Muiesan G, Agabiti-Rosei E, Muiesan M L
J Hypertens Suppl. 1985 Dec;3(4):S45-50.
In hypertension, changes of cardiac anatomy and function are not just a simple consequence of the increased pressure load. The sympathetic nervous system activity is one of the factors which may influence the cardiac performance, and possibly also the cardiac anatomy of hypertensive patients. Several clinical studies have provided evidence of a subset of patients, usually with mild or borderline hypertension, with an increased cardiac performance, higher plasma catecholamine concentrations and/or greater response to beta-adrenergic stimulation. Animal studies have strongly suggested a possible role of adrenergic factors in the development of left ventricular hypertrophy (LVH). In man, plasma catecholamines are usually higher in hypertensive patients with LVH, and a correlation between left ventricular mass and plasma noradrenaline has also been observed. An impaired response to beta-adrenergic stimulation has been reported in hypertensive animals and in patients with LVH. Several studies have also suggested that reversal of LVH may be more easily induced by those antihypertensive drugs that reduce, or at least do not stimulate, the sympathetic activity, although exceptions to this statement may be observed.
在高血压中，心脏解剖结构和功能的变化不仅仅是压力负荷增加的简单结果。交感神经系统活动是可能影响心脏功能，也可能影响高血压患者心脏解剖结构的因素之一。多项临床研究已证实，有一部分患者（通常为轻度或临界高血压患者）心脏功能增强、血浆儿茶酚胺浓度升高和/或对β-肾上腺素能刺激反应更强。动物研究强烈提示，肾上腺素能因素在左心室肥厚（LVH）的发生发展中可能起作用。在人类中，LVH高血压患者的血浆儿茶酚胺通常较高，并且还观察到左心室质量与血浆去甲肾上腺素之间存在相关性。据报道，高血压动物和LVH患者对β-肾上腺素能刺激的反应受损。多项研究还表明，降低或至少不刺激交感神经活动的抗高血压药物可能更容易诱导LVH逆转，尽管可能会有例外情况。
