Shimada K, Kitazumi T, Ogura H, Sadakane N, Ozawa T
J Am Geriatr Soc. 1986 Jun;34(6):431-4. doi: 10.1111/j.1532-5415.1986.tb03410.x.
The present study was performed to obtain basic information as to the influences of two fundamental variables, age and blood pressure, on the circulatory responses during the Valsalva maneuver. Although a positive linear relationship between age and resting systolic blood pressure was present in the study population of 90 normal and uncomplicated hypertensive subjects, the pressure overshoot and the change in R-R intervals during phase 4 in the Valsalva maneuver were significantly inversely related to age or resting systolic blood pressure independently of each other variable. Furthermore, age was related negatively to the maximum R-R interval in phase 4 and positively to the decline of blood pressure post-Valsalva release in phase 3 even after adjusting for the effect of blood pressure, but age-independent relationships between these two indexes and resting systolic blood pressure were not statistically significant. The data indicate that changes in circulatory responses to the Valsalva maneuver occur with aging and high blood pressure, suggesting that the sympathetic vasoregulation and the baroreflex control of heart rate in the maneuver are impaired by these two variables. Such alterations appear to be more strongly related to age than to blood pressure level.
本研究旨在获取关于年龄和血压这两个基本变量对瓦尔萨尔瓦动作期间循环反应影响的基础信息。尽管在90名正常且无并发症的高血压受试者的研究人群中，年龄与静息收缩压之间存在正线性关系，但瓦尔萨尔瓦动作第4期的压力过冲和R-R间期变化彼此独立地与年龄或静息收缩压显著负相关。此外，即使在调整血压影响后，年龄与第4期最大R-R间期呈负相关，与瓦尔萨尔瓦动作释放后第3期血压下降呈正相关，但这两个指标与静息收缩压之间的年龄独立关系无统计学意义。数据表明，随着年龄增长和高血压，对瓦尔萨尔瓦动作的循环反应会发生变化，提示该动作中的交感神经血管调节和心率压力反射控制受到这两个变量的损害。这种改变似乎与年龄的关系比与血压水平的关系更强。
