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临界高血压和轻度高血压患者血压及心率的短期变异性

Short-term variability of blood pressure and heart rate in borderline and mildly hypertensive subjects.

作者信息

Takalo R, Korhonen I, Turjanmaa V, Majahalme S, Tuomisto M, Uusitalo A

机构信息

Department of Biomedical Sciences, University of Tampere, Finland.

出版信息

Hypertension. 1994 Jan;23(1):18-24. doi: 10.1161/01.hyp.23.1.18.

Abstract

Electrocardiogram and intra-arterial blood pressure were recorded in 96 men (aged 35 to 45 years) by the Oxford method over a 30-hour period. The study involved 33 normotensive, 29 borderline hypertensive, and 34 mildly hypertensive individuals, as assessed by the cuff method. Five-minute periods during sleep and with subjects in supine, sitting, and standing positions were extracted from the recordings for frequency domain analysis. Power spectrum density estimates of systolic blood pressure, diastolic blood pressure, and heart rate were calculated by an autoregressive method over the bandwidths of 0.02 to 0.075 (low-frequency), 0.075 to 0.15 (midfrequency), and 0.15 to 0.35 Hz (high-frequency), attributable to thermoregulatory, baroreceptor, and respiratory activity. No significant intergroup differences were observed at nighttime, but in different body positions the borderline hypertensive subjects frequently had either greater low-frequency variability or smaller midfrequency variability than the other groups. In this respect, the power spectra for systolic and diastolic blood pressures provided better statistical differentiation between the groups than those for heart rate. Furthermore, the borderline hypertensive subjects exhibited attenuated night-day changes in the low-frequency band for all time series. The results suggest that in borderline hypertension the baroreceptor oscillations are shifted to lower frequencies, presumably reflecting altered function of the sympathetic nervous system. In conclusion, spectral analysis of blood pressure variability for controlled test situations made it possible to detect differences in the cardiovascular regulatory systems between normotensive, borderline hypertensive, and mildly hypertensive individuals.

摘要

采用牛津方法在30小时内记录了96名年龄在35至45岁之间男性的心电图和动脉内血压。根据袖带法评估,该研究纳入了33名血压正常者、29名临界高血压者和34名轻度高血压者。从记录中提取睡眠期间以及受试者仰卧、坐着和站立姿势下的5分钟时间段进行频域分析。通过自回归方法计算收缩压、舒张压和心率在0.02至0.075(低频)、0.075至0.15(中频)和0.15至0.35赫兹(高频)带宽范围内的功率谱密度估计值,这些频段分别归因于体温调节、压力感受器和呼吸活动。夜间未观察到显著的组间差异,但在不同体位下,临界高血压受试者的低频变异性通常比其他组更大或中频变异性更小。在这方面,收缩压和舒张压的功率谱比心率的功率谱在组间提供了更好的统计学区分。此外,所有时间序列中,临界高血压受试者在低频段的昼夜变化减弱。结果表明,在临界高血压中,压力感受器振荡转移到较低频率,这可能反映了交感神经系统功能的改变。总之,对可控测试情境下血压变异性进行频谱分析,使得检测血压正常者、临界高血压者和轻度高血压者心血管调节系统之间的差异成为可能。

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