Baker Heart and Diabetes Institute, Melbourne, Victoria.
University of Michigan Medical Center, Ann Arbor, Michigan, USA.
J Hypertens. 2019 Dec;37(12):2333-2340. doi: 10.1097/HJH.0000000000002198.
: In quadrupeds, the arterial baroreflex has dominance in the reflex homeostatic responses, which protect against haemorrhage. In humans, it is the low pressure cardiopulmonary reflex, which protects against the analogous cardiovascular challenge of gravity-dependent venous pooling with standing. To preserve orthostatic cardiovascular homeostasis with the emergence of bipedalism in humans the low pressure reflex, a minor, subsidiary reflex in quadripeds, was co-opted. Mirroring the imperfect skeletal evolution to bipedalism, this cardiovascular development has been problematic, with dysregulation manifesting as disabling orthostatic intolerance syndromes and, paradoxically, an orthostatic hypertensive response that appears to play a role in the development of essential hypertension in some people. Improved understanding of these evolutionary faults provides new options for postural and pharmacological treatments.
在四足动物中，动脉压力反射在反射性稳态反应中占主导地位，可防止出血。在人类中，是低压心肺反射，可防止类似于重力依赖静脉淤积的站立时心血管挑战。为了在人类出现直立行走时保持直立心血管稳态，四足动物中的次要、附属低压反射被采用。这种心血管发展与不完善的骨骼进化相呼应，存在问题，表现为调节障碍，表现为使人丧失能力的直立不耐受综合征，矛盾的是，还表现为直立性高血压反应，这种反应似乎在某些人中对原发性高血压的发展起作用。对这些进化缺陷的更好理解为姿势和药物治疗提供了新的选择。
