种族差异与静息总外周阻力：系统评价与荟萃分析。
Ethnic Differences in Resting Total Peripheral Resistance: A Systematic Review and Meta-Analysis.
机构信息
From the Department of Psychology (Brownlow, Vasey), The Ohio State University, Columbus, Ohio; Department of Psychological Science (Williams, Thayer), University of California, Irvine, Irvine, California; Department of Pediatrics and Medicine (Kapuku), Georgia Prevention Institute, Augusta, Georgia; Department of Social Work and Nursing (Anderson), Florida State University, Tallahassee, Florida; Section for Experimental Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg (Koenig), Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern (Koenig), Bern, Switzerland; and Department of Psychiatry and Behavioral Sciences, Behavioral Medicine, School of Medicine (Hill), Duke University, Durham, North Carolina.
出版信息
Psychosom Med. 2020 Jul/Aug;82(6):548-560. doi: 10.1097/PSY.0000000000000820.
OBJECTIVE
Decades of research suggest that there may be important ethnic differences in the hemodynamic mechanisms that co-determine arterial blood pressure, the primary diagnostic index of hypertension. In general, studies have observed that, compared with European Americans (EAs), African Americans (AAs) exhibit higher total peripheral resistance (TPR), an important summative index of peripheral vascular constriction. In contrast, EAs have been reliably shown to exhibit greater cardiac output (CO), which is directly linked to left ventricle and overall cardiac blood flow. We have previously proposed that elevated basal TPR, in particular, represents one component of the cardiovascular conundrum, characterized, paradoxically, by elevated resting heart rate variability among AAs relative to EAs. The present meta-analysis and systematic review of the literature sought to extend this previous work by establishing the magnitude of the empirically implied ethnic differences in resting TPR and CO.
METHODS
A search of the literature yielded 140 abstracts on differences in TPR between AAs and EAs; 40 were included. Sample sizes, means, and standard deviations for baseline TPR with samples that included EAs and AAs were collected, and Hedges g was computed.
RESULTS
Findings indicated that AAs had higher baseline TPR than did EAs (Hedges g = 0.307, SE = 0.043, confidence interval= 0.224 to 0.391, p < .001). In addition, EAs had higher resting CO than did AAs (Hedges g = -0.214, SE = 0.056, confidence interval = -0.324 to -0.104, p < .001).
CONCLUSIONS
We discuss the present findings in the context of the role of elevated TPR in the deleterious effects of high blood pressure specifically for AAs.
目的
几十年来的研究表明，在决定动脉血压的血流动力学机制方面，可能存在重要的种族差异，而动脉血压是高血压的主要诊断指标。一般来说，研究观察到，与欧洲裔美国人（EAs）相比，非裔美国人（AAs）表现出更高的总外周阻力（TPR），这是外周血管收缩的一个重要综合指标。相比之下，EAs 的心输出量（CO）被可靠地证明更高，而 CO 直接与左心室和整体心脏血流相关。我们之前提出，基础 TPR 升高，特别是代表心血管难题的一个组成部分，其特点是 AAs 的静息心率变异性相对于 EAs 升高。本研究对文献进行了荟萃分析和系统回顾，旨在通过确定 TPR 和 CO 的种族差异的实际程度来扩展之前的工作。
方法
对 TPR 种族差异的文献进行了搜索，共获得 140 篇关于 AAs 和 EAs 之间 TPR 差异的摘要，其中 40 篇被纳入。收集了包含 EAs 和 AAs 的样本的 TPR 基线的样本量、平均值和标准差，并计算了 Hedges g。
结果
研究结果表明，AAs 的 TPR 基线高于 EAs（Hedges g = 0.307，SE = 0.043，置信区间= 0.224 至 0.391，p <.001）。此外，EAs 的静息 CO 高于 AAs（Hedges g = -0.214，SE = 0.056，置信区间= -0.324 至 -0.104，p <.001）。
结论
我们在 TPR 升高在高血压的有害影响中作用的背景下讨论了本研究的发现，特别是对 AAs 的影响。
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