Relationship between sympathetic baroreflex sensitivity and arterial stiffness in elderly men and women.
Relationship between sympathetic baroreflex sensitivity and arterial stiffness in elderly men and women.
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DOI：
10.1161/hypertensionaha.111.176560
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发表时间：
2012-01
期刊：
影响因子：
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通讯作者：
Fu Q
中科院分区：
文献类型：
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作者：
Okada Y;Galbreath MM;Shibata S;Jarvis SS;VanGundy TB;Meier RL;Vongpatanasin W;Levine BD;Fu Q
先前的人类研究表明，大动脉僵硬度会导致与年龄相关的心血管压力感受性反射敏感性下降。交感压力反射敏感性是否也是如此尚不清楚。我们测试了这样的假设：交感压力反射敏感性与老年人压力感受器节段（颈动脉和主动脉）的僵硬有关，并且性别影响这种关系。通过 30 名男性 [69±1（平均值±SEM）岁]和 31 名女性（68±1 岁）仰卧休息期间每次心跳舒张压和相应肌肉交感神经活动（显微神经造影）的自发变化来评估交感压力反射敏感性。还测定了颈动脉硬度（B 型超声检查）和主动脉硬度（磁共振成像）。我们发现老年女性的交感压力感受性反射敏感性低于老年男性（–2.33±0.25 vs. –3.32±0.25 爆发·100 次–1·mmHg–1；P=0.007）。老年女性的颈动脉和主动脉β硬度指数高于男性（6.68±0.48 vs. 5.10±0.50和4.03±0.47 vs. 2.68±0.42；均P<0.050）。男性和女性的交感压力反射敏感性与颈动脉僵硬度呈负相关（r=0.49 和 0.50，均 P<0.05），而女性中这种关系平行向上移动（朝向敏感性降低），斜率没有变化（0.26 vs. 0.24 a.u.）。交感压力反射敏感性和主动脉僵硬度显示出相似的趋势。因此，压力感觉动脉僵硬度似乎是老年男性和女性交感压力反射敏感性的独立决定因素之一。老年女性交感压力感受性反射敏感性较低，可能会增加她们患高血压的风险。
Previous human studies have shown that large-artery stiffness contributes to an age-related decrease in cardiovagal baroreflex sensitivity. Whether this is also true with sympathetic baroreflex sensitivity is unknown. We tested the hypothesis that sympathetic baroreflex sensitivity is associated with the stiffness of baroreceptor segments (the carotid artery and the aorta) in elderly individuals, and that sex affects this relationship. Sympathetic baroreflex sensitivity was assessed from the spontaneous changes in beat-by-beat diastolic pressure and corresponding muscle sympathetic nerve activity (microneurography) during supine rest in 30 men [69±1 (mean±SEM) years] and 31 women (68±1 years). Carotid artery stiffness (B-mode ultrasonography) and aortic stiffness (magnetic resonance imaging) were also determined. We found that elderly women had lower sympathetic baroreflex sensitivity than elderly men (–2.33±0.25 vs. –3.32±0.25 bursts·100 beats–1·mmHg–1; P=0.007). β-stiffness indices of the carotid artery and the aorta were greater in elderly women than in men (6.68±0.48 vs. 5.10±0.50 and 4.03±0.47 vs. 2.68±0.42; both P<0.050). Sympathetic baroreflex sensitivity was inversely correlated with carotid artery stiffness in both men and women (r=0.49 and 0.50, both P<0.05), while this relation was shifted in parallel upward (towards a reduced sensitivity) in women with no changes in the slope (0.26 vs. 0.24 a.u.). Sympathetic baroreflex sensitivity and aortic stiffness showed similar trends. Thus, barosensory artery stiffness seems to be one independent determinant of sympathetic baroreflex sensitivity in elderly men and women. The lower sympathetic baroreflex sensitivity in elderly women may predispose them to an increased prevalence of hypertension.