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β-肾上腺素能阻滞剂对原发性高血压患者血压和心率短期变异性的影响。

Effects of beta-adrenergic blockade on short-term variability of blood pressure and heart rate in essential hypertension.

作者信息

Girard A, Meilhac B, Mounier-Vehier C, Elghozi J L

机构信息

Pharmacology Laboratory, Faculty of Medicine Necker, Paris, France.

出版信息

Clin Exp Hypertens. 1995 Jan-Feb;17(1-2):15-27. doi: 10.3109/10641969509087051.

Abstract

Short-term fluctuations in blood pressure (BP) and heart rate (HR) were analysed in a group of twelve males with essential hypertension. Indirect finger BP was measured by a Finapres device. The effect of a 7-day administration of a cardioselective beta-adrenoceptor blocker, acebutolol (400 mg/day), was studied in a double-blind, randomized, placebo-controlled cross-over study. Compared with placebo, acebutolol caused a significant decrease in BP and HR. In addition, the standard deviation (SD) of BP and HR were reduced after acebutolol in the standing position. Spectral analysis of fluctuations in BP showed a reduction in the variability underlying the SD changes of BP and HR. This reduction predominated in the mid frequency (MF) region corresponding to Mayer waves. This effect was marked for HR since the MF component for standing HR after acebutolol was 46% the placebo level. The average reduction in MF component for standing Systolic BP (SBP) was 36%. No significant correlation was found between the Mayer wave reduction and the systolic, diastolic BP or HR lowering effect of acebutolol. No significant changes in the gain of the transfer function between MF SBP and HR fluctuations in the standing position were observed. The reduced MF component of HR and BP variability after acebutolol could be due to a peripheral cardiac and non-cardiac sympatholytic effect of chronic beta-adrenoceptor blockade.

摘要

对一组12名原发性高血压男性患者的血压(BP)和心率(HR)的短期波动情况进行了分析。使用Finapres设备间接测量手指血压。在一项双盲、随机、安慰剂对照的交叉研究中,研究了心脏选择性β-肾上腺素能受体阻滞剂醋丁洛尔(400毫克/天)连续给药7天的效果。与安慰剂相比,醋丁洛尔使血压和心率显著降低。此外,站立位时服用醋丁洛尔后,血压和心率的标准差(SD)降低。血压波动的频谱分析显示,血压和心率标准差变化背后的变异性降低。这种降低在对应于迈尔波的中频(MF)区域占主导。这种效应在心率方面很明显,因为服用醋丁洛尔后站立心率的MF成分是安慰剂水平的46%。站立收缩压(SBP)的MF成分平均降低36%。未发现迈尔波降低与醋丁洛尔的收缩压、舒张压或心率降低作用之间存在显著相关性。站立位时,MF SBP与HR波动之间的传递函数增益未观察到显著变化。服用醋丁洛尔后心率和血压变异性的MF成分降低可能是由于慢性β-肾上腺素能受体阻滞的外周心脏和非心脏交感神经溶解作用。

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