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原发性高血压患者的体循环动脉顺应性和舒张期血流

Systemic arterial compliance and diastolic runoff in essential hypertension.

作者信息

Levenson J A, Safar M E, Simon A C, Kheder A I, Daou J N, Levy B I

出版信息

Angiology. 1981 Jun;32(6):402-13. doi: 10.1177/000331978103200606.

Abstract

Systemic arterial compliance was estimated in 31 men, including 15 patients with sustained essential hypertension and 16 normal subjects of the same age. Values were derived from analysis of the monoexponential blood pressure-time curve during diastole, according to a simple viscoelastic model. In normal subjects, baseline arterial compliance was 2.56 +/- 0.18 ml/mm Hg. A significant decrease (1.88 +/- 0.13 ml/mm Hg; P less than 0.001) was observed in hypertensives. Administration of vasoactive substances (angiotensin and sodium nitroprusside) showed that, for the same blood pressure levels, normal subjects and hypertensives had similar values for compliance. However, the correlation between the basal values of diastolic pressure and compliance was significant in normal subjects (r = --0.76) but not in hypertensives (r = --0.33); these results suggested differences between acute and long-term conditions in patients and controls. Calculated diastolic runoff was similar in both groups, approximating 58 and 55% of the stroke volume respectively. This study provides evidence that, in sustained essential hypertension, (1) the reduced arterial compliance cannot be related exclusively to the level of blood pressure, but also requires some abnormality of the volume of large arteries, and (2) the reservoir role of the large arteries is maintained.

摘要

对31名男性进行了全身动脉顺应性评估,其中包括15名持续性原发性高血压患者和16名同龄正常受试者。根据一个简单的粘弹性模型,通过分析舒张期单指数血压-时间曲线得出相关数值。在正常受试者中,基线动脉顺应性为2.56±0.18 ml/mm Hg。高血压患者的动脉顺应性显著降低(1.88±0.13 ml/mm Hg;P<0.001)。给予血管活性物质(血管紧张素和硝普钠)后发现,在相同血压水平下,正常受试者和高血压患者的顺应性数值相似。然而,舒张压基础值与顺应性之间的相关性在正常受试者中显著(r = -0.76),而在高血压患者中不显著(r = -0.33);这些结果表明患者和对照组在急性和长期情况下存在差异。两组的计算舒张期血流量相似,分别约为每搏输出量的58%和55%。这项研究提供了证据,即在持续性原发性高血压中,(1)动脉顺应性降低不能仅与血压水平相关,还需要大动脉容积出现一些异常,并且(2)大动脉的储存功能得以维持。

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