High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests.
High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests.
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DOI：
10.3109/08037051.2012.759689
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发表时间：
2013-06
期刊：
影响因子：
1.8
通讯作者：
Narkiewicz K
中科院分区：
文献类型：
--
作者：
Hering D;Kara T;Kucharska W;Somers VK;Narkiewicz K
正常高血压（BP）会增加心血管（CV）疾病的风险。这种风险增加的潜在机制尚不清楚。交感神经激活似乎是将正常高血压与CV疾病联系起来的潜在机制。本研究探讨了正常高血压与最佳血压相比是否与休息时和/或实验室应激时的交感神经兴奋有关。在静息和负荷试验中记录心率（HR）、血压和肌肉交感神经活动（MSNA）（持续的手握和精神压力）在18个科目（15名男性和3名女性）正常高血压（收缩压130至139 mm Hg，舒张压85至89 mm Hg，或两者）和12名年龄（两组均为34±3岁）和体重指数（两组均为25±2 kg/m2）匹配的最佳血压（<120/80 mm Hg）受试者（10名男性和2名女性）。尽管静息血压水平较高，但正常高血压组的MSNA高于最佳血压组（26±3 vs 18±2 bursts/min，P<0.05）。在持续握力期间，正常高血压组MSNA增加37±14%，而最佳血压组增加49±15%（P=0.55）。心理应激时的变化分别为50±28%和37± 12%（P=0.73）。正常高血压组和最佳血压组的收缩压对握力和精神应激的反应无显著差异。两组之间的基线HR和对负荷试验的变时性反应相当。与最佳血压相比，正常高血压与静息MSNA增加有关，但对应激试验的神经和循环反应正常。这些发现表明交感神经系统的紧张性激活可能先于显性动脉高压，并导致血压正常值高的受试者发生CV疾病的风险增加。
High-normal blood pressure (BP) increases the risk of cardiovascular (CV) disease. The mechanisms underlying this increased risk are not clear. Sympathetic activation appears to be a potential mechanism linking high-normal BP to CV disease. This study examined whether high-normal BP compared to optimal BP is linked to sympathoexcitation at rest and/or during laboratory stressors. Heart rate (HR), BP and muscle sympathetic nerve activity (MSNA) were obtained at rest and during stress tests (sustained hand grip and mental stress) in 18 subjects (15 males and 3 females) with high-normal BP (systolic BP of 130 to 139 mm Hg, diastolic BP of 85 to 89 mm Hg, or both) and in 12 subjects (10 males and 2 females) with optimal BP (<120/80 mm Hg) matched for age (34±3 years in both groups) and body mass index (25±2 kg/m2 in both groups). Despite the higher resting BP levels, MSNA was higher in subjects with high-normal BP than in the optimal BP group (26±3 vs 18±2 bursts/min, P<0.05). During sustained hand grip, MSNA increased by 37±14% in high-normal BP group compared with an increase of 49±15% in optimal BP group (P=0.55). Changes during mental stress were 50±28% and 37±12%, respectively (P=0.73). There were no significant differences in SBP responses to handgrip and mental stress between the high-normal and optimal BP groups. Baseline HR and chronotropic responses to stress tests were comparable between the two groups. In comparison to optimal BP, high-normal BP is associated with increased resting MSNA, but normal neural and circulatory responses to stress tests. These findings suggest that tonic activation of the sympathetic nervous system may precede overt arterial hypertensionand contribute to an excess risk of CV disease in subjects with high-normal BP.
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