Cerasola G, Cottone S, D'Ignoto G, Grasso L, Carone M B
Institute of Internal Medicine, Hypertension Center, University of Palermo, Italy.
J Hypertens Suppl. 1988 Nov;6(1):S55-8.
Although increased sympathetic outflow has been implicated in the induction of early essential hypertension, the increase in norepinephrine with advancing age could reflect a compensatory mechanism for a declining peripheral response to adrenergic stimuli or an age-related decrease in norepinephrine clearance. To evaluate the activity of the sympathetic system and of plasma renin in elderly patients with borderline and established essential hypertension, 31 borderline hypertensives aged less than 60 years (mean age 38 years), 30 established essential hypertensives aged less than 60 years (mean age 39 years), 15 borderline hypertensives aged greater than 60 years (mean age 66 years) and 15 essential hypertensives aged greater than 60 years (mean age 68 years) were studied at rest and after dynamic exercise. Blood pressure and the heart rate were automatically recorded and blood samples were collected for plasma renin activity and plasma epinephrine and norepinephrine assays. Plasma epinephrine levels showed no significant differences between the groups examined at rest. Nevertheless, young borderline hypertensives had higher plasma epinephrine levels than young essential hypertensives after stress, and elderly borderline hypertensives showed higher plasma epinephrine levels than the age-matched essential hypertensives in response to dynamic exercise. The plasma renin activity profile was similar among all the groups, but dynamic exercise induced a greater increase in borderline than in essential hypertensives. Moreover, the stress-induced increase in plasma norepinephrine levels was higher in essential than in borderline hypertensives. Our results show a greater epinephrine response to stress in elderly and young borderline hypertensives than in age-matched essential hypertensives.(ABSTRACT TRUNCATED AT 250 WORDS)
虽然交感神经输出增加被认为与早期原发性高血压的诱发有关，但随着年龄增长去甲肾上腺素的增加可能反映了对肾上腺素能刺激外周反应下降的一种代偿机制，或者是与年龄相关的去甲肾上腺素清除率降低。为了评估临界和确诊原发性高血压老年患者的交感神经系统和血浆肾素活性，研究了31名年龄小于60岁（平均年龄38岁）的临界高血压患者、30名年龄小于60岁（平均年龄39岁）的确诊原发性高血压患者、15名年龄大于60岁（平均年龄66岁）的临界高血压患者和15名年龄大于60岁（平均年龄68岁）的原发性高血压患者，分别在静息状态和动态运动后进行研究。自动记录血压和心率，并采集血样用于血浆肾素活性、血浆肾上腺素和去甲肾上腺素检测。静息时各研究组间血浆肾上腺素水平无显著差异。然而，应激后年轻临界高血压患者的血浆肾上腺素水平高于年轻原发性高血压患者，且老年临界高血压患者在动态运动时的血浆肾上腺素水平高于年龄匹配的原发性高血压患者。所有组的血浆肾素活性情况相似，但动态运动后临界高血压患者的升高幅度大于原发性高血压患者。此外，原发性高血压患者应激诱导的血浆去甲肾上腺素水平升高幅度高于临界高血压患者。我们的结果显示，老年和年轻临界高血压患者对应激的肾上腺素反应比年龄匹配的原发性高血压患者更大。（摘要截选至250字）
