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年轻的临界高血压患者对心算应激反应过度:R-R间期的频谱分析

Young borderline hypertensives are hyperreactive to mental arithmetic stress: spectral analysis of R-R intervals.

作者信息

Itoh H, Takeda K, Nakamura K, Fujita H, Uchida A, Kuwahara T, Takenaka K, Tanaka M, Nakata T, Sasaki S

机构信息

Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan.

出版信息

J Auton Nerv Syst. 1995 Aug 4;54(2):155-62. doi: 10.1016/0165-1838(95)00008-l.

Abstract

To investigate whether sympathetic tone and its reactivity to stress are increased in borderline hypertension, we compared pressor and autonomic nervous responses to mental arithmetic stress in male borderline hypertensives (BH) and normotensive volunteers (NT). Three age groups, 30, 40 and 50-year-old groups, which included 30 to 39, 40 to 49 and 50 to 59-year-old subjects, were studied. Fractional LF (%LF), fractional HF (%HF) and L/H, obtained from the power spectrum of R-R intervals, were used as indices of autonomic nervous function. Baseline autonomic nervous indices did not differ between NT and BH of any age group. Blood pressure rose higher during mental arithmetic stress in 50 than in 30-year-old NT but not in comparable age groups of BH. Pressor responses were augmented in BH compared to NT only in the 30-year-old group. However, the differences were not significant when pressor responses were expressed as percent increases in blood pressure. Both %L and L/H increased during arithmetic stress. The increase in %L did not differ between NT and BH but that in L/H (% delta L/H) was larger in 50 than in 30-year-old NT. % delta L/H was larger in BH than in NT only in the 30-year-old group. These findings suggest that both pressor and autonomic nervous responses to metal arithmetic stress were altered by aging and augmented in BH compared to NT in the 30-year-old group.

摘要

为了研究临界高血压患者交感神经张力及其对应激的反应性是否增加,我们比较了男性临界高血压患者(BH)和血压正常志愿者(NT)对心算应激的升压和自主神经反应。研究了三个年龄组,即30岁、40岁和50岁组,分别包括30至39岁、40至49岁和50至59岁的受试者。从R-R间期功率谱获得的低频分数(%LF)、高频分数(%HF)和L/H用作自主神经功能指标。任何年龄组的NT和BH之间基线自主神经指标均无差异。50岁的NT在心算应激期间血压升高幅度高于30岁的NT,但在同龄的BH组中并非如此。仅在30岁组中,与NT相比,BH的升压反应增强。然而,当将升压反应表示为血压升高百分比时,差异并不显著。在算术应激期间,%L和L/H均增加。NT和BH之间%L的增加没有差异,但50岁的NT中L/H的增加(%ΔL/H)大于30岁的NT。仅在30岁组中,BH的%ΔL/H大于NT。这些发现表明,与NT相比,30岁组的BH对心算应激的升压和自主神经反应均随年龄而改变且增强。

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