Kuzmenko N V, Pliss M G, Tsyrlin V A
V.A.Almazov National Medical Research Centre, 2 Akkuratova str., St. Petersburg 197341, Russian Federation, e-mail:
I.P.Pavlov Saint-Petersburg First State Medical University, 6-8 L'va Tolstogo str., St. Petersburg 197022, Russian Federation.
Adv Gerontol. 2020;33(4):748-760.
It is known that with the aging, the adaptive capabilities of his body decrease. This is due to both changes in autonomic regulation and morphological remodeling of the cardiovascular system. To assess age-related changes in the autonomic nervous and cardiovascular systems, a meta-analysis was carried out, which examined changes in the aging of hemodynamic parameters [blood pressure (BP) and heart rate (HR)], heart rate variability (HRV), catecholamine concentrations, electrical activity of muscle sympathetic nerves (MSHA) , as well as the magnitude of the BR. The results of 32 works from the PubMed database were analyzed, in which healthy people of different age groups (27±5 and 64±5 years) were compared by the studied indicators. As a result of a meta-analysis, it was found that in older people compared with young people, the BP is higher, HR remains unchanged, but HRV and BR significantly decrease, the sympathetic-vagal balance shifts toward an increase in sympathetic effects on heart function, MSNA and plasma noradrenaline level increase. In the elderly people a loosening in autonomic control with an increase in sympathetic nervous activity causes an increase in the baseline of BP and its increase in conditions of stress. These changes are the cause of a decrease in the adaptive abilities of the old person and a substrate for the development of cardiovascular pathologies.
众所周知,随着年龄的增长,人体的适应能力会下降。这是由于自主神经调节的变化以及心血管系统的形态重塑所致。为了评估自主神经系统和心血管系统的年龄相关变化,进行了一项荟萃分析,该分析研究了血流动力学参数(血压和心率)、心率变异性、儿茶酚胺浓度、肌肉交感神经电活动以及压力反射幅度在衰老过程中的变化。分析了来自PubMed数据库的32项研究结果,其中通过所研究的指标对不同年龄组(27±5岁和64±5岁)的健康人群进行了比较。荟萃分析的结果发现,与年轻人相比,老年人的血压更高,心率保持不变,但心率变异性和压力反射显著降低,交感-迷走平衡向交感神经对心脏功能影响增加的方向转变,肌肉交感神经活动和血浆去甲肾上腺素水平升高。在老年人中,自主神经控制的松弛以及交感神经活动的增加导致血压基线升高及其在应激状态下的升高。这些变化是老年人适应能力下降的原因,也是心血管疾病发生发展的基础。