Relationship between central sympathetic activity and stages of human hypertension
Relationship between central sympathetic activity and stages of human hypertension
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DOI：
10.1016/j.amjhyper.2003.10.010
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发表时间：
2004-03-01
影响因子：
3.2
通讯作者：
Mary, DASG
中科院分区：
文献类型：
--
作者：
Smith, PA;Graham, LN;Mary, DASG
背景：原发性高血压（EHT）患者交感神经功能亢进的程度因其严重程度和并发症而异。有没有数据的交感神经活动在临界（BHT）或白大衣高血压（WHT）相对于EHT的各个阶段，尽管建议都导致建立EHT和器官损伤通过交感神经机制。我们计划确定BHT和WHT患者与正常和持续EHT的各个阶段相关的交感神经活动的幅度。方法：我们检查了90名未经治疗的受试者，包括BHT（n = 13），WHT（n = 12），预防，检测，评估联合国家委员会第六次报告，和高血压EHT第1阶段的治疗（EHT-1 n = 12），EHT 2和3期（EHT-2/3 n = 14），高-正常压力正常血压组（NT组）13例，EHT合并左室肥厚组（EHT+LVH组）12例。我们将肌肉交感神经活动量化为多单位放电（MSNA）和单单位放电（s-MSNA）的平均频率。我们发现了一个更大的BHT中的平均中枢交感神经频率（至少P < .01）（75 +/- 5.8次脉冲/100次搏动），EHT-1（76 +/- 4.0冲动/100次搏动）和EHT+LVH（79 +/- 4.3次脉冲/100次搏动）比EHT-2/3（57 +/- 3.1脉冲/100次搏动）、WHT（52 +/- 3.6脉冲/100次搏动）、HN（42 +/- 3.9脉冲/100次搏动）和NT（33 +/- 3.6脉冲/100次搏动）。BHT活动过度接近EHT，而WHT更接近NT。结论：中枢交感神经活动是最大的BHT，早期阶段，复杂的EHT，因此可能发挥不可分割的作用，在高血压及其并发症的发展。交感神经功能亢进发生在WHT中，但程度低于BHT。(C)2004年美国高血压杂志有限公司
Background: The magnitude of sympathetic hyperactivity in essential hypertension (EHT) varies with its severity and complications. There are no data on sympathetic nerve activity in borderline (BHT) or white-coat hypertension (WHT) relative to the various stages of EHT, despite suggestions that both lead to established EHT and organ damage through sympathetic mechanisms. We planned to determine the magnitude of sympathetic nerve activity in patients with BHT and WHT in relation to normality and various stages of sustained EHT.Methods: We examined 90 untreated subjects comprising matched groups with BHT (n = 13), WHT (n = 12), Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure EHT stage 1 (EHT-1 n = 12), EHT stages 2 and 3 (EHT-2/3 n = 14), high-normal pressure (HN n = 14), and normal pressure (NT n = 13), as well as a group with EHT complicated by left ventricular hypertrophy (EHT+LVH n = 12). We quantified muscle sympathetic nerve activity as the mean frequency of multiunit discharge (MSNA) and that of single-units (s-MSNA).Results: We found a greater (at least P < .01) mean central sympathetic frequency in BHT (75 +/- 5.8 impulses/100 beats), EHT-1 (76 +/- 4.0 impulses/100 beats), and EHT+LVH (79 +/- 4.3 impulses/100 beats) than in EHT-2/3 (57 +/- 3.1 impulses/100 beats), WHT (52 +/- 3.6 impulses/100 beats), HN (42 +/- 3.9 impulses/100 beats), and NT (33 +/- 3.6 impulses/100 beats). BHT hyperactivity was closer to that of EHT, whereas WHT was closer to NT.Conclusions: Central sympathetic activity was greatest in BHT, early stage, and complicated EHT, and as such is likely to play an integral role in the development of hypertension and its complications. Sympathetic hyperactivity occurs in WHT, but to a lesser extent than in BHT. (C) 2004 American Journal of Hypertension, Ltd.