POTENTIATION OF SYMPATHETIC-NERVE RESPONSES TO HYPOXIA IN BORDERLINE HYPERTENSIVE SUBJECTS
POTENTIATION OF SYMPATHETIC-NERVE RESPONSES TO HYPOXIA IN BORDERLINE HYPERTENSIVE SUBJECTS
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DOI：
10.1161/01.hyp.11.6.608
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发表时间：
1988-06-01
期刊：
影响因子：
8.3
通讯作者：
ABBOUD, FM
中科院分区：
文献类型：
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作者：
SOMERS, VK;MARK, AL;ABBOUD, FM
我们测试了交感神经对缺氧刺激化学感受器的反应在边缘性高血压患者中被夸大的假设。我们比较了8名边缘性高血压患者和8名年龄、性别、体重和身高匹配且无高血压家族史的正常对照患者对等氧缺氧的反应。在缺氧前和缺氧时测量心率、平均血压、分钟通气量和肌肉交感神经活动。我们还测量了缺氧期间自愿呼吸暂停一段时间的反应。两组因缺氧引起的心率、血压和通气量的增加无显著差异。而缺氧时高血压组交感神经活动增加40.6 +/- 13.6%（平均+/- SE），高于对照组20.4 +/- 5.0% （p < 0.05）。在6名高血压患者和6名对照组中，在缺氧时进行呼吸暂停时，高血压患者交感神经活动增加了605.0 +/- 294.3%，而对照组仅增加了52.8 +/- 17.3% （p < 0.001）。我们的结论是，化学感受器反射在边缘性高血压患者中增强，并导致缺氧时交感神经活动的过度增加。当呼吸和胸部传入活动的抑制影响被呼吸暂停消除时，这种增强的化学受体反射尤为明显。这种夸张的反应可能导致边缘性高血压患者交感神经活动过度，并导致高血压患者睡眠呼吸暂停的不良后果。
We tested the hypothesis that sympathetic nerve responses to stimulation of chemoreceptors by hypoxia are exaggerated in borderline hypertensive humans. We compared responses to isocapnic hypoxia in eight borderline hypertensive subjects and eight normotensive control subjects matched for age, sex, weight, and height without a family history of hypertension. Measurements of heart rate, mean blood pressure, minute ventilation, and sympathetic nerve activity to muscle were made before and during hypoxia. We also measured responses to a period of voluntary apnea during hypoxia. There were no significant differences between the increases in heart rate, blood pressure, and ventilation in response to hypoxia in the two groups. However, during hypoxia sympathetic activity in the hypertensive subjects increased by 40.6 +/- 13.6% (mean +/- SE), greater than the increase of 20.4 +/- 5.0% in the control subjects (p less than 0.05). In six hypertensive and six control subjects, when apnea was performed during hypoxia, sympathetic activity increased by 605.0 +/- 294.3% in the hypertensive subjects and by only 52.8 +/- 17.3% in the control subjects (p less than 0.001). We conclude that the chemoreceptor reflex is enhanced in borderline hypertensive subjects and results in exaggerated increases in sympathetic nerve activity during hypoxia. This enhanced chemoreceptor reflex is especially obvious when the inhibitory influence of breathing and thoracic afferent activity is eliminated by apnea. This exaggerated response may contribute to excess sympathetic activity in borderline hypertensive subjects and to adverse consequences of sleep apnea in hypertensive subjects.