, have higher VC both at rest (3.48 ± 1.26 vs. 2.67 ± 0.72 units, p = 0.05) and peak reactive hyperemia (25, 02 ± 8.18 vs. 18.66 ± 6.07 units, p = 0.04). The indices of cardiac autonomic modulation were similar between the groups. However, in the peripheral autonomic modulation, greater variability was observed in prehypertensive patients compared to normotensive individuals (9.4 [4.9-12.7] vs. 18.3 [14.8-26.7] mmHg2; p < 0.01) and higher spectral components of very low (6.9 [2.0-11.1] vs. 13.5 [10.7-22.4] mmHg2, p = 0.01) and low frequencies (1.7 [1.0-3.0] vs. 3.0 [2.0-4.0] mmHg2, p = 0.04) of SBP. Additionally, we observed a lower gain of baroreflex control in prehypertensive patients compared to normotensive patients (12.16 ± 4.18 vs. 18.23 ± 7.11 ms/mmHg, p = 0.03), but similar delay time (-1.55 ± 0.66 vs. -1.58 ± 0.72 s, p = 0.90).
Prehypertensive patients with FHSAH have autonomic dysfunction and increased vascular conductance when compared to normotensive patients with the same risk factor.
有系统性动脉高血压家族史（FHSAH）和/或高血压前期的个体患这种疾病的风险更高。
评估患有FHSAH的高血压前期患者的自主神经和血管功能。
25名患有FHSAH的年轻志愿者，14名血压正常者和11名高血压前期受试者接受了血管功能评估，通过静息和反应性充血期间的前臂血管传导率（VC）（Hokanson®）以及心脏和外周自主神经调节，分别通过心率（心电图）和收缩压（SBP）的频谱分析进行量化（FinometerPRO®）。传递函数分析用于测量压力反射的增益和反应时间。采用的统计学显著性为p≤0.05。
与血压正常的个体相比，高血压前期个体在静息时（3.48±1.26对2.67±0.72单位，p = 0.05）和反应性充血峰值时（25.02±8.18对18.66±6.07单位，p = 0.04）的VC更高。两组之间心脏自主神经调节指标相似。然而，在外周自主神经调节方面，与血压正常的个体相比，高血压前期患者观察到更大的变异性（9.4 [4.9 - 12.7]对18.3 [14.8 - 26.7] mmHg2；p < 0.01）以及SBP的极低频率（6.9 [2.0 - 11.1]对13.5 [10.7 - 22.4] mmHg2，p = 0.01）和低频（1.7 [1.0 - 3.0]对3.0 [2.0 - 4.0] mmHg2，p = 0.04）的更高频谱成分。此外，与血压正常的患者相比，我们观察到高血压前期患者的压力反射控制增益较低（12.16±4.18对18.23±7.11 ms/mmHg，p = 0.03），但延迟时间相似（-1.55±0.66对-1.58±0.72 s，p = 0.90）。
与具有相同风险因素的血压正常患者相比，患有FHSAH的高血压前期患者存在自主神经功能障碍且血管传导率增加。
