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高血压患者后代中交感肾上腺活动增强及行为诱发的心血管反应性缺失。

Absence of enhanced sympathoadrenal activity and behaviorally evoked cardiovascular reactivity among offspring of hypertensives.

作者信息

Manuck S B, Polefrone J M, Terrell D F, Muldoon M F, Kasprowicz A L, Waldstein S R, Jennings R J, Malkoff S B, Marsland A, Graham R E

机构信息

Department of Psychology, University of Pittsburgh, PA 15260, USA.

出版信息

Am J Hypertens. 1996 Mar;9(3):248-55. doi: 10.1016/0895-7061(95)00303-7.

Abstract

To determine whether offspring of hypertensives show enhanced sympathetic nervous system activity, we evaluated several indices of sympathoadrenal activation and cardiovascular responsiveness to behavioral stimuli among 90 normotensive, young adult men having either one or two hypertensive parents (PH+(-), PH++) or normotensive parents only (PH--) (n = 30/group). Measurements included heart rate (HR) and blood pressure (BP) reactions to three mental stressors (the Stroop test, mental arithmetic, mirror tracing), a cold pressor test, postural adjustment (60 degrees upright tilt), isometric exercise and bicycle ergometry, as well as the 24-h excretion of catecholamines (epinephrine [E], norepinephrine [NE]) and venous plasma catecholamine concentrations, both at rest (seated and supine) and in response to the Stroop test and upright tilt. The three groups did not differ in age, education, body mass index (BMI), estimated aerobic fitness, resting HR, cardiac preejection period (PEP) and PEP:LVET (left ventricular ejection time) ratio, 24-h Na or K excretion, or fasting lipids, insulin or plasma renin activity. Resting systolic and diastolic BP varied as a function of parental hypertension, and were significantly higher in PH++ than among PH-- subjects (P < .05). No significant group difference was observed on any measure of plasma or urinary catecholamines, nor did offspring of hypertensives (PH++ or PH+-) showed greater HR or BP reactions than PH-- subjects to any of the several laboratory challenges. In sum, we find no evidence of enhanced sympathetic activity or heightened cardiovascular responsiveness among normotensive young adults who are familially predisposed to essential hypertension.

摘要

为了确定高血压患者的后代是否表现出增强的交感神经系统活动,我们评估了90名血压正常的年轻成年男性的交感肾上腺激活和心血管对行为刺激反应性的几个指标,这些男性有一位或两位高血压父母(PH+(-)、PH++)或仅有血压正常的父母(PH--)(每组n = 30)。测量包括对三种精神应激源(斯特鲁普测验、心算、镜像追踪)、冷加压试验、姿势调整(60度直立倾斜)、等长运动和自行车测力计运动的心率(HR)和血压(BP)反应,以及静息状态(坐着和仰卧)和对斯特鲁普测验及直立倾斜反应时儿茶酚胺(肾上腺素[E]、去甲肾上腺素[NE])的24小时排泄量和静脉血浆儿茶酚胺浓度。三组在年龄、教育程度、体重指数(BMI)、估计的有氧适能、静息心率、心脏射血前期(PEP)和PEP:LVET(左心室射血时间)比值、24小时钠或钾排泄量、或空腹血脂、胰岛素或血浆肾素活性方面没有差异。静息收缩压和舒张压随父母高血压情况而变化,PH++组显著高于PH--组(P < .05)。在血浆或尿儿茶酚胺的任何测量指标上均未观察到显著的组间差异,高血压患者的后代(PH++或PH+-)在应对几种实验室刺激时,其心率或血压反应也不比PH--组更大。总之,我们没有发现有原发性高血压家族倾向的血压正常的年轻成年人存在交感神经活动增强或心血管反应性增强的证据。

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