Daniels S R, Kimball T R, Khoury P, Witt S, Morrison J A
Department of Pediatrics, University of Cincinnati, College of Medicine, Ohio, USA.
Hypertension. 1996 Jul;28(1):37-41. doi: 10.1161/01.hyp.28.1.37.
The purpose of this study was to investigate the association of sex, race, lean body mass, and fat mass with the hemodynamic determinants of blood pressure, including stroke volume, heart rate, and total peripheral vascular resistance. The study included 201 subjects aged 6 to 17 years, 105 of whom were male and 98 of whom were black. Lean body mass and fat mass were both significant (P < .05) independent determinants of stroke volume, cardiac output, and total peripheral vascular resistance. However, the direction of the effect of lean body mass was opposite for stroke volume and cardiac output compared with that of total peripheral vascular resistance. The direct relationship of lean body mass with systolic blood pressure (SBP) and diastolic blood pressure (DBP) (regression coefficients, 0.55 +/- 0.05 for SBP and 0.47 +/- 0.05 for DBP) indicates that the effect of lean body mass on cardiac output may predominate. Lean body mass explained substantially more of the variance of the hemodynamic variables than did fat mass. After control for the effects of body size, male subjects had higher heart rate and cardiac output, and female subjects had higher vascular resistance. White subjects had higher stroke volume and cardiac output, and black subjects had higher peripheral vascular resistance. This study demonstrates that lean body mass is a more important correlate of the hemodynamic determinants of blood pressure than is fat mass and that sex and race have significant independent relationships with the hemodynamic determinants of blood pressure in children and adolescents.
本研究的目的是调查性别、种族、瘦体重和脂肪量与血压的血流动力学决定因素之间的关联，这些因素包括每搏输出量、心率和总外周血管阻力。该研究纳入了201名6至17岁的受试者，其中105名男性，98名黑人。瘦体重和脂肪量都是每搏输出量、心输出量和总外周血管阻力的显著（P < .05）独立决定因素。然而，与总外周血管阻力相比，瘦体重对每搏输出量和心输出量的影响方向相反。瘦体重与收缩压（SBP）和舒张压（DBP）的直接关系（回归系数，SBP为0.55 +/- 0.05，DBP为0.47 +/- 0.05）表明，瘦体重对心输出量的影响可能占主导。瘦体重比脂肪量能解释更多血流动力学变量的方差。在控制了体型的影响后，男性受试者的心率和心输出量较高，女性受试者的血管阻力较高。白人受试者的每搏输出量和心输出量较高，黑人受试者的外周血管阻力较高。本研究表明，与脂肪量相比，瘦体重是血压血流动力学决定因素的更重要相关因素，并且性别和种族与儿童和青少年血压的血流动力学决定因素存在显著的独立关系。
