Arterial baroreceptors in the management of systemic hypertension.
Arterial baroreceptors in the management of systemic hypertension.
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发表时间：
2010
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通讯作者：
P. Kougias;Sarah M. Weakley;Q. Yao;P. Lin;Changyi J. Chen
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作者：
P. Kougias;Sarah M. Weakley;Q. Yao;P. Lin;Changyi J. Chen
高血压是一种与显着发病率相关的多因素疾病。交感神经系统活动的增加已被认为是一个重要的病因，并且部分地受到动脉和心肺压力感受器产生的传入输入的调节，其激活会导致交感神经输出的抑制。多年来，人们一直认为压力感受器仅控制短期血压变化，这一结论源于对窦主动脉去神经支配（SAD）动物模型的观察以及动物模型中也出现的压力感受器快速重置现象。然而，最新的观察表明，SAD 相当不完善，并且重置很少是完整的。最近的研究表明，压力感受器可以更长期地控制交感神经输出，并参与肾脏的液体容量调节，因此有可能长期调节血压。重要的是，这些发现与人类的研究和观察一致。与此同时，颈动脉窦电刺激模型已经开发出来，并在动物身上进行了成功测试。在这些令人鼓舞的结果之后，评估颈动脉窦电操作在治疗全身性高血压中的临床应用的人体试验已经开始，迄今为止的结果表明，这代表了临床医生对抗慢性动脉高血压的一种令人兴奋的潜在工具。
Hypertension is a multifactorial disease associated with significant morbidity. Increased sympathetic nervous system activity has been noted as an important etiologic factor and is, in part, regulated by afferent input arising from arterial and cardiopulmonary baroreceptors, activation of which causes inhibition of sympathetic output. It was thought for many years that baroreceptors control only short-term blood pressure changes, a conclusion stemming from observations in sinoaortic denervation (SAD) animal models and the phenomenon of rapid baroreceptor resetting, also seen in animal models. Newer observations, however, indicate that SAD is rather imperfect and resetting is rarely complete. Recent studies reveal that baroreceptors control sympathetic output on a more long-term basis and participate in fluid volume regulation by the kidney, and thus have the potential to adjust blood pressure chronically. Importantly, these findings are consistent with studies and observations in humans. Meanwhile, a model of electrical stimulation of the carotid sinus has been developed and successfully tested in animals. Following these encouraging results human trials to evaluate the clinical application of electrical carotid sinus manipulation in the treatment of systemic hypertension have commenced, and results so far indicate that this represents an exciting potential tool in the clinician's armament against chronic arterial hypertension.