Lee D D, DeQuattro V, Cox T, Pyter L, Foti A, Allen J, Barndt R, Azen S, Davison G
University of Southern California School of Medicine, Los Angeles 90033.
J Hum Hypertens. 1987 Sep;1(2):147-51.
To determine the effects of hygienic (non-drug) therapy on blood pressure (BP) control and its relationship to sympathetic tone and left ventricular mass (LVM) in primary hypertension, plasma norepinephrine (NE) and renin activity (PRA), LVM, and nutritional and behavioral status were assessed in 76 borderline to mild hypertensives. Pretherapy plasma NE was related to diastolic blood pressure (DBP) and PRA (r = 0.24, P less than .05 and r = 0.37, P less than .01, respectively). Plasma NE of high renin patients (221 +/- 52) (mean +/- SD) was greater than that of normal renin patients (159 +/- 61, ng/l, P less than .01). LVM was related to systolic blood pressure (SBP) (P less than .001), DBP (P less than .01) and urinary sodium (P less than .05), and inversely related to PRA (P less than .01). Septal wall thickness was related to hostility (r = 0.42, P less than .05). After seven weeks of hygienic therapy, DBP was reduced by 6 mmHg (P less than .01). The change in SBP was related to baseline plasma NE (P less than .05) and inversely related to LVM (P less than .05). These results suggest that raised sympathetic tone may be a pathogenic factor in primary hypertension and that hygienic therapy lowers BP more effectively in patients with raised sympathetic tone and low LVM.
为了确定卫生（非药物）疗法对原发性高血压患者血压控制的影响及其与交感神经张力和左心室质量（LVM）的关系，我们对76例临界至轻度高血压患者进行了血浆去甲肾上腺素（NE）、肾素活性（PRA）、LVM以及营养和行为状况的评估。治疗前血浆NE与舒张压（DBP）和PRA相关（r分别为0.24，P<0.05和r为0.37，P<0.01）。高肾素患者的血浆NE（221±52）（均值±标准差）高于正常肾素患者（159±61，ng/l，P<0.01）。LVM与收缩压（SBP）（P<0.001）、DBP（P<0.01）和尿钠（P<0.05）相关，与PRA呈负相关（P<0.01）。室间隔厚度与敌意相关（r=0.42，P<0.05）。经过7周的卫生疗法后，DBP降低了6 mmHg（P<0.01）。SBP的变化与基线血浆NE相关（P<0.05），与LVM呈负相关（P<0.05）。这些结果表明，交感神经张力升高可能是原发性高血压的致病因素，卫生疗法对交感神经张力升高和LVM较低的患者能更有效地降低血压。
