Spieker C, Barenbrock M, Rahn K H, Zidek W
Medizinische Poliklinik, University of Münster, Germany.
Blood Press. 1993 Mar;2(1):35-9. doi: 10.3109/08037059309077524.
Circadian rhythm of blood pressure and of heart rate was studied in patients with hyperthyroidism (n = 10), pheochromocytoma (n = 8), primary hyperaldosteronism (n = 7), and in a control group of essential hypertensive patients (n = 18) and of normotensive healthy subjects (n = 11). 24-hour blood pressure was monitored non-invasively using SpaceLabs (SL 90207) with 8-min intervals in the daytime (8 a.m. to 10 p.m.) and 30-min intervals during night-time (10 p.m. to 8 a.m.). To characterize circadian blood pressure rhythm the difference between the mean blood pressure during daytime and that during night-time was calculated. In patients with hyperthyroidism the day-night difference of the systolic and diastolic blood pressure and of the heart rate was significantly reduced when compared to the normotensive control group (p < 0.05). The day-night difference of the systolic and diastolic blood pressure was significantly lower in the group with pheochromocytoma and hyperthyroidism than in the essential hypertensive controls (p < 0.05); the day-night difference of the heart rate was similar. In the patients with primary hyperaldosteronism the day-night differences of the systolic and diastolic blood pressure and of the heart rate was similar to those in essential hypertensive controls. We conclude that endocrine disorders affecting sympathetic activity like pheochromocytoma or hyperthyroidism influence the circadian blood pressure rhythm, whereas the renin-aldosterone-system has no major impact on the diurnal blood pressure variation. The results therefore support the hypothesis that circadian blood pressure variation is mainly mediated by a modulation of the sympathetic tone.
对甲状腺功能亢进患者（n = 10）、嗜铬细胞瘤患者（n = 8）、原发性醛固酮增多症患者（n = 7）以及原发性高血压患者对照组（n = 18）和血压正常的健康受试者对照组（n = 11）的血压和心率昼夜节律进行了研究。使用太空实验室（SL 90207）以无创方式监测24小时血压，白天（上午8点至晚上10点）每隔8分钟测量一次，夜间（晚上10点至上午8点）每隔30分钟测量一次。为了描述昼夜血压节律，计算白天平均血压与夜间平均血压之间的差值。与血压正常的对照组相比，甲状腺功能亢进患者的收缩压、舒张压和心率的昼夜差值显著降低（p < 0.05）。嗜铬细胞瘤和甲状腺功能亢进组的收缩压和舒张压昼夜差值显著低于原发性高血压对照组（p < 0.05）；心率昼夜差值相似。原发性醛固酮增多症患者的收缩压、舒张压和心率昼夜差值与原发性高血压对照组相似。我们得出结论，影响交感神经活动的内分泌紊乱，如嗜铬细胞瘤或甲状腺功能亢进，会影响昼夜血压节律，而肾素 - 醛固酮系统对昼夜血压变化没有重大影响。因此，这些结果支持了昼夜血压变化主要由交感神经张力调节介导的假说。
