Neural and humoral mechanisms involved in blood pressure variability.
Neural and humoral mechanisms involved in blood pressure variability.
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DOI：
10.1097/00004872-198404000-00013
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发表时间：
1984-04-01
影响因子：
4.9
通讯作者：
Sleight, P
中科院分区：
文献类型：
--
作者：
Conway, J;Boon, N;Sleight, P
为了研究血压变异性，我们测定了20例临界性高血压患者睡眠和清醒过程中的血压、心率、血浆去甲肾上腺素和肾上腺素浓度以及血浆肾素活性。对一些标准化测试的反应也进行了测量。这些包括阅读、心算、改变姿势、体育锻炼以及对静脉注射苯肾上腺素和去甲肾上腺素的反应。压力感受性反射对心率控制的敏感性也是由注射苯肾上腺素后心率周期(R-R间期)与收缩压变化之间的关系确定的。24小时内连续记录血压。从睡眠期间达到的最低水平开始，血压随着受试者恢复意识而上升，但直到阅读也恢复了精神活动，血压才恢复到基线水平。通过心算，血压进一步升高。伴随这些变化的是血浆肾上腺素浓度比血浆去甲肾上腺素浓度有更大的比例上升。血浆肾素活性变化不大。对苯肾上腺素和去甲肾上腺素的升压反应与压力感受器敏感性呈负相关。睡眠时血压的下降和心算时血压的上升也与反射的敏感度呈负相关。在每个受试者中，全天记录的收缩压与R-R间期呈负相关。这种关系的斜率和R-R间期的范围在压力反射最敏感的受试者中最大。
In order to study blood pressure variability we have measured blood pressure, heart rate, plasma noradrenaline and adrenaline concentration and plasma renin activity during sleep and during the waking process in 20 subjects with borderline hypertension. The responses to a number of standardized tests were also measured. These were reading, mental arithmetic, change in posture, physical exercise and the response to intravenously injected phenylephrine and noradrenaline. The sensitivity of the baroreflex for heart rate control was also determined from the relationship between heart period (R-R interval) and change in systolic pressure after the injection of phenylephrine. Blood pressure was also recorded continuously for 24 hours. From the lowest levels achieved during sleep, blood pressure rose as the subjects regained consciousness but was not restored to its baseline value until mental activity was also restored by reading. Blood pressure rose further with mental arithmetic. These changes were accompanied by a greater proportional rise in plasma adrenaline than in plasma noradrenaline concentrations. Plasma renin activity changed little. The pressor responses to phenylephrine and noradrenaline were inversely related to baroreceptor sensitivity. The fall in blood pressure with sleep and the rise with mental arithmetic was also inversely related to the sensitivity of the reflex. Systolic pressure recorded throughout the day was inversely related to the R-R interval in each subject. The slope of this relationship and range of R-R interval was greatest in the subjects with the most sensitive baroreflexes.