Laitinen T, Hartikainen J, Vanninen E, Niskanen L, Geelen G, Länsimies E
Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Finland.
J Appl Physiol (1985). 1998 Feb;84(2):576-83. doi: 10.1152/jappl.1998.84.2.576.
We evaluated the correlates of baroreflex sensitivity (BRS) in healthy subjects. The study consisted of 117 healthy, normal-weight, nonsmoking male and female subjects aged 23-77 yr. Baroreflex control of heart rate was measured by using the phenylephrine bolus-injection technique. Frequency- and time-domain analysis of heart rate variability and an exercise test were performed. Plasma norepinephrine, epinephrine, insulin, and arginine vasopressin concentrations and plasma renin activity were measured. In the univariate analysis, BRS correlated with age (r = -0.65, P < 0.001), diastolic blood pressure (r = -0.47, P < 0.001), exercise capacity (r = 0.60, P < 0.001), and the high-frequency component of heart rate variability (r = 0.64, P < 0.001). There was also a significant correlation between BRS and plasma norepinephrine concentration (r = -0.22, P < 0.05) and plasma renin activity (r = 0.32, P < 0.001). According to the multivariate analysis, age and gender were the most important physiological correlates of BRS. They accounted for 52% of interindividual BRS variation. In addition, diastolic blood pressure and high-frequency component of heart rate variability were significant independent correlates of BRS. BRS was significantly higher in men than in women (15.0 +/- 1.2 vs. 10.2 +/- 1.1 ms/mmHg, respectively; P < 0.01). Twenty-four percent of women > 40 yr old and 18% of men > 60 yr old had markedly depressed BRS (< 3 ms/mmHg). We conclude that physiological factors, particularly age and gender, have significant impact on BRS in healthy subjects. In addition, we demonstrate that BRS values that have been proposed to be useful in identifying postinfarction patients at high risk of sudden death are frequently found in healthy subjects.
我们评估了健康受试者压力反射敏感性（BRS）的相关因素。该研究纳入了117名年龄在23 - 77岁之间的健康、体重正常、不吸烟的男性和女性受试者。采用苯肾上腺素推注技术测量心率的压力反射控制。进行了心率变异性的频域和时域分析以及运动试验。测量了血浆去甲肾上腺素、肾上腺素、胰岛素和精氨酸加压素浓度以及血浆肾素活性。单因素分析中，BRS与年龄（r = -0.65，P < 0.001）、舒张压（r = -0.47，P < 0.001）、运动能力（r = 0.60，P < 0.001）以及心率变异性的高频成分（r = 0.64，P < 0.001）相关。BRS与血浆去甲肾上腺素浓度（r = -0.22，P < 0.05）和血浆肾素活性（r = 0.32，P < 0.001）之间也存在显著相关性。多因素分析显示，年龄和性别是BRS最重要的生理相关因素。它们占个体间BRS变异的52%。此外，舒张压和心率变异性的高频成分是BRS的显著独立相关因素。男性的BRS显著高于女性（分别为15.0±1.2与10.2±1.1 ms/mmHg；P < 0.01）。40岁以上女性的24%和60岁以上男性的18%有明显降低的BRS（< 3 ms/mmHg）。我们得出结论，生理因素，尤其是年龄和性别，对健康受试者的BRS有显著影响。此外，我们证明在健康受试者中经常能发现被认为有助于识别心肌梗死后猝死高危患者的BRS值。
