神经源性仰卧位高血压研究现状

doi:10.3969/j.issn.1672-6731.2020.11.014

摘要/Abstract

摘要：

神经源性仰卧位高血压是自主神经功能衰竭的一种表现，常与神经源性直立性低血压伴随存在，其确切发病机制尚不清楚，可能与动脉压力反射缓冲功能障碍有关。神经源性仰卧位高血压缺乏特征性临床表现，目前的诊断标准是，诊断明确的神经源性直立性低血压患者仰卧位休息至少5分钟后测量血压，收缩压≥ 140 mm Hg/舒张压≥ 90 mm Hg；夜间或睡眠时血压升高的患者应考虑神经源性仰卧位高血压可能。治疗原则需兼顾神经源性仰卧位高血压和神经源性直立性低血压，目前尚缺乏有效治疗药物。

关键词: 高血压, 体位, 自主神经通路, 综述

Abstract:

Neurogenic supine hypertensive (NSH) is one of the types of autonomic nervous function failure, often occurs in neurogenic orthostatic hypotension (NOH) patients. The exact pathogenesis is unknown and may be related to the dysfunction of the stress-reflex buffering function. NSH lacks specificity. The current diagnostic criteria are systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg measured after at least 5 min of supine rest in diagnosed NOH patients. Patients with elevated blood pressure at night or during sleep should consider the possibility of NSH. Treatment requires both NOH and NSH, and there is currently a lack of effective drugs to treat NSH.

Key words: Hypertension, Posture, Autonomic pathways, Review

丁岩, 袁媛, 李宁, 詹淑琴. 神经源性仰卧位高血压研究现状[J]. 中国现代神经疾病杂志, 2020, 20(11): 1014-1019.

DING Yan, YUAN Yuan, LI Ning, ZHAN Shu-qin. Research status of neurogenic supine hypertension[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(11): 1014-1019.

http://journal11.magtechjournal.com/cjcnn/CN/Y2020/V20/I11/1014

参考文献

[1] Jordan J, Fanciulli A, Tank J, Calandra-Buonaura G, Cheshire WP, Cortelli P, Eschlboeck S, Grassi G, Hilz MJ, Kaufmann H, Lahrmann H, Mancia G, Mayer G, Norcliffe-Kaufmann L, Pavy-Le Traon A, Raj SR, Robertson D, Rocha I, Reuter H, Struhal W, Thijs RD, Tsioufis KP, Gert van Dijk J, Wenning GK, Biaggioni I. Management of supine hypertension in patients with neurogenic orthostatic hypotension:scientific statement of the American Autonomic Society, European Federation of Autonomic Societies, and the European Society of Hypertension[J]. J Hypertens, 2019, 37:1541-1546.
[2] Brignole M, Moya A, de Lange FJ, Deharo JC, Elliott PM, Fanciulli A, Fedorowski A, Furlan R, Kenny RA, Martín A, Probst V, Reed MJ, Rice CP, Sutton R, Ungar A, van Dijk JG;ESC Scientific Document Group. 2018 ESC Guidelines for the diagnosis and management of syncope[J]. Eur Heart J, 2018, 39:1883-1948.
[3] Milazzo V, Di Stefano C, Milan A, Ravera A, Sobrero G, Sabia L, Veglio F, Maule S. Cardiovascular complications in patients with autonomic failure[J]. Clin Auton Res, 2015, 25:133-140.
[4] Fanciulli A, Strano S, Ndayisaba JP, Goebel G, Gioffrè L, Rizzo M, Colosimo C, Caltagirone C, Poewe W, Wenning GK, Pontieri FE. Detecting nocturnal hypertension in Parkinson's disease and multiple system atrophy:proposal of a decision-support algorithm[J]. J Neurol, 2014, 261:1291-1299.
[5] Fanciulli A, Göbel G, Ndayisaba JP, Granata R, Duerr S, Strano S, Colosimo C, Poewe W, Pontieri FE, Wenning GK. Supine hypertension in Parkinson's disease and multiple system atrophy[J]. Clin Auton Res, 2016, 26:97-105.
[6] Umehara T, Matsuno H, Toyoda C, Oka H. Clinical characteristics of supine hypertension in de novo Parkinson disease[J]. Clin Auton Res, 2016, 26:15-21.
[7] Struhal W, Lahrmann H, Mathias CJ. Incidence of cerebrovascular lesions in pure autonomic failure[J]. Auton Neurosci, 2013, 179:159-162.
[8] Garland EM, Gamboa A, Okamoto L, Raj SR, Black BK, Davis TL, Biaggioni I, Robertson D. Renal impairment of pure autonomic failure[J]. Hypertension, 2009, 54:1057-1061.
[9] Celedonio JE, Arnold AC, Dupont WD, Ramirez CE, Diedrich A, Okamoto LE, Raj SR, Robertson D, Peltier AC, Biaggioni I, Shibao CA. Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure[J]. Clin Auton Res, 2015, 25:309-315.
[10] Shannon JR, Jordan J, Diedrich A, Pohar B, Black BK, Robertson D, Biaggioni I. Sympathetically mediated hypertension in autonomic failure[J]. Circulation, 2000, 101:2710-2715.
[11] Arnold AC, Okamoto LE, Gamboa A, Shibao C, Raj SR, Robertson D, Biaggioni I. Angiotensin Ⅱ, independent of plasma renin activity, contributes to the hypertension of autonomic failure[J]. Hypertension, 2013, 61:701-706.
[12] Baker J, Kimpinski K. Management of supine hypertension complicating neurogenic orthostatic hypotension[J]. CNS Drugs, 2017, 31:653-663.
[13] Sharabi Y, Eldadah B, Li ST, Dendi R, Pechnik S, Holmes C, Goldstein DS. Neuropharmacologic distinction of neurogenic orthostatic hypotension syndromes[J]. Clin Neuropharmacol, 2006, 29:97-105.
[14] Shibao C, Okamoto LE, Gamboa A, Yu C, Diedrich A, Raj SR, Robertson D, Biaggioni I. Comparative efficacy of yohimbine against pyridostigmine for the treatment of orthostatic hypotension in autonomic failure[J]. Hypertension, 2010, 56:847-851.
[15] Arnold AC, Biaggioni I. Management approaches to hypertension in autonomic failure[J]. Curr Opin Nephrol Hypertens, 2012, 21:481-485.
[16] Goldstein DS, Holmes C, Sharabi Y, Brentzel S, Eisenhofer G. Plasma levels of catechols and metanephrines in neurogenic orthostatic hypotension[J]. Neurology, 2003, 60:1327-1332.
[17] Sharabi Y, Imrich R, Holmes C, Pechnik S, Goldstein DS. Generalized and neurotransmitter-selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension[J]. Mov Disord, 2008, 23:1725-1732.
[18] Imrich R, Eldadah BA, Bentho O, Pechnik S, Sharabi Y, Holmes C, Grossman E, Goldstein DS. Functional effects of cardiac sympathetic denervation in neurogenic orthostatic hypotension[J]. Parkinsonism Relat Disord, 2009, 15:122-127.
[19] Goldstein DS, Sharabi Y. Neurogenic orthostatic hypotension:a pathophysiological approach[J]. Circulation, 2009, 119:139-146.
[20] Tipre DN, Goldstein DS. Cardiac and extracardiac sympathetic denervation in Parkinson's disease with orthostatic hypotension and in pure autonomic failure[J]. J Nucl Med, 2005, 46:1775-1781.
[21] Biaggioni I, Garcia F, Inagami T, Haile V. Hyporeninemic normoaldosteronism in severe autonomic failure[J]. J Clin Endocrinol Metab, 1993, 76:580-586.
[22] Arnold AC, Okamoto LE, Gamboa A, Black BK, Raj SR, Elijovich F, Robertson D, Shibao CA, Biaggioni I. Mineralocorticoid receptor activation contributes to the supine hypertension of autonomic failure[J]. Hypertension, 2016, 67:424-429.
[23] Low PA. Neurogenic orthostatic hypotension:pathophysiology and diagnosis[J]. Am J Manag Care, 2015, 21(13 Suppl):248-257.
[24] Freeman R. Clinical practice:neurogenic orthostatic hypotension[J]. N Engl J Med, 2008, 358:615-624.
[25] Fanciulli A, Jordan J, Biaggioni I, Calandra-Buonaura G, Cheshire WP, Cortelli P, Eschlboeck S, Grassi G, Hilz MJ, Kaufmann H, Lahrmann H, Mancia G, Mayer G, Norcliffe-Kaufmann L, Pavy-Le Traon A, Raj SR, Robertson D, Rocha I, Struhal W, Thijs R, Tsioufis KP, van Dijk JG, Wenning GK. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS):endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH)[J]. Clin Auton Res, 2018, 28:355-362.
[26] Maule S, Milan A, Grosso T, Veglio F. Left ventricular hypertrophy in patients with autonomic failure[J]. Am J Hypertens, 2006, 19:1049-1954.
[27] Vagaonescu TD, Saadia D, Tuhrim S, Phillips RA, Kaufmann H. Hypertensive cardiovascular damage in patients with primary autonomic failure[J]. Lancet, 2000, 355:725-726.
[28] Oh YS, Kim JS, Yang DW, Koo JS, Kim YI, Jung HO, Lee KS. Nighttime blood pressure and white matter hyperintensities in patients with Parkinson disease[J]. Chronobiol Int, 2013, 30:811-817.
[29] Lim TS, Lee PH, Kim HS, Yong SW. White matter hyperintensities in patients with multiple system atrophy[J]. J Neurol, 2009, 256:1663-1670.
[30] Kuo HK, Sorond F, Iloputaife I, Gagnon M, Milberg W, Lipsitz LA. Effect of blood pressure on cognitive functions in elderly persons[J]. J Gerontol A Biol Sci Med Sci, 2004, 59:1191-1194.
[31] Frewen J, Savva GM, Boyle G, Finucane C, Kenny RA. Cognitive performance in orthostatic hypotension:findings from a nationally representative sample[J]. J Am Geriatr Soc, 2014, 62:117-122.
[32] Birkenhäger AM, van den Meiracker AH. Causes and consequences of a non-dipping blood pressure profile[J]. Neth J Med, 2007, 65:127-131.
[33] Pavelic A, Krbot Skoric M, Crnošija L, Habek M. Postprandial hypotension in neurological disorders:systematic review and meta-analysis[J]. Clin Auton Res, 2017, 27:263-271.
[34] Espay AJ, LeWitt PA, Hauser RA, Merola A, Masellis M, Lang AE. Neurogenic orthostatic hypotension and supine hypertension in Parkinson's disease and related synucleinopathies:prioritisation of treatment targets[J]. Lancet Neurol, 2016, 15:954-966.
[35] Ahmed A, Ruzieh M, Kanjwal S, Kanjwal K. Syndrome of supine hypertension with orthostatic hypotension:pathophysiology and clinical approach[J]. Curr Cardiol Rev,2020, 16:48-54.
[36] Jordan J, Biaggioni I. Diagnosis and treatment of supine hypertension in autonomic failure patients with orthostatic hypotension[J]. J Clin Hypertens (Greenwich), 2002, 4:139-145.
[37] Shibao C, Gamboa A, Diedrich A, Biaggioni I. Management of hypertension in the setting of autonomic dysfunction[J]. Curr Treat Options Cardiovasc Med, 2006, 8:105-109.
[38] Gibbons CH, Schmidt P, Biaggioni I, Frazier-Mills C, Freeman R, Isaacson S, Karabin B, Kuritzky L, Lew M, Low P, Mehdirad A, Raj SR, Vernino S, Kaufmann H. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension[J]. J Neurol, 2017, 264:1567-1582.
[39] Low PA, Tomalia VA. Orthostatic hypotension:mechanisms, causes, management[J]. J Clin Neurol, 2015, 11:220-226.
[40] Jordan J, Tank J, Heusser K, Reuter H, Biaggioni I. What do we really know about supine hypertension in patients with orthostatic hypotension[J]. Curr Opin Cardiol, 2019, 34:384-389.
[41] Vallelonga F, Maule S. Diagnostic and therapeutical management of supine hypertension in autonomic failure:a review of the literature[J]. J Hypertens, 2019, 37:1102-1111.
[42] Shannon JR, Jordan J, Robertson D. Blood pressure in autonomic failure:drinks, meals and other ordeals[J]. Clin Sci (Lond), 1998, 94:5.
[43] Young TM, Mathias CJ. Treatment of supine hypertension in autonomic failure with gastrostomy feeding at night[J]. Auton Neurosci, 2008, 143(1/2):77-78.
[44] Jordan J, Shannon JR, Black BK, Ali Y, Farley M, Costa F, Diedrich A, Robertson RM, Biaggioni I, Robertson D. The pressor response to water drinking in humans:a sympathetic reflex[J]? Circulation, 2000, 101:504-509.
[45] Wilcox CS, Puritz R, Lightman SL, Bannister R, Aminoff MJ. Plasma volume regulation in patients with progressive autonomic failure during changes in salt intake or posture[J]. J Lab Clin Med, 1984, 104:331-339.
[46] Shibao C, Gamboa A, Abraham R, Raj SR, Diedrich A, Black B, Robertson D, Biaggioni I. Clonidine for the treatment of supine hypertension and pressure natriuresis in autonomic failure[J]. Hypertension, 2006, 47:522-526.
[47] Onrot J, Goldberg MR, Biaggioni I, Hollister AS, Kincaid D, Robertson D. Postjunctional vascular smooth muscle alpha-2 adrenoreceptors in human autonomic failure[J]. Clin Invest Med, 1987, 10:26-31.
[48] Lo MW, Goldberg MR, McCrea JB, Lu H, Furtek CI, Bjornsson TD. Pharmacokinetics of losartan, an angiotensin Ⅱ receptor antagonist, and its active metabolite EXP3174 in humans[J]. Clin Pharmacol Ther, 1995, 58:641-649.

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