本態性および動脈硬化性高血圧症における血行動態および心機能の加齢的変化について　　とくに血行力学的特徴型を考慮して

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  • The aging change of haemodynamics and cardiac function in essential hypertension.
  • ホンタイセイ オヨビ ドウミャク コウカセイ コウケツアツショウ ニ オケル
  • とくに血行力学的特徴型を考慮して

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The change of haemodynamics and cardiac function due to aging in essential hypertension were studied in 1668 patients of nontreated and compensated essential hypertension. The haemodynamic measurements were performed by polygraphic analysis used of Welzer-Boeger's and Blumberger-Holldack's methods before the antihypertensive therapy. These subjects were classified for haemodynamic characteristic type of hypertension (W, W+E′, E′, M types etc.). In W type hypertensives (hyper-resistant hypertension), there were many cases in younger group and a little in elderly age group. The persentage of E′ (hyper-volume elasticity coefficient type) and W+W′ type (mixed resistant type) were increased with aging, however, N (normal type), M (high output type) and M+E′ type (mixed high output type) were noted with no relation of aging. In aging change of blood pressure and heart rate, increase of systolic pressure and pulse pressure, and decrease of diastolic pressure and heart rate were observed. On haemodynamics, with aging, increase of cardiac output and volume elasticity coefficient, and decrease of total peripheral resistance were demonstrated and also increase of cardiac function indices (ET/PEP, DP/ICT, SV/ET) among elderly age group were revealed. In W type hypertensives, diastolic hypertension was noted, moreover, decrease of cardiac output, increase of total peripheral resistance and lowering of cardiac function were shown among elderly age group, though tendency of increasing cardiac output, decreasing total peripheral resistance and increasing cardiac function were observed with aging in other haemodynamic characteristic types. In elderly age group of essential hypertension, the cardiac function was relatively kept well and the afterload was not so significant. On the other hand, in younger and middle age groups, the increased afterload and the lowered cardiac function were revealed, and then the afterload reduction therapy due to vasodilator was required clinically.

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