Hausberg M, Sinkey C A, Mark A L, Hoffman R P, Anderson E A
Department of Internal Medicine, Cardiovascular, Research Center, University of Iowa College of Medicine, Veterans Affairs Medical Center, Iowa City, USA.
Am J Hypertens. 1998 Nov;11(11 Pt 1):1312-20. doi: 10.1016/s0895-7061(98)00146-0.
Insulin resistance and elevated sympathetic nerve activity (SNA) are observed in young borderline hypertensive humans. A positive family history of hypertension (FH) is a strong risk factor for developing hypertension. To assess whether insulin resistance and increased sympathetic tone precede the onset of hypertension, we studied 17 young adults with and 17 without a documented family history of hypertension. Subjects were matched for age (33+/-0.4 years in FH positive and 32+/-0.5 years in FH negative; mean+/-SE) and body mass index (BMI, 25+/-1 kg/m2 in both FH positive and FH negative subjects). We measured blood pressure (BP), heart rate (HR), muscle sympathetic nerve activity (MSNA, microneurography), forearm blood flow, and insulin sensitivity (total glucose uptake determined by an euglycemic/hyperinsulinemic clamp using stable isotope tracer infusion), and calculated forearm vascular resistance (FVR). Mean BP and HR were similar in both groups (86+/-3 mm Hg and 61+/-2 beats/min, and 85+/-2 mm Hg and 62 +/-2 beats/min, respectively, in FH positive and negative respectively, P = ns). Baseline MSNA (24 +/-3 bursts/min in FH positive v 20+/-3 bursts/min in FH negative, P = ns) and total glucose uptake [0.104+/-0.014 mg/(kg x min x microU insulin/mL) in FH positive v 0.095+/-0.014 mg/(kg xmin x microU insulin/mL) in FH negative, P = ns] did not differ between the groups. Sympathetic and vascular responses to insulin were also similar in both groups. The increase in MSNA was 10+/-2 bursts/ min in FH positive and 10+/-1 bursts/min in FH negative, P = ns. Thus, age- and weight-matched offspring with and without a FH of hypertension did not vary in MSNA or insulin sensitivity. These findings suggest that in the absence of obesity and high arterial pressure, a FH of hypertension may not be accompanied by decreased insulin sensitivity or increased MSNA.
在年轻的临界高血压人群中观察到胰岛素抵抗和交感神经活动（SNA）增强。高血压家族史（FH）是发生高血压的一个重要危险因素。为了评估胰岛素抵抗和交感神经张力增加是否先于高血压的发生，我们研究了17名有高血压家族史记录的年轻成年人和17名无此记录的年轻成年人。受试者按年龄（FH阳性组为33±0.4岁，FH阴性组为32±0.5岁；均值±标准误）和体重指数（BMI，FH阳性组和FH阴性组均为25±1kg/m2）进行匹配。我们测量了血压（BP）、心率（HR）、肌肉交感神经活动（MSNA，微神经ography）、前臂血流量和胰岛素敏感性（通过使用稳定同位素示踪剂输注的正常血糖/高胰岛素钳夹法测定的总葡萄糖摄取量），并计算了前臂血管阻力（FVR）。两组的平均BP和HR相似（FH阳性组分别为86±3mmHg和61±2次/分钟，FH阴性组分别为85±2mmHg和62±2次/分钟，P = 无显著性差异）。基线MSNA（FH阳性组为24±3次/分钟，FH阴性组为20±3次/分钟，P = 无显著性差异）和总葡萄糖摄取量[FH阳性组为0.104±0.014mg/（kg×分钟×微单位胰岛素/毫升），FH阴性组为0.095±0.014mg/（kg×分钟×微单位胰岛素/毫升），P = 无显著性差异]在两组之间无差异。两组对胰岛素的交感神经和血管反应也相似。FH阳性组MSNA的增加为10±2次/分钟，FH阴性组为10±1次/分钟，P = 无显著性差异。因此，年龄和体重匹配的有和无高血压家族史的后代在MSNA或胰岛素敏感性方面没有差异。这些发现表明，在没有肥胖和高动脉压的情况下，高血压家族史可能不会伴有胰岛素敏感性降低或MSNA增加。
