Horký K, Bultas J, Jáchymová M, Jindra A, Savlíková J, Peleska J, Umnerová V, Jarolím M, Stolba P
II. interní klinika 1. lékarské fakulty Univerzity Karlovy, Praha.
Vnitr Lek. 1993 Jan;39(1):4-14.
Investigations in genetic forms of experimental hypertensions revealed certain haemodynamic, metabolic and humoral abnormalities in experimental animals already during the prehypertensive period. With regard to the obvious ratio of hereditary factors in the pathogenesis of human essential hypertension (EH), the objective of the present study was to test whether also in healthy normotensive subjects with a positive family history of EH some metabolic and humoral deviations can be detected, as compared with offspring from normotensive families. The authors compared therefore selected biochemical and humoral parameters in 20 sons of hypertensive parents (SH) with the findings in 20 sons from normotensive pa families (SN). SH had, as compared with SN, a significantly higher systolic BP (119 +/- 2.59 > 111.0 +/- +/- 2.04 mmHg). The trend of higher basal blood sugar levels 5.03 +/- 0.15 > 4.70 +/- 0.41 mmol/l) and the higher concentration of immunoreactive insulin (81.4 +/- 9.54 > 70.4 +/- after a glucose load +/- 7.78 microU/l) did not reach statistical significance. In SH plasma concentrations of adrenaline, noradrenaline and dopamine were significantly higher as well as the atrial natriuretic factor (11.7 +/- 0.77 > 8.4 +/- 0.40 fmol/ml) and of endothelin (18.2 +/- 1.70 > 12.7 +/- 0.87 fmol/ml). A load of 75 g glucose raised, as expected, the blood sugar level, IRI and C-peptide, but reduced unexpectedly the endothelin concentration in both groups. As to other biochemical parameters (fibrinogen, sodium, potassium, urea, creatinine, uric acid, cholesterol, HDL- and LDL-fractions, triacylglycerols), no significant differences were found between SH and SN. The finding of a raised mass of the left ventricle and certain differences in the diastolic and systolic left ventricular function are discussed in another paper. The results indicate that in young men with a positive family-history of EH already certain haemodynamic, metabolic and humoral deviations exist before clinical manifestation of hypertension which could contribute to later development of EH and its organ complications.
对实验性高血压遗传形式的研究表明，在实验动物的高血压前期就已经出现了某些血液动力学、代谢和体液异常。鉴于遗传因素在人类原发性高血压（EH）发病机制中所占的明显比例，本研究的目的是检验与血压正常家庭的后代相比，在有EH家族史的健康血压正常受试者中是否也能检测到一些代谢和体液偏差。因此，作者比较了20名高血压患者的儿子（SH）和20名血压正常患者的儿子（SN）的某些生化和体液参数。与SN相比，SH的收缩压显著更高（119±2.59＞111.0±2.04mmHg）。基础血糖水平较高的趋势（5.03±0.15＞4.70±0.41mmol/l）以及葡萄糖负荷后免疫反应性胰岛素浓度较高（81.4±9.54＞70.4±7.78μU/l）未达到统计学显著性。在SH中，肾上腺素、去甲肾上腺素和多巴胺的血浆浓度以及心房利钠因子（11.7±0.77＞8.4±0.40fmol/ml）和内皮素（18.2±1.70＞12.7±0.87fmol/ml）也显著更高。如预期的那样，75g葡萄糖负荷使两组的血糖水平、IRI和C肽升高，但意外地降低了内皮素浓度。至于其他生化参数（纤维蛋白原、钠、钾、尿素、肌酐、尿酸、胆固醇、高密度脂蛋白和低密度脂蛋白组分、三酰甘油），SH和SN之间未发现显著差异。左心室质量增加以及舒张期和收缩期左心室功能的某些差异在另一篇论文中进行了讨论。结果表明，在有EH家族史的年轻男性中，在高血压临床表现之前就已经存在某些血液动力学、代谢和体液偏差，这可能有助于EH及其器官并发症的后期发展。
