原发性单纯收缩期高血压患者自主神经活性及其昼夜节律

目的:探讨原发性单纯收缩期高血压患者自主神经活性及其昼夜节律变化.方法:对92例原发性单纯收缩期高血压患者进行24h及每小时心率变异时域分析,并与年龄匹配的对照组比较,同时比较高血压伴与不伴左心室肥厚者心率变异及其昼夜节律.结果:原发性单纯收缩期高血压患者时域分析各项指标均下降(P＜0.01),高血压伴左心室肥厚组rMSSD、pNN50进一步降低(P＜0.01),昼夜节律消失.结论:原发性单纯收缩期高血压患者心率变异减低,自主神经功能受损,平衡失调.高血压伴左心室肥厚者迷走神经功能进一步受损,昼夜节律消失.

A study on heart rate variability and its circadian rhythm of patients with isolated systolic hypertension

Objective:To investigate heart rate variability(HRV)and its circadian rhythm of patients with isolated systolic hypertension.Methods:HRV was evaluated by using 24-hour Holter monitoring in 92 isolated systolic hypertensive patients, and compared with age-matched normal controls.Furthermore,HRV and its circadian rhythm were evaluated in two subgroups with and without left ventricular hypertrophy(LVH).Results:All HRV time domain index were lower among patients than normal controls.As compared with the patients with and without LVH,rMSSD and pNN50 were significantly decreased in patients with LVH.The circadian rhythm was blunted in patients without LVH,but it was absent in patients with LVH.Conclusion:Our results suggest that HRV is decreased in isolated systolic hypertensive patients.Parasympathetic tone is lower in patients with LVH than those without LVH,and the sympathetic/parasympathetic tone is altered.