高血压的血流动力学

Hans P. Schobel MD (Assistant Professor of Medicine), Roland E. Schmieder MD (Associate Professor of Medicine)
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引用次数: 2

摘要

在原发性高血压发展过程中发生的血流动力学变化只能通过纵向研究来检测。因此,一些长期研究表明,原发性高血压患者的循环从年轻时的“高输出、正常阻力”状态转变为老年时的“低输出、高阻力”状态。然而,这种模式并不是统一的,原发性高血压也可能在没有心输出量升高的前提下,由外周阻力增加开始。这些不同的血流动力学模式的原因尚不清楚。交感神经过度活动可能,至少在一定程度上,是原发性高血压开始阶段血流动力学改变的原因。原发性高血压不同发展阶段的血流动力学特征可能有很大差异,也受年龄的影响。因此,抗高血压药物的正确使用应根据潜在的血流动力学紊乱进行个体化指导。
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Haemodynamics in hypertension

The haemodynamic changes that occur during the development of established essential hypertension can be detected only by longitudinal studies. Several long-term studies thus indicate that the circulation in essential hypertension shifts from a ‘high-output, normal resistance' state in young age toward a ‘low-output, high-resistance’ state in old age. However, this pattern is not a uniform one, and essential hypertension may also start by an increase in peripheral resistance without a prior phase of an elevated cardiac output. The reasons for these different haemodynamic patterns are not yet understood. Sympathetic overactivity may, at least in part, be responsible for the haemodynamic changes seen in the starting phase of essential hypertension.

The haemodynamic characteristics in the different developmental stages of essential hypertension may vary considerably and are also influenced by ageing. Therefore, the proper use of anti-hypertensive drug treatment should be directed individually according to the underlying haemodynamic disturbances.

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