Structural changes in resistance and capacitance vessels in borderline hypertension.
Structural changes in resistance and capacitance vessels in borderline hypertension.
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临界高血压中阻力和电容血管的结构变化。
DOI：
10.1161/01.hyp.6.6_pt_2.iii69
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Mark,AL
中科院分区：
文献类型：
--
作者：
Mark,AL
在患有交界性或轻度高血压的人中，静息血管阻力可能是正常的。然而，这一发现是一种表面现象，它可以掩盖血管结构变化的存在，这些变化可能对循环的阻力和电容功能产生重要影响。本文综述了有关交界性高血压血管结构改变的几项研究。首先，BHT患者和有高血压家族史的血压正常的年轻男性的前臂血管扩张能力有限；这表明前臂阻力血管存在结构变化。第二，BHT患者前臂静脉扩张性降低。这种下降大部分是由非肾上腺素能机制引起的--这表明BHT患者的静脉可能存在结构变化。第三，Takeshita及其同事的研究表明，钠的摄入可能会影响血管结构的变化。在对盐负荷有反应的高血压患者中，血压和血管阻力增加，盐负荷限制了血管扩张剂对缺血10分钟的反应。盐负荷对血管扩张剂反应的这种影响在一些患者(盐应答者)中发生，但在另一些患者(盐无应答者)中没有。功能研究支持这一概念，即阻力和电容血管的结构变化发生在人类高血压的早期阶段。这些变化可能不完全是对动脉压升高的适应性反应，因为它们既发生在电容血管中，也发生在阻力血管中。此外，结构的变化似乎对钠摄入量等因素做出了反应。这些观察表明，人类高血压的血管结构变化可能部分与神经体液影响或与原发血管异常有关。
Vascular resistance at rest may be normal in humans with borderline or mild hypertension. However, this finding is a facade which can obscure the presence of vascular structural alterations that may have an important influence on resistance and capacitance functions of the circulation. This paper reviews several studies regarding vascular structural changes in borderline hypertension (BHT). First, forearm vasodilator capacity is limited in BHT and in normotensive young men with a family history of hypertension; this suggests the presence of structural changes in forearm resistance vessels. Second, forearm venous distensibility is decreased in BHT. Most of this decrease is caused by nonadrenergic mechanisms--which suggests that there may be structural changes in veins in BHT. Third, the studies of Takeshita and colleagues suggest that sodium intake may influence vascular structural changes. In hypertensive patients who responded to salt loading with increased blood pressure and vascular resistance, salt loading limited vasodilator responses to 10 minutes of ischemia. This effect of salt loading on vasodilator responses occurred in some patients (salt-responders), but not in others (salt-nonresponders). Functional studies support the concept that structural changes in resistance and capacitance vessels occur during the early stages of human hypertension. These changes may not be entirely adaptive responses to elevated arterial pressure, since they occur in capacitance as well as resistance vessels. In addition, the structural changes appear to be responsive to factors such as sodium intake. These observations suggest that vascular structural changes in human hypertension may be related in part to neurohumoral influences or to primary vascular abnormalities.