Jensen L W, Bagger J P, Pedersen E B
Research Laboratory for Nephrology and Hypertension, Skejby Hospital, Aarhus, Denmark.
Blood Press. 1996 Sep;5(5):292-9. doi: 10.3109/08037059609078062.
The aim of this study was to assess the blood pressure profile and vasoactive hormones in valvular aortic disease. Thirteen aortic stenosis and/or aortic regurgitation patients were matched with 13 control subjects. Ambulatory blood pressure monitoring was performed for 24 h. Arterial and venous plasma concentrations of renin, angiotensin II, aldosterone, arginine vasopressin, atrial natriuretic peptide, immunoreactive endothelin and cyclic-GMP were measured. The mean 24-h blood pressure was higher in the patient group (94.9 mmHg) compared with control subjects (88.2 mmHg) (p < 0.0001), despite no differences in daytime blood pressures. The nocturnal blood pressure fall was attenuated in the patients (systolic/diastolic blood pressure -8.5/-3.5; -20.3/-14.3 mmHg (p < 0.001/p < 0.01)); in heart rate too the nightly fall was blunted in the patients (-4.8/ -13.4/min (p < 0.0013)). PRA, Ang II, AVP, ANP, ir-ET and cGMP were significantly increased in the patients compared to the controls. Nightly systolic blood pressure fall was inversely related to arterial (r = -0.75, p < 0.003) and venous (r = -0.65, p < 0.04) plasma renin activity and arterial aldosterone (r = -0.64, p < 0.05) in valvular aortic disease patients. In conclusion, valvular aortic disease patients have attenuated falls in blood pressure and heart rate during the night. Increased activity in the renin aldosterone system may be involved in this abnormal blood pressure regulation.
本研究的目的是评估瓣膜性主动脉疾病患者的血压状况和血管活性激素水平。13例主动脉瓣狭窄和/或主动脉瓣关闭不全患者与13名对照者进行匹配。进行24小时动态血压监测。测量动脉和静脉血浆中的肾素、血管紧张素II、醛固酮、精氨酸加压素、心房利钠肽、免疫反应性内皮素和环磷酸鸟苷的浓度。尽管白天血压无差异，但患者组的24小时平均血压（94.9 mmHg）高于对照组（88.2 mmHg）（p < 0.0001）。患者夜间血压下降减弱（收缩压/舒张压-8.5/-3.5；-20.3/-14.3 mmHg（p < 0.001/p < 0.01））；心率方面，患者夜间下降也变钝（-4.8/-13.4/分钟（p < 0.0013））。与对照组相比，患者的血浆肾素活性、血管紧张素II、精氨酸加压素、心房利钠肽、免疫反应性内皮素和环磷酸鸟苷显著升高。在瓣膜性主动脉疾病患者中，夜间收缩压下降与动脉（r = -0.75，p < 0.003）和静脉（r = -0.65，p < 0.04）血浆肾素活性以及动脉醛固酮（r = -0.64，p < 0.05）呈负相关。总之，瓣膜性主动脉疾病患者夜间血压和心率下降减弱。肾素 - 醛固酮系统活性增加可能参与了这种异常的血压调节。
