Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Toon, Japan.
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan.
Am J Hypertens. 2018 Sep 11;31(10):1120-1126. doi: 10.1093/ajh/hpy100.
Although blood pressure (BP) is regulated by the autonomic nervous system, it is not fully understood how autonomic activity affects BP at home in the general population.
Subjects were enrolled from 2009 to 2012 and included 1,888 men and women aged 30-79 years. We measured casual BP in the morning during health checkups and asked participants to monitor BP at home twice in the morning and evening for 1 week. The mean of the two measurements of mean arterial pressure (MAP) was calculated. Five-minute recordings of the pulse wave from a fingertip sensor were used to determine the following indices of heart rate variability (HRV): standard deviation of normal-to-normal RR intervals (SDNN), root mean square of successive differences in RR intervals (RMSSD), high frequency (HF) power, low frequency (LF) power, and LF/HF.
Sex- and age-adjusted means of casual MAP, and morning and evening MAP at home were significantly different among quartiles of SDNN, RMSSD, and HF. When further adjusted for smoking, alcohol drinking, medication for hypertension, diabetes, sleeping hours, snoring, and mental health status, the associations were somewhat attenuated. Inverse relationships were found between the means of morning home MAP, and RMSSD (P = 0.02) and HF (P = 0.051) after adjustment for confounders. The association between MAP and RMSSD, or MAP and HF was evident in individuals <65 years old.
Low HF and RMSSD, which reflect impaired parasympathetic nervous system activity, were associated with increased home MAP in the morning rather than in the evening.
尽管血压（BP）受自主神经系统调节，但自主活动如何影响一般人群家中的血压尚不完全清楚。
受试者于 2009 年至 2012 年期间招募，包括 1888 名年龄在 30-79 岁的男性和女性。我们在健康检查期间测量了早晨的偶然血压，并要求参与者在家中早晚各测量血压两次，持续一周。平均动脉压（MAP）的两次测量值的平均值被计算出来。使用指尖传感器的脉搏波的 5 分钟记录来确定心率变异性（HRV）的以下指标：正常到正常 RR 间隔的标准差（SDNN）、RR 间隔连续差异的均方根（RMSSD）、高频（HF）功率、低频（LF）功率和 LF/HF。
SDNN、RMSSD 和 HF 的四分位数之间，偶然 MAP 和在家中早晨和晚上的 MAP 的性别和年龄调整平均值存在显著差异。当进一步调整吸烟、饮酒、高血压药物治疗、糖尿病、睡眠时间、打鼾和心理健康状况等因素后，关联有所减弱。在家中早晨 MAP 的平均值与 RMSSD（P=0.02）和 HF（P=0.051）呈负相关，调整混杂因素后。在家中早晨 MAP 与 RMSSD 或 MAP 与 HF 之间的关联在年龄<65 岁的个体中是明显的。
低 HF 和 RMSSD，反映了副交感神经系统活动受损，与在家中早晨而非晚上的 MAP 升高有关。
