Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
François M. Abboud Cardiovascular Research Center, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
Am J Hypertens. 2019 May 9;32(6):564-569. doi: 10.1093/ajh/hpz035.
Age-associated arterial stiffening may be the result of greater tonic sympathetic nerve activity. However, age-associated changes in central artery responsiveness to sympathoexcitatory stimuli are understudied. Therefore, we examined changes in central artery stiffness and wave reflection in response to sympathoexcitatory stimuli in young and older adults.
Fourteen young (25 ± 4 years) and 15 older (68 ± 4 years) subjects completed 3 minutes of the cold pressor test (CPT) and lower-body negative pressure (LBNP) separated by 15 minutes. Carotid-femoral pulse wave velocity (cfPWV), central augmentation pressure (cAP), and augmentation index (AIx) were measured in duplicate during rest and the final minute of each perturbation.
Young subjects had lower baseline cfPWV, cAP, and AIx than older subjects (P < 0.05 for all). During the CPT mean arterial pressure (MAP), cfPWV, cAP, and AIx increased in both groups (P < 0.05 for all); however, changes (Δ) in MAP (18 ± 7 vs. 9 ± 5 mm Hg), cfPWV (1.3 ± 0.7 vs. 0.6 ± 0.9 m/s), cAP (4 ± 2 vs. 6 ± 3 mm Hg), and AIx (18 ± 9% vs. 7 ± 4%) were greater in young vs. older subjects, respectively (P < 0.05 for all). With MAP as a covariate, cfPWV, cAP, and AIx responses to the CPT were no longer significantly different between groups. During LBNP, changes in MAP (-1 ± 3 vs. -3 ± 5 mm Hg), cfPWV (0.5 ± 0.3 vs. 0.5 ± 0.7 m/s), cAP (-2 ± 2 vs. -2 ± 3 mm Hg), and AIx (-7 ± 7% vs. -3 ± 6%) were similar between young and older groups, respectively (P > 0.05 for all).
Collectively, our data suggest the sympathetic nervous system may directly modulate central hemodynamics and that age-associated differences in central artery responsiveness to sympathoexcitatory stimuli are largely attributable to differential blood pressure responses.
与年龄相关的动脉僵硬可能是由于紧张性交感神经活动增加所致。然而,中枢动脉对交感神经兴奋刺激的反应性随年龄变化的研究还很少。因此,我们研究了年轻和老年受试者在交感神经兴奋刺激下中枢动脉僵硬和波反射的变化。
14 名年轻受试者(25 ± 4 岁)和 15 名老年受试者(68 ± 4 岁)分别完成了 3 分钟的冷加压试验(CPT)和下肢负压(LBNP),两者之间间隔 15 分钟。在休息和每个刺激的最后 1 分钟,重复测量颈股脉搏波速度(cfPWV)、中心增强压(cAP)和增强指数(AIx)。
年轻组的基础 cfPWV、cAP 和 AIx 均低于老年组(P < 0.05)。在 CPT 期间,两组的平均动脉压(MAP)、cfPWV、cAP 和 AIx 均升高(P < 0.05);然而,MAP(18 ± 7 与 9 ± 5mmHg)、cfPWV(1.3 ± 0.7 与 0.6 ± 0.9m/s)、cAP(4 ± 2 与 6 ± 3mmHg)和 AIx(18 ± 9%与 7 ± 4%)的变化(Δ)在年轻组中更大,分别为(P < 0.05)。当以 MAP 为协变量时,CPT 时 cfPWV、cAP 和 AIx 的反应在两组间不再有显著差异。在 LBNP 期间,MAP(-1 ± 3 与-3 ± 5mmHg)、cfPWV(0.5 ± 0.3 与 0.5 ± 0.7m/s)、cAP(-2 ± 2 与-2 ± 3mmHg)和 AIx(-7 ± 7%与-3 ± 6%)的变化在年轻和老年组之间相似,分别为(P > 0.05)。
总的来说,我们的数据表明,交感神经系统可能直接调节中枢血液动力学,与年龄相关的中枢动脉对交感神经兴奋刺激的反应性差异主要归因于血压反应的差异。