本態性高血圧症の循環動態

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タイトル別名
  • Studies on Circulatory Dynamics in Essential Hypertension
  • 本態性高血圧症の循環動態--等尺性握力負荷法による研究
  • ホンタイセイ コウケツアツショウ ノ ジュンカン ドウタイ トウシャクセイ ア
  • 等尺性握力負荷法による研究

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Cardiovascular dynamics at rest and during isometric exercise were studied on patients with untreated essential hypertension and normal healthy subjects. Impedance cardiography was carried out on 34 of the mild hypertensives with Veterans-Administration scoring (VA)<7 and 24 of the moderate ones with VA>8 as well as 20 normal healthy subjects, at rest and during the sustained handgrip (30 percent of the maximal voluntary grip for a minute duration). The patients with severe hypertension, overt cardic failure and/or cerebrovascular accidents were excluded from this study. In the resting state, the moderate hypertensives revealed smaller stroke and cardiac indices, lower Heather index and peak dZ/dt value and longer R-Z interval than the mild hypertensives and the normal controls. Resting cardiac work index was augmented in the mild hypertensives than the other two groups. Blood pressure and total vascular resistance at rest were higher in the moderate and the mild hypertensives in this order than the normals, while there was no significant difference in heart rate among these three groups.<BR>In response to the sustained handgrip exercise, heart rate and blood pressure increased by almost the same extent in all the three groups. The mild hypertensives responded to the exercise by significant increase in cardiac index and shortening of R-Z interval without any significant change in Heather index, while the moderate ones responded by significant decrease in cardiac index and lengthening of R-Z interval with substantial depression in Heather index. Cardiac work index and total vascular resistance were augmented during the exercise in all the groups. These findings would indicate that the mild hypertensives are in a normal circulatory state with a more excessive reactivity while the moderate ones are in a depressed circulatory state with an insufficient reaction to the exercise.<BR>In conclusion, cardiac performance in essential hypertension may remain normal or even hyperkinetic in its earlier stage, and become overtly, or at least covertly impaired in the fully established stage.

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