原著

早朝高血圧症の心拍変動解析

大　久　典　子*1　吉　田　克　己*2　賀　来　満　夫*3
　　　　　　　　　　　　　　　　　　　　　　
The Autonomic Nervous Activity in Patients with Essential Hypertension
who Showed Early Morning Rise of Blood Pressure

Noriko OHISA*1, Katsumi YOSHIDA, MD*2 and Mitsuo KAKU, MD*3

Autonomic nervous function was evaluated by means of power spectral analysis of heart rate variability in patients with essential hypertension who showed early morning rise of blood pressure(BP). We monitored ambulatory(BP) and physical activity in 80 untreated patients using TM 2425(A&D Co. Ltd.). Early morning rise of BP was defined as a patient’s blood pressure obtained between 6:00 to 9:00am is 170mmHg or higher. Patients who showed early morning rise of BP were categorized into two groups. Twenty patients, whose mean BP obtained between 6:00 to 9:00am were higher than those obtained between 3:00 to 6:00am by 30mmHg or more, were defined as a surge type. Sixty patients, in whom the difference in BP was less than 30mmHg, were defined as a sustained type.
Power spectral analysis of hourly R-R intervals for 24 hours was performed to obtain the low frequency power(LF, 0.04 to 0.15 Hz) and high frequency power(HF, 0.15 to 0.40 Hz). LFn and LF/HF ratio were considered to be indexes of sympathetic nervous activity, and HF parasympathetic nervous activity, respectively. Between 3:00 to 6:00am, LFn and LF/HF were significantly higher and HF was significantly lower in the sustained type patients than in the surge type patients. LF/HF and LFn in the surge type elevated significantly between 6:00 to 9:00am. These results indicate that both the loss of nocturnal decline in BP in the sustained type and the morning rise in BP in the surge type to occurred in association with changes in autonomic nervous system.
[Rinsho Byori 51 : 414〜418, 2003]

*1Department of Clinical Laboratory, Tohoku University Hospital, Sendai 980-8574

【Key Words】early morning rise of blood pressure(早朝高血圧症)，autonomic nervous activity(自律神経)，heart rate variability(心拍変動)，blood pressure(血圧)

受付2003年2月24日・受理2003年4月17日
*1東北大学医学部附属病院検査部，*2同　医学部免疫血液病制御，
*3同　医学部分子診断学(〒980-8574 仙台市青葉区星陵町1-1)

E-mail :bigkyu-thk@umin.ac.jp