Siché J P, Tremel F, Comparat V, de Gaudemaris R, Mallion J M
Department of Internal Medicine and Cardiology, Centre Hospitalier Universitaire de Grenoble, France.
J Hypertens. 1995 Jan;13(1):147-53.
We hypothesize that in essential hypertension sympathetic nervous activity is related to the development of left ventricular hypertrophy, which can be regarded as a measure of the severity of hypertension.
Using spectral analysis, we studied the short-term variability in resting blood pressure and heart rate in essential hypertensive subjects. We measured blood over 10 min using a Finapres in 88 subjects after 20 min rest. We performed echocardiography to evaluate left ventricular hypertrophy and thereby identified three groups: 23 control subjects (group I), 29 hypertensive subjects (World Health Organization criteria) without left ventricular hypertrophy (group II) and 36 hypertensive subjects with left ventricular hypertrophy (group III). None had been treated for hypertension before the study.
The variability in blood pressure over a low-frequency period considered to be a marker of sympathetic activity was significantly increased in group II compared with groups I and III (analysis of covariance taking into account blood pressure and age). The variability in heart rate was similar in groups II and III, but both groups had a significantly reduced variability in heart rate compared with group I.
These data, which examine globally, using a non-invasive method, all neurohormonal factors associated with the development of left ventricular hypertrophy, demonstrate that, in the time course of hypertension, low-frequency oscillations in blood pressure and heart rate are shifted to a lower level, presumably reflecting altered function of the sympathetic nervous system. We suggest that spectral analysis of blood pressure at rest in hypertensive patients can lead to complementary information to single measures of blood pressure and detect differences in the cardiovascular regulatory system.
我们假设，在原发性高血压中，交感神经活动与左心室肥厚的发展相关，左心室肥厚可被视为高血压严重程度的一种衡量指标。
我们运用频谱分析研究了原发性高血压患者静息血压和心率的短期变异性。在88名受试者休息20分钟后，使用Finapres测量其10分钟以上的血压。我们进行了超声心动图检查以评估左心室肥厚，从而确定了三组：23名对照受试者（第一组），29名无左心室肥厚的高血压受试者（符合世界卫生组织标准）（第二组）和36名有左心室肥厚的高血压受试者（第三组）。在研究前，所有受试者均未接受过高血压治疗。
与第一组和第三组相比，第二组中被认为是交感神经活动标志物的低频期血压变异性显著增加（采用协方差分析并考虑血压和年龄）。第二组和第三组的心率变异性相似，但与第一组相比，这两组的心率变异性均显著降低。
这些数据使用非侵入性方法全面检查了与左心室肥厚发展相关的所有神经激素因素，表明在高血压病程中，血压和心率的低频振荡转移到了较低水平，大概反映了交感神经系统功能的改变。我们认为，对高血压患者静息血压进行频谱分析可提供补充信息，以补充单次血压测量，并检测心血管调节系统的差异。
