Weiss Y A, Safar M E, London G M, Simon A C, Levenson J A, Milliez P M
Am J Med. 1978 Mar;64(3):382-7. doi: 10.1016/0002-9343(78)90216-4.
Repeat hemodynamic determinations were performed in 37 young men with borderline hypertension. The duration of the follow up study was 47 +/- three months. At each determination, those with borderline hypertension were compared to a group of matched normal subjects. Blood pressure increased from the first to the second determination, but the increase was significant only for systolic (P less than 0.001) and mean (P less than 0.01) arterial presssures. Cardiac index and heart rate, which were initially increased, decreased significantly (P less than 0.02; P less than 0.01, respectively) and decreased to normal values; total peripheral resistance increased (P less than 0.01); blood and plasma volumes decreased (P less than 0.01). At the first determination, the cardiac index-heart rate correlation was significant (P less than 0.01) and the cardiac index-blood volume correlation was not. At the second determination, on the contrary, the cardiac index-total blood volume correlation was significant (P less than 0.001) whereas the cardiac index-heart rate correlation was not. The study provides evidence that patients with borderline hypertension, over a short-term period, show (1) a greater increase in systolic than in diastolic pressure, (2) a return of cardiac output toward normal values through a decrease both in heart rate and blood volume, and (3) an increased importance of volume factors in the cardiac output control.
对37名临界高血压青年男性进行了重复血流动力学测定。随访研究持续时间为47±3个月。每次测定时,将临界高血压患者与一组匹配的正常受试者进行比较。血压从第一次测定到第二次测定有所升高,但仅收缩压(P<0.001)和平均动脉压(P<0.01)的升高具有统计学意义。最初升高的心脏指数和心率显著下降(分别为P<0.02;P<0.01)并降至正常水平;总外周阻力增加(P<0.01);血容量和血浆容量减少(P<0.01)。在第一次测定时,心脏指数与心率的相关性显著(P<0.01),而心脏指数与血容量的相关性不显著。相反,在第二次测定时,心脏指数与总血容量的相关性显著(P<0.001),而心脏指数与心率的相关性不显著。该研究提供了证据,表明临界高血压患者在短期内表现出:(1)收缩压升高幅度大于舒张压;(2)通过心率和血容量的降低使心输出量恢复到正常水平;(3)容量因素在控制心输出量中的重要性增加。