Department of Internal Medicine, Maastricht University Medical Centre.
CARIM School for Cardiovascular Diseases, Maastricht University.
J Hypertens. 2023 Feb 1;41(2):254-261. doi: 10.1097/HJH.0000000000003323. Epub 2022 Nov 17.
Low baroreflex sensitivity (BRS) has been hypothesized to underlie high blood pressure (BP) and greater BP variability on the longer term, but evidence is scarce. In addition, these associations may differ by sex and (pre)diabetes. Therefore, we investigated whether cardiovagal BRS is associated with short- to mid-term mean BP and BP variability, and differs according to sex and (pre)diabetes.
Cross-sectional data from the population-based Maastricht study (age 60 ± 8 years, 52% men), where office ( n = 2846), 24-h ( n = 2404) and 7-day BP measurements ( n = 2006) were performed. Spontaneous BRS was assessed by cross-correlating systolic BP and instantaneous heart rate. We used linear regression with adjustments for age, sex, BP or BP variability, and cardiovascular risk factors.
With regard to BP, 1-SD (standard deviation) lower BRS (-5.75 ms/mmHg) was associated with higher office, 24-h and 7-day systolic BP (2.22 mmHg [95% confidence interval [CI]: 1.59; 2.80], 0.95 mmHg [0.54; 1.36], and 1.48 mmHg [0.99; 1.97], respectively) and diastolic BP (1.31 mmHg [0.97; 1.66], 0.57 mmHg [0.30; 0.84], and 0.86 mmHg [0.54; 1.17], respectively). Per 1-SD lower BRS, these associations were stronger in women (0.5-1.5 mmHg higher compared to men), and weaker in those with type 2 diabetes (1-1.5 mmHg lower compared to normal glucose metabolism). With regard to BP variability, BRS was not consistently associated with lower BP variability.
Lower cardiovagal BRS is associated with higher mean BP from the short- to mid-term range, and not consistently with BP variability. The associations with mean BP are stronger in women and weaker in those with type 2 diabetes.
低血压反射敏感性（BRS）被认为是高血压和长期血压变异性的基础，但证据有限。此外，这些关联可能因性别和（前驱）糖尿病而不同。因此，我们研究了心脏迷走神经 BRS 是否与短期至中期平均血压和血压变异性相关，以及是否因性别和（前驱）糖尿病而不同。
来自基于人群的马斯特里赫特研究的横断面数据（年龄 60±8 岁，52%为男性），其中进行了诊室（n=2846）、24 小时（n=2404）和 7 天血压测量（n=2006）。通过交叉相关收缩压和即时心率来评估自主 BRS。我们使用线性回归，调整年龄、性别、血压或血压变异性以及心血管危险因素。
在血压方面，BRS 降低 1 个标准差（-5.75 毫秒/毫米汞柱）与诊室、24 小时和 7 天收缩压（分别为 2.22 毫米汞柱[95%置信区间：1.59；2.80]、0.95 毫米汞柱[0.54；1.36]和 1.48 毫米汞柱[0.99；1.97]）和舒张压（1.31 毫米汞柱[0.97；1.66]、0.57 毫米汞柱[0.30；0.84]和 0.86 毫米汞柱[0.54；1.17]）均升高。与男性相比，BRS 每降低 1 个标准差，女性的相关性更强（高 0.5-1.5 毫米汞柱），而 2 型糖尿病患者的相关性更弱（低 1-1.5 毫米汞柱）与正常葡萄糖代谢相比）。关于血压变异性，BRS 与较低的血压变异性没有一致的相关性。
较低的心脏迷走神经 BRS 与短期至中期的平均血压升高相关，与血压变异性无关。与平均血压的关联在女性中更强，在 2 型糖尿病患者中更弱。
