The role of the autonomic nervous system in hypertension.
The role of the autonomic nervous system in hypertension.
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DOI：
10.1291/hypres.18.99
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发表时间：
1995-06-01
期刊：
影响因子：
--
通讯作者：
Julius, S
中科院分区：
文献类型：
--
作者：
Amerena, J;Julius, S
随着时间的推移，自主神经系统在高血压的发生和维持中的作用越来越清楚。早期的研究表明，高血压时血管阻力的增加并不依赖于过度的自主神经张力，因此推测自主神经系统与高血压关系不大。最近的研究表明，高动力临界性高血压的初始血流动力学异常是“正常”血管阻力，心脏输出和心率升高，与中枢起源的交感神经张力增加和副交感神经张力降低的标志物相关。随着时间的推移，存在向高外周阻力和正常心输出量血流动力学状态的转变，这是由于外周阻力血管和心脏中的适应性结构变化的发展。高血压患者的自主神经功能异常以及随后的血管和心脏变化可能解释了高血压与冠心病危险因素之间的某些联系。高血压中发现的自主神经失衡可能不是偶然发生的，我们假设这是由于负责更明显防御反应的基因的遗传造成的，这在早期可能赋予了生存优势，但现在允许负面影响这种特征变得明显。
The role of the autonomic nervous system in the genesis and maintenance of hypertension is becoming clearer with time. Early research suggested that increased vascular resistance in hypertension was not dependent on excess autonomic tone and thus it was presumed that the autonomic nervous system had little to do with hypertension. More recent studies have demonstrated that the initial hemodynamic abnormality in hyperkinetic borderline hypertension is "normal" vascular resistance, with an elevated cardiac optput and heart rate, associated with markers of increased sympathetic and decreased parasympathetic tone of central origin. Over time there is a transition to the high peripheral resistance and normal cardiac output hemodynamic state characteristic of established hypertension, which is due to the development of adaptive structural changes in the peripheral resistance vessels and heart. The autonomic abnormality in hypertension and subsequent vascular and cardiac changes may explain some of association between hypertension and risk factors for coronary heart disease. The autonomic imbalance found in hypertension may not be a chance occurrence and we postulate that it is due to the inheritance of the genes responsible for a more pronounced defense reaction, which in earlier times may have conferred a survival advantage but now permit the negative impact of this trait to become evident.