Atherosclerosis and Blood Pressure Variability

摘要: See related article, pp 465–472 In this issue, Johansson et al1 find that markers of atherosclerosis and inflammation (which is present in atherosclerotic plaques) are associated with postural hypotension. When we stand, >500 mL blood descend into the legs, decreasing pressure. The baroreflex initial mechanism called play to stabilize Blood pressure changes sensed by baroreceptors carotids aortic arch signaled brain stem, which initiates an increase heart rate a single heartbeat. Sympathetic nerves then lead vasoconstriction so returns toward baseline levels ≈20 seconds after standing. system fails, hypotension ensues. Postural not just risk for falls, it also increased incidence stroke myocardial infarction.2 Baroreflex control slowly deteriorates advancing age, diminishing both sympathetic3 parasympathetic4 nervous responses hypertension Loss function accelerated atherosclerosis. Consequently, episodic increases age vascular disease. impaired subjects carotid plaque coronary atherosclerosis.5 Diminished variability sign loss excess cardiovascular mortality total mortality6 predicts artery After infarction, depressed sensitivity predicted 280% cardiac mortality.7 report proteins control. Why should be so? Baroreceptors …