RELATIONSHIP OF ARTERIAL COMPLIANCE TO BAROREFLEX FUNCTION IN HYPERTENSIVE PATIENTS
RELATIONSHIP OF ARTERIAL COMPLIANCE TO BAROREFLEX FUNCTION IN HYPERTENSIVE PATIENTS
复制标题
DOI：
10.1152/ajpheart.1993.265.1.h232
复制
发表时间：
1993-07-01
影响因子：
--
通讯作者：
CREAGER, MA
中科院分区：
文献类型：
--
作者：
LAGE, SG;POLAK, JF;CREAGER, MA
本研究的目的是确定高血压患者颈动脉顺应性是否降低，并评估动脉顺应性降低是否与动脉压力反射功能异常有关。因此，同时测量颈动脉直径（通过计算机化高分辨率b超）和血压，以确定23例正常血压和16例年龄匹配的高血压患者的颈动脉顺应性。此外，通过测量心率对输注硝普赛和苯肾上腺素引起的血压变化的反应，评估了12例正常人和9例高血压患者的动脉压力反射功能。与血压正常者相比，高血压患者的依从性降低（5.9 +/- 0.7 vs. 16.6 +/- 1.8 10(-7) m2/kPa，平均+/- SE， P < 0.001）。高血压组R-R间期变化与收缩压变化相关的压反射斜率小于正常组（12.3 +/- 2 vs. 18.9 +/- 2 ms/mmHg, P < 0.05）。因此，当考虑正常血压和高血压受试者时，气压反射斜率与依从性之间存在显著相关性（r = 0.53, P < 0.05）。然而，单独分析时，在正常血压组（r = 0.04, P = NS）和高血压组（r = 0.43, P = NS）中，气压反射斜率与依从性均无相关性。年龄与依从性有显著相关性（r = -0.48, P < 0.01），而与气压反射功能无显著相关性。由此可见，高血压患者颈动脉顺应性异常，动脉压力反射性心率调节减弱。虽然这两种异常都发生在高血压患者中，但相关性较差表明动脉顺应性降低并不是导致这些患者血压反射功能障碍的唯一原因。
The objectives of this study were to determine whether carotid arterial compliance is reduced in patients with hypertension and to assess whether reduced arterial compliance is related to abnormal arterial baroreflex function. Accordingly, concurrent measurements of carotid arterial diameter (via computerized high resolution B-mode ultrasonography) and blood pressure were made to determine carotid arterial compliance in 23 normotensive and 16 age-matched hypertensive patients. In addition, arterial baroreflex function was assessed in 12 of the normal subjects and nine of the hypertensive patients by measuring the heart rate response to changes in blood pressure induced by infusions of nitroprusside and phenylephrine. Compared with the normotensive subjects, the patients with hypertension had reduced compliance (5.9 +/- 0.7 vs. 16.6 +/- 1.8 10(-7) m2/kPa, mean +/- SE, P < 0.001). The baroreflex slope relating the change in R-R interval to the change in systolic blood pressure during the drug infusions was less in the hypertensive than normotensive subjects (12.3 +/- 2 vs. 18.9 +/- 2 ms/mmHg, P < 0.05). Consequently, when both normotensive and hypertensive subjects were considered, there was a significant correlation between the baroreflex slope and compliance (r = 0.53, P < 0.05). However, there was no correlation between the baroreflex slope and compliance within either the normotensive group (r = 0.04, P = NS) or the hypertensive group (r = 0.43, P = NS) when analyzed separately. There was a significant correlation between age and compliance (r = -0.48, P < 0.01) but not between age and baroreflex function. It is concluded that in patients with hypertension, carotid arterial compliance is abnormal and arterial baroreflex regulation of heart rate is attenuated. Although these abnormalities both occur in patients with hypertension, the poor correlation suggests that reduced arterial compliance is not solely responsible for baroreflex dysfunction in these individuals.