From the Department of Population Science and Experimental Medicine, Institute of Cardiovascular Sciences, University College London, United Kingdom (C.P., S.J., N.C., A.D.H.).
Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom (A.F., L.D.H., G.D.S., D.A.L.).
Hypertension. 2018 Nov;72(5):1103-1108. doi: 10.1161/HYPERTENSIONAHA.118.11925.
Unlike in older people, it has been suggested that elevated blood pressure (BP) in young people is because of high cardiac output accompanied by normal total peripheral resistance (TPR)-a hyperkinetic/hyperdynamic circulation. We investigated this in a large, United Kingdom-based birth cohort of adolescents. The study was conducted on 2091 17-year-old participants in the ALSPAC (Avon Longitudinal Study of Parents and Children)-a prospective population-based birth cohort study. BP measurement and echocardiography were performed, and heart rate (HR), stroke volume (SV), and TPR were calculated. Data are means (SD). Higher quintiles of systolic BP were associated with higher SV, higher HR, and higher TPR. The proportional contribution made by SV, HR, and TPR to mean arterial pressure differed little by systolic BP quintile (SV [32%-34%], HR [25%-29%], and TPR [39%-41%]). Higher BP is attributable to a combination of higher cardiac output (ie, SV×HR) and higher TPR in a population-based sample of adolescents. There is no evidence of a disproportionate contribution from elevated cardiac output at higher BP levels.
与老年人不同，有人认为年轻人血压升高是由于心输出量增加伴随正常总外周阻力（TPR）——高动力/高动力循环所致。我们在一个基于英国的大型青少年队列中对此进行了研究。该研究对参加阿冯纵向研究父母和儿童（ALSPAC）的 2091 名 17 岁参与者进行了检测——这是一项前瞻性基于人群的出生队列研究。进行了血压测量和超声心动图检查，并计算了心率（HR）、每搏量（SV）和 TPR。数据为平均值（SD）。收缩压的五分位数越高，SV、HR 和 TPR 越高。SV、HR 和 TPR 对平均动脉压的贡献比例在收缩压五分位数上差异不大（SV[32%-34%]、HR[25%-29%]和 TPR[39%-41%]）。在基于人群的青少年样本中，更高的血压归因于心输出量（即 SV×HR）和更高的 TPR 的组合。在更高的血压水平下，没有证据表明心输出量的不成比例增加。
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