正常压力个体的盐敏感性与改变的自主心脏调节有关:一项随机对照干预研究
Jetta J Oppelaar1,2, Thomas A Bouwmeester3,4, Anastasia A Silova1
1Section of Nephrology, Department of Internal Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands.
American journal of physiology. Renal physiology
|October 5, 2023
概括
健康个体的盐敏感性与系统血管阻力降低和心脏自主调节的改变有关,而不是细胞外液体的变化. 了解这些因素对于管理血压对的反应至关重要.
科学领域:
- 心血管生理学心血管生理学
- 自主神经系统功能 自主神经系统功能
- 处理的脏处理
背景情况:
- 血压 (BP) 对摄入的反应有所不同,区分盐敏感 (SS) 和耐盐 (SR) 个体,但潜在的病理生理学仍然不清楚.
- 盐敏感性有助于高血压,需要对正常压力个体的机制有更深入的了解.
研究的目的:
- 研究高摄入量对体液,血管度和自主心脏反应与健康的正常血压个体血压变化的影响.
- 为了确定区分盐敏感与盐耐药个体的因素,超越细胞外体积扩张.
主要方法:
- 一项随机交叉研究,涉及51名低和高饮食的正常压力个体.
- 非侵入性连续指纹血压监测,以评估心脏输出,全身血管阻力 (SVR),心率变化 (HRV) 和交叉相关性巴罗反射灵敏度 (xBRS).
- 细胞外体积 (ECV) 用iohexol测量参与者的一个子集.
主要成果:
- 对盐敏感的个体 (25%) 在高摄入量后,平均动脉压 (MAP) 显著增加,与较高的SVR相关.
- 在高摄入量后,SS和SR组之间没有观察到体重,心率或ECV的显著差异.
- 与SR参与者相比,SS参与者在低和高条件下显示出显著更高的xBRS和HRV,这表明自主调节发生了改变.
结论:
- 在正常压力个体中,盐敏感性与在高摄入量和改变自主心脏调节期间降低SVR的能力受损有关.
- 细胞外流体膨胀不是在稳定状态测量中对盐敏感性的歧视因素.
- 不充分的血管扩张和自主心脏功能的改变似乎在盐敏感血压升高的病理生理学中至关重要,这表明新的治疗点.
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