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临界高血压患者体位改变时的肾素-血管紧张素-醛固酮系统、RR间期及血压变异性

Renin-angiotensin-aldosterone system, RR interval, and blood pressure variability during postural changes in borderline arterial hypertension.

作者信息

Duprez D A, De Sutter J H, De Buyzere M L, Rietzschel E R, Rimbaut S, Kaufman J M, Van Hoecke M J, Clement D L

机构信息

Department of Cardiology, University Hospital, Gent, Belgium.

出版信息

Am J Hypertens. 1995 Jul;8(7):683-8. doi: 10.1016/0895-7061(95)00080-9.

Abstract

This study aimed to examine the changes in RR interval and blood pressure (BP) variability and humoral factors during postural changes in borderline arterial hypertension. Twenty-nine patients (44 +/- 3 year; BP, 145 +/- 3/84 +/- 3 mm Hg) with borderline hypertension and a control group of 38 subjects (35 +/- 2 year; BP, 123 +/- 3/70 +/- 2 mm Hg) underwent power spectrum analysis of RR interval and BP (low frequency (LF), 0.05 to 0.15 Hz; high frequency (HF), 0.15 to 0.40 Hz) in the supine and standing positions. Concentrations of plasma renin activity, angiotensin II, and aldosterone in supine and standing positions had been determined in the hypertensive group. Borderline hypertensives are characterized by higher oscillations of systolic and diastolic BP, but not of RR interval in the supine position versus the control group. Low frequency and HF components of systolic and diastolic BP expressed as absolute data are also significantly higher in borderline hypertensives. Moreover, standing tended to increase the LF/HF ratio of both RR interval and BP variability compared to controls. The standing position was able to further activate the LF but not the HF component of BP variability. In borderline hypertension renin release during postural changes correlated well with the decrease in the power of the HF vagal component of RR interval variability (r = -0.70, P < .001) and with the increase of the LF component of diastolic blood pressure variability (r = 0.43, P = .03). In conclusion, our results indicate that in borderline arterial hypertension, LF and HF oscillations of BP are already significantly increased at rest.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究旨在探讨临界动脉高血压患者体位改变时RR间期、血压(BP)变异性及体液因子的变化。29例临界高血压患者(年龄44±3岁;血压145±3/84±3 mmHg)和38例对照组受试者(年龄35±2岁;血压123±3/70±2 mmHg)在仰卧位和站立位接受RR间期和BP的功率谱分析(低频(LF),0.05至0.15 Hz;高频(HF),0.15至0.40 Hz)。已测定高血压组仰卧位和站立位时血浆肾素活性、血管紧张素II和醛固酮的浓度。与对照组相比,临界高血压患者仰卧位时收缩压和舒张压的波动较高,但RR间期波动不明显。临界高血压患者收缩压和舒张压的低频和高频成分以绝对值表示也显著更高。此外,与对照组相比,站立位时RR间期和BP变异性的低频/高频比值有增加趋势。站立位能够进一步激活BP变异性的低频成分,但不能激活高频成分。在临界高血压中,体位改变时肾素释放与RR间期变异性的高频迷走神经成分功率降低(r = -0.70,P <.001)以及舒张压变异性的低频成分增加(r = 0.43,P =.03)密切相关。总之,我们的结果表明,在临界动脉高血压中,静息时BP的低频和高频振荡已经显著增加。(摘要截短至250字)

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