Nami R, Martinelli M, Panza F, Pavese G, Carletti F, Buracchi P, Lucani B, Pazzaglia A, Saia F, Gennari C
Istituto di Patologia Speciale Medica, Università degli Studi di Siena.
Minerva Cardioangiol. 1993 Sep;41(9):387-95.
The aim of this study was to evaluate age, plasmatic renin activity (PRA), plasma aldosterone levels and the total quantity of urinary catecholamines (TOT. UR. CAT.) in a large population of out-patients suffering from essential arterial hypertension (EAH). A total of 986 patients were examined (540 women and 426 men aged between 15 and 87 years) suffering form slight or moderate EAH (WHO stage 1-2). After a wash-out period of two weeks, systolic and diastolic arterial pressure was measured together with heart rate in clino- and orthostatism. Blood samples were collected to determine PRA and plasma aldosterone, and lastly a 24-hour urine collection was made to measure the total quantity of catecholamines. It emerged that there was a significant increase in systolic pressure, whereas heart rate and PRA diminished significantly when correlated with age; diastolic pressure was also considerably lower, but did not reach statistical significance. Moreover, it was found that there was a significant positive correlation between PRA and TOT. UR. CAT., whereas no correlation was found between age and plasma aldosterone and between blood pressure and the various endocrine parameters examined. These data confirm the changes in the biological, hemodynamic and endocrine profiles observed in elderly hypertensive patients in comparison to young hypertensive patients, and suggests that age may be an important predictive factor of the activity of both the renin-angiotensin and sympathetic nervous system which appear to be closely connected and gradually attenuated by age.
本研究旨在评估大量原发性高血压（EAH）门诊患者的年龄、血浆肾素活性（PRA）、血浆醛固酮水平及尿儿茶酚胺总量（TOT. UR. CAT.）。共检查了986例患者（540名女性和426名男性，年龄在15至87岁之间），患有轻度或中度EAH（WHO 1-2期）。经过两周的洗脱期后，在临床和直立位测量收缩压、舒张压以及心率。采集血样以测定PRA和血浆醛固酮，最后收集24小时尿液以测量儿茶酚胺总量。结果显示，收缩压显著升高，而心率和PRA与年龄相关时显著降低；舒张压也明显较低，但未达到统计学意义。此外，发现PRA与TOT. UR. CAT.之间存在显著正相关，而年龄与血浆醛固酮之间以及血压与所检查的各种内分泌参数之间均未发现相关性。这些数据证实了与年轻高血压患者相比，老年高血压患者在生物学、血流动力学和内分泌方面的变化，并表明年龄可能是肾素-血管紧张素和交感神经系统活性的重要预测因素，这两个系统似乎密切相关且随年龄逐渐减弱。
