Messerli F H, Sundgaard-Riise K, Ventura H O, Dunn F G, Glade L B, Frohlich E D
Lancet. 1983 Oct 29;2(8357):983-6. doi: 10.1016/s0140-6736(83)90977-7.
In an attempt to dissociate the cardiovascular adaptations to high blood pressure from those of ageing, 30 patients with established essential hypertension aged over 65 years were matched for mean arterial pressure, race, sex, height, and weight with 30 patients younger than 42 years. Cardiac output, heart rate, stroke volume, intravascular volume, renal blood flow, and plasma renin activity were significantly lower in the elderly, whereas total peripheral (and renal vascular) resistance, left ventricular posterior wall and septal thicknesses, and left ventricular mass were higher. Intravascular volume correlated inversely with total peripheral resistance in both groups and in all patients. Pathophysiological findings of essential hypertension in the elderly are characterised by a hypertrophied heart of the concentric type with a low cardiac output resulting from a smaller stroke volume and a slower heart rate. Renal blood flow is disproportionally reduced and total peripheral and renal vascular resistance elevated.
为了区分高血压患者心血管系统的适应性变化与衰老相关的变化，选取了30例65岁以上确诊为原发性高血压的患者，将其平均动脉压、种族、性别、身高和体重与30例42岁以下的患者进行匹配。老年患者的心输出量、心率、每搏输出量、血管内容量、肾血流量和血浆肾素活性显著降低，而总外周（及肾血管）阻力、左心室后壁和室间隔厚度以及左心室质量则较高。两组所有患者的血管内容量均与总外周阻力呈负相关。老年原发性高血压的病理生理表现为同心型心脏肥厚，每搏输出量较小和心率较慢导致心输出量降低。肾血流量不成比例地减少，总外周及肾血管阻力升高。
