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Liu C, Ye Z, Chen L, Wang H, Wu B, Li D, Pan S, Qiu W, Ye H. Interaction effects between sleep-related disorders and depression on hypertension among adults: a cross-sectional study. BMC Psychiatry 2024; 24:482. [PMID: 38956492 PMCID: PMC11221077 DOI: 10.1186/s12888-024-05931-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Hypertension, sleep disorders, and depression represent notable public health issues, and their interconnected nature has long been acknowledged. The objective of this study is to explore the interplay between sleep disorders and depression in the context of hypertension. METHODS This cross-sectional study involved 42,143 participants aged 18 and above from the NHANES database across seven survey cycles between 2005 and 2018. After excluding those with missing data on depression, sleep disorders, and hypertension, as well as incomplete main variables, 33,383 participants remained. We used weighted logistic regression to examine the relationship between sleep disorders, depression, and hypertension. Additionally, we assessed the interaction between sleep disorders and depression on hypertension using both multiplicative and additive approaches to quantify their combined effect. RESULTS Compared to individuals without sleep disorders, those with sleep disorders have an increased risk of hypertension (OR = 1.51, 95% CI: 1.37-1.67). Furthermore, individuals with depression experience a significantly higher risk of hypertension compared to those with sleep disorders alone (OR = 2.34, 95% CI: 1.95-2.80). Our study reveals a positive interaction between sleep disorders and depression in relation to hypertension risk (OR = 1.07, 95% CI: 1.02-1.13). In addition, we observed the quantitative additive interaction indicators (RERI = 0.73, 95% CI: 0.56 ~ 0.92; API = 0.31, 95% CI: 0.11 ~ 0.46; SI = 2.19, 95% CI: 1.08-3.46) influencing hypertension risk. Furthermore, our research also identified that individuals with less than 7 h of sleep, a sleep latency period between 5 and 30 min, or a latency period exceeding 30 min experience a significantly increased risk of hypertension. CONCLUSIONS Our research uncovered separate links between sleep disorders, depression, and hypertension prevalence. Moreover, we identified an interaction between depression and sleep disorders in hypertension prevalence. Enhancing mental well-being and tackling sleep disorders could help prevent and manage hypertension. Yet, more investigation is required to establish causation and clarify mechanisms.
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Affiliation(s)
- Chunhua Liu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Zegen Ye
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Liping Chen
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Huaqiang Wang
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Binbin Wu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Di Li
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Sisi Pan
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Weiwen Qiu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China.
- Department of Neurology, Lishui Hospital of Traditional Chinese Medicine, Zhejiang University of Chinese Medicine, 800 Zhongshan Street, Lishui City, Zhejiang, 323000, China.
| | - Haiqin Ye
- Lishui Central Hospital, No. 289 Kuocang Road, Liandu District, Lishui City, Zhejiang Province, China.
- Department of Clinical Training, Lishui Municipal Central Hospital, Lishui, Zhejiang Province, 323000, China.
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Vasan S, Lim MH, Eikelis N, Lambert E. Investigating the relationship between early cardiovascular disease markers and loneliness in young adults. Sci Rep 2024; 14:14221. [PMID: 38902298 PMCID: PMC11190220 DOI: 10.1038/s41598-024-65039-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
Loneliness is recognised as a risk factor for cardiovascular disease development. However, it is unclear whether loneliness itself or other closely related mental health symptoms, such as depression and social anxiety, are associated with the development of cardiovascular disease. In the present study, we examined the relationship between loneliness and several early cardiovascular disease markers in young adults, after controlling for depression and social anxiety. Sixty-six young adults (18-35 years old, Mage = 22.70; 75.8% females) completed psychological questionnaires and took part in several physiological tests assessing cardiovascular health (e.g., vascular function). Results revealed higher loneliness was significantly associated with shorter pulse transit time (β = - 0.70, p = 0.002; shorter pulse transit time is a subclinical marker for arterial stiffness). Additionally, results show that while loneliness and depression were both related to vascular dysfunction in young adults, the underlining physiological mechanisms through which they affect vascular function may be different. Specifically, higher loneliness was associated with increased arterial stiffness, whereas depression was associated with increased endothelial dysfunction (β = - 0.43, p = 0.04). Our findings indicate that presence of loneliness and depression in young adults may be accompanied by early indicators of poor cardiovascular health, such as arterial stiffness and endothelial dysfunction. Results from the study further support the link between loneliness and cardiovascular disease development.
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Affiliation(s)
- Shradha Vasan
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia.
- Department of Mental Health Services, St. Vincent's Hospital Melbourne, Melbourne, Australia.
| | - Michelle H Lim
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia
| | - Elisabeth Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
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Gumede NAC, Khathi A. The Role of Pro-Opiomelanocortin Derivatives in the Development of Type 2 Diabetes-Associated Myocardial Infarction: Possible Links with Prediabetes. Biomedicines 2024; 12:314. [PMID: 38397916 PMCID: PMC10887103 DOI: 10.3390/biomedicines12020314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Myocardial infarction is a major contributor to CVD-related mortality. T2DM is a risk factor for MI. Stress activates the HPA axis, SNS, and endogenous OPS. These POMC derivatives increase the blood glucose and cardiovascular response by inhibiting the PI3K/AkT insulin signaling pathway and increasing cardiac contraction. Opioids regulate the effect of the HPA axis and SNS and they are cardioprotective. The chronic activation of the stress response may lead to insulin resistance, cardiac dysfunction, and MI. Stress and T2DM, therefore, increase the risk of MI. T2DM is preceded by prediabetes. Studies have shown that prediabetes is associated with an increased risk of MI because of inflammation, hyperlipidemia, endothelial dysfunction, and hypertension. The HPA axis is reported to be dysregulated in prediabetes. However, the SNS and the OPS have not been explored during prediabetes. The effect of prediabetes on POMC derivatives has yet to be fully explored and understood. The impact of stress and prediabetes on the cardiovascular response needs to be investigated. This study sought to review the potential impact of prediabetes on the POMC derivatives and pathways that could lead to MI.
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Affiliation(s)
- Nompumelelo Anna-Cletta Gumede
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa;
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Xu X, Liang W, Tang J, Wu Z. New-Onset Sleep Disorders before Cardiac Surgery May Indicate an Increased Risk of Postoperative Atrial Fibrillation. Ann Thorac Cardiovasc Surg 2023; 29:287-293. [PMID: 37357401 PMCID: PMC10767658 DOI: 10.5761/atcs.oa.23-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/15/2023] [Indexed: 06/27/2023] Open
Abstract
PURPOSE We aimed to determine if sleep disorders before cardiac surgery indicate an increased risk of postoperative atrial fibrillation (POAF). METHODS In this study, 238 patients undergoing coronary artery bypass grafting in our center were included. Patients were separated into the preoperative sleep disorder group and the control group. The primary endpoint was the incidence of POAF, and the secondary endpoints were the incidence of postoperative stroke, duration of invasive ventilation, length of intensive care unit, and hospitalization stay. Propensity score matching and multivariable logistic regression were used for adjusting potential confounders. RESULTS A total of 165 (69.3%) patients had sleep disorders before surgery, and 73 well-matched pairs were generated. A higher incidence of POAF was found in the preoperative sleep disorder group (16.4% versus 5.5%, p = 0.034). In multivariable logistic regression, preoperative sleep disorders were correlated to a higher risk of POAF (odds ratio = 4.627, 95% confidence interval: 1.181-18.123, p = 0.028). In the subgroup of patients without long-term sleep disorders, those who experienced preoperative sleep disorders had a higher incidence of POAF (16.1% versus 4.3%, p = 0.024), meanwhile, no difference was found in the subgroup of long-term sleep disorders. CONCLUSION New-onset sleep disorders before cardiac surgery may indicate a higher incidence of POAF.
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Affiliation(s)
- Xiaokang Xu
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Weitao Liang
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Juan Tang
- Acupuncture and Moxibustion School of Teaching Hospital of Chengdu University of TCM, Chengdu, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
| | - Zhong Wu
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
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Harandi AA, Kimia N, Medghalchi A, Sharifipour E, Pakdaman H, Siavoshi F, Barough SS, Esfandani A, Hosseini MH. Cerebral hemodynamic response to generalized anxiety disorder. Psychiatry Res Neuroimaging 2023; 333:111654. [PMID: 37229961 DOI: 10.1016/j.pscychresns.2023.111654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/12/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is the least studied among anxiety disorders. Therefore, we aimed to compare the cervical blood flow velocities using doppler ultrasonography in untreated chronic GAD patients and healthy individuals. MATERIAL AND METHODS In this study, thirty-eight GAD patients were enrolled. And thirty-eight healthy volunteers were recruited as control participants. The common carotid artery (CCA), internal carotid artery (ICA), and vertebral artery (VA) of both sides were explored. Also, we trained machine learning models based on cervical arteries characteristics to diagnose GAD patients. RESULTS Patients with chronic untreated GAD showed a significant increase in peak systolic velocity (PSV) bilaterally in the CCA and the ICA (P value < 0.05). In GAD patients, the end-diastolic velocity (EDV) of bilateral CCA, VA, and left ICA was significantly decreased. The Resistive Index (RI) showed a significant increase in all patients with GAD. Moreover, the Support Vector Machine (SVM) model showed the best accuracy in identifying anxiety disorder. CONCLUSION GAD is associated with hemodynamic alterations of extracranial cervical arteries. With a larger sample size and more generalized data, it is possible to make a robust machine learning-based model for GAD diagnosis.
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Affiliation(s)
- Ali Amini Harandi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Negin Kimia
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Medghalchi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Sharifipour
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Pakdaman
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Siavoshi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Akram Esfandani
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fontes MAP, Marins FR, Patel TA, de Paula CA, Dos Santos Machado LR, de Sousa Lima ÉB, Ventris-Godoy AC, Viana ACR, Linhares ICS, Xavier CH, Filosa JA, Patel KP. Neurogenic Background for Emotional Stress-Associated Hypertension. Curr Hypertens Rep 2023; 25:107-116. [PMID: 37058193 PMCID: PMC10103037 DOI: 10.1007/s11906-023-01235-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE OF REVIEW The response to natural stressors involves both cardiac stimulation and vascular changes, primarily triggered by increases in sympathetic activity. These effects lead to immediate flow redistribution that provides metabolic support to priority target organs combined with other key physiological responses and cognitive strategies, against stressor challenges. This extremely well-orchestrated response that was developed over millions of years of evolution is presently being challenged, over a short period of time. In this short review, we discuss the neurogenic background for the origin of emotional stress-induced hypertension, focusing on sympathetic pathways from related findings in humans and animals. RECENT FINDINGS The urban environment offers a variety of psychological stressors. Real or anticipatory, emotional stressors may increase baseline sympathetic activity. From routine day-to-day traffic stress to job-related anxiety, chronic or abnormal increases in sympathetic activity caused by emotional stressors can lead to cardiovascular events, including cardiac arrhythmias, increases in blood pressure and even sudden death. Among the various alterations proposed, chronic stress could modify neuroglial circuits or compromise antioxidant systems that may alter the responsiveness of neurons to stressful stimuli. These phenomena lead to increases in sympathetic activity, hypertension and consequent cardiovascular diseases. The link between anxiety, emotional stress, and hypertension may result from an altered neuronal firing rate in central pathways controlling sympathetic activity. The participation of neuroglial and oxidative mechanisms in altered neuronal function is primarily involved in enhanced sympathetic outflow. The significance of the insular cortex-dorsomedial hypothalamic pathway in the evolution of enhanced overall sympathetic outflow is discussed.
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Affiliation(s)
- Marco Antônio Peliky Fontes
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil.
| | - Fernanda Ribeiro Marins
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Tapan A Patel
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cristiane Amorim de Paula
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Liliane Ramos Dos Santos Machado
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Érick Bryan de Sousa Lima
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Ana Caroline Ventris-Godoy
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Ana Clara Rocha Viana
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Isadora Cristina Souza Linhares
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | | | | | - Kaushik P Patel
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
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Helman TJ, Headrick JP, Stapelberg NJC, Braidy N. The sex-dependent response to psychosocial stress and ischaemic heart disease. Front Cardiovasc Med 2023; 10:1072042. [PMID: 37153459 PMCID: PMC10160413 DOI: 10.3389/fcvm.2023.1072042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Stress is an important risk factor for modern chronic diseases, with distinct influences in males and females. The sex specificity of the mammalian stress response contributes to the sex-dependent development and impacts of coronary artery disease (CAD). Compared to men, women appear to have greater susceptibility to chronic forms of psychosocial stress, extending beyond an increased incidence of mood disorders to include a 2- to 4-fold higher risk of stress-dependent myocardial infarction in women, and up to 10-fold higher risk of Takotsubo syndrome-a stress-dependent coronary-myocardial disorder most prevalent in post-menopausal women. Sex differences arise at all levels of the stress response: from initial perception of stress to behavioural, cognitive, and affective responses and longer-term disease outcomes. These fundamental differences involve interactions between chromosomal and gonadal determinants, (mal)adaptive epigenetic modulation across the lifespan (particularly in early life), and the extrinsic influences of socio-cultural, economic, and environmental factors. Pre-clinical investigations of biological mechanisms support distinct early life programming and a heightened corticolimbic-noradrenaline-neuroinflammatory reactivity in females vs. males, among implicated determinants of the chronic stress response. Unravelling the intrinsic molecular, cellular and systems biological basis of these differences, and their interactions with external lifestyle/socio-cultural determinants, can guide preventative and therapeutic strategies to better target coronary heart disease in a tailored sex-specific manner.
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Affiliation(s)
- Tessa J. Helman
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
- Correspondence: Tessa J. Helman
| | - John P. Headrick
- Schoolof Pharmacy and Medical Sciences, Griffith University, Southport, QLD, Australia
| | | | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
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Effect of wither application of an analogue of pig appeasing pheromone on encounters between unfamiliar mini-pigs. Porcine Health Manag 2022; 8:50. [PMID: 36514149 DOI: 10.1186/s40813-022-00294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The practice of mixing unfamiliar pigs on farms is common but results in fighting, welfare problems and performance issues. Pigs have different ways of resolving social conflicts, including aggressive and affiliative behaviours. Synthetic appeasing pheromones have demonstrated many positive effects in animal husbandry and are regularly used by breeders to improve animal welfare and performance. The aim of the study was to investigate the effect of a new method of applying pig appeasing-pheromone (PAP) to the withers in an experimental model of pig mixing to determine whether PAP reduced aggression and fighting, increased prosocial behaviours, and improved behavioural and physiological indicators of welfare. RESULTS PAP reduced fighting between mini-pigs (df = 1; F = 13.47; P = 0.001; mixed logistic regression). Even if not significant, agonistic behaviours tended to be reduced when the treatment was applied (df = 1; F = 4.14; P = 0.058; mixed logistic regression). Likewise, mini-pigs seemed to be scored as not aggressive at all (df = 1; F = 3.61; P = 0.070; GLMM) and to be less aggressive toward the other pig than when placebo was applied. Concerning the latency of the first contact without aggression, a significant effect was found between the PAP and placebo groups (df = 1; χ2 = 4.74; P = 0.0295; Cox model). Moreover, even if not significant, the treated mini-pigs seemed to spent more time looking at each other (df = 1; F = 3.59; P = 0.071; GLMM) and immobile and/or ground sniffing (df = 1; F = 3.18; P = 0.088; GLMM) than those that received placebo. No significant difference was found between groups for salivary cortisol concentration (df = 1; F = 0.10; P = 0.752; GLMM), but variances between groups were heterogeneous at every time. No significant difference was found between groups regarding alpha-amylase activity (df = 1; F = 0.25; P = 0.621; GLMM), but variances between groups were heterogeneous at T0, T1 and T3. These results indicate that the variability (dispersion) within each group was lower when PAP was applied than when the placebo was applied. CONCLUSIONS The new method of applying PAP improved welfare of mini-pigs (as models of domestic pigs) by reducing fighting, among other interesting results. PAP seems thus a promising biomimetic tool to enhance animal welfare in pig production systems.
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Basu-Ray I, Metri K, Khanra D, Revankar R, Chinnaiyan KM, Raghuram N, Mishra MC, Patwardhan B, Sharma M, Basavaraddi IV, Anand A, Reddy S, Deepak KK, Levy M, Theus S, Levine GN, Cramer H, Fricchione GL, Hongasandra NR. A narrative review on yoga: a potential intervention for augmenting immunomodulation and mental health in COVID-19. BMC Complement Med Ther 2022; 22:191. [PMID: 35850685 PMCID: PMC9289356 DOI: 10.1186/s12906-022-03666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has a significant mortality rate of 3–5%. The principal causes of multiorgan failure and death are cytokine release syndrome and immune dysfunction. Stress, anxiety, and depression has been aggravated by the pandemic and its resultant restrictions in day-to-day life which may contribute to immune dysregulation. Thus, immunity strengthening and the prevention of cytokine release syndrome are important for preventing and minimizing mortality in COVID-19 patients. However, despite a few specific remedies that now exist for the SARS-CoV-2virus, the principal modes of prevention include vaccination, masking, and holistic healing methods, such as yoga. Currently, extensive research is being conducted to better understand the neuroendocrinoimmunological mechanisms by which yoga alleviates stress and inflammation. This review article explores the anti-inflammatory and immune-modulating potentials of yoga, along with its role in reducing risk for immune dysfunction and impaired mental health. Methods We conducted this narrative review from published literature in MEDLINE, EMBASE, COCHRANE databases. Screening was performed for titles and abstracts by two independent review authors; potentially eligible citations were retrieved for full-text review. References of included articles and articles of major non-indexed peer reviewed journals were searched for relevance by two independent review authors. A third review author checked the excluded records. All disagreements were resolved through discussion amongst review authors or through adjudication by a fourth review author. Abstracts, editorials, conference proceedings and clinical trial registrations were excluded. Observations Yoga is a nonpharmacological, cost-effective, and safe intervention associated with several health benefits. Originating in ancient India, this vast discipline consists of postures (asanas), breathing techniques (pranayama), meditation (dhyana/dharana), and relaxation. Studies have demonstrated yoga’s ability to bolster innate immunity and to inhibit cytokine release syndrome. As an intervention, yoga has been shown to improve mental health, as it alleviates anxiety, depression, and stress and enhances mindfulness, self-control, and self-regulation. Yoga has been correlated with numerous cardioprotective effects, which also may play a role in COVID-19 by preventing lung and cardiac injury. Conclusion and relevance This review paves the path for further research on yoga as a potential intervention for enhancing innate immunity and mental health and thus its role in prevention and adjunctive treatment in COVID-19.
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Roohafza H, Sattari N, Nouri F, Talaei M, Masoumi G, Sarrafzadegan N, Sadeghi M. Do any kinds of perceived stressors lead to hypertension? A longitudinal cohort study. Hypertens Res 2022; 45:1058-1066. [DOI: 10.1038/s41440-022-00895-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/24/2022] [Accepted: 02/21/2022] [Indexed: 11/10/2022]
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Carnevale D. Neuroimmune axis of cardiovascular control: mechanisms and therapeutic implications. Nat Rev Cardiol 2022; 19:379-394. [PMID: 35301456 DOI: 10.1038/s41569-022-00678-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 12/21/2022]
Abstract
Cardiovascular diseases (CVDs) make a substantial contribution to the global burden of disease. Prevention strategies have succeeded in reducing the effect of acute CVD events and deaths, but the long-term consequences of cardiovascular risk factors still represent the major cause of disability and chronic illness, suggesting that some pathophysiological mechanisms might not be adequately targeted by current therapies. Many of the underlying causes of CVD have now been recognized to have immune and inflammatory components. However, inflammation and immune activation were mostly regarded as a consequence of target-organ damage. Only more recent findings have indicated that immune dysregulation can be pathogenic for CVD, identifying a need for novel immunomodulatory therapeutic strategies. The nervous system, through an array of afferent and efferent arms of the autonomic nervous system, profoundly affects cardiovascular function. Interestingly, the autonomic nervous system also innervates immune organs, and neuroimmune interactions that are biologically relevant to CVD have been discovered, providing the foundation to target neural reflexes as an immunomodulatory therapeutic strategy. This Review summarizes how the neural regulation of immunity and inflammation participates in the onset and progression of CVD and explores promising opportunities for future therapeutic strategies.
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Affiliation(s)
- Daniela Carnevale
- Department of Molecular Medicine, Sapienza University, Rome, Italy. .,Research Unit of Neuro and Cardiovascular Pathophysiology, IRCCS Neuromed, Pozzilli, Italy.
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Amirul Islam FM, Lambert EA, Islam SMS, Islam MA, Maddison R, Thompson B, Lambert GW. Factors associated with antihypertensive medication use and blood pressure control in a rural area in Bangladesh: baseline data from a cluster randomised control trial. BMC Public Health 2021; 21:2316. [PMID: 34949160 PMCID: PMC8705124 DOI: 10.1186/s12889-021-12379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of antihypertensive medications is critical for controlling high blood pressure. We aimed to investigate associations between socio-demographic factors and antihypertensive medications use, and antihypertensive medications use with different types of drugs use with levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP). METHODS For the present report we derived data from the baseline measurements of a cluster randomised control trial on 307 participants with previously diagnosed hypertension from the rural district of Narial in Bangladesh. We measured the participant's current blood pressure levels and recorded antihypertensive medications uses. Associated factors included socio-economic status, diabetes, antihypertensive medications use, and types of drugs and doses used for controlling blood pressure. We applied analysis of variance and logistic regression techniques to identify factors associated with blood pressure. RESULTS Of the total participants, 144 (46.9%) were on antihypertensive medications. After multivariate adjustment, binary logistic regression revealed that employees (odds ratio, (95% confidence interval (CI)) (OR 3.58, 95%CI 1.38-9.28) compared to farmers, and people with diabetes (OR 2.43, 95%CI 1.13-5.26) compared to people without diabetes were associated with a higher proportion of antihypertensive medications use. Of 144 participants on antihypertensive medications, 7 (5%) had taken two doses, 114 (79%) had taken one dose per day and the rest were irregular in medication use. The mean (standard deviation) [min, max] SBP and DBP were 149 (19) mmHg [114, 217] and 90 (10) mmHg [75, 126], respectively. Overall, there was no significant difference in SBP (p = 0.10) or DBP (p = 0.67) between participants with or without antihypertensive medications or using any type of medications (p = 0.54 for SBP and 0.76 for DBP). There was no significant association between antihypertensive medications use and elevated BP levels SBP/DBP≥140/90 mmHg (p = 0.42) CONCLUSION: Less than half of the people with hypertension were on medication. Irrespective of the antihypertensive medications use, most of the participant's blood pressure was high. Further study is needed with a large sample to understand the factors and aetiology of unmanaged hypertension in rural areas of Bangladesh where the prevalence of hypertension is very high.
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Affiliation(s)
- Fakir M Amirul Islam
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia. .,Organisation for Rural Community Development (ORCD), Dariapur, Narail, Bangladesh.
| | - Elisabeth A Lambert
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.,Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Burwood, VIC, 3125, Australia
| | - M Ariful Islam
- Organisation for Rural Community Development (ORCD), Dariapur, Narail, Bangladesh
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Burwood, VIC, 3125, Australia
| | - Bruce Thompson
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
| | - Gavin W Lambert
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.,Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
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Dagan O, Buisman RSM, Nivison MD, Waters TEA, Vaughn BE, Bost KK, Bleil ME, Vandell DL, Booth-LaForce C, Roisman GI. Does secure base script knowledge mediate associations between observed parental caregiving during childhood and adult romantic relationship quality and health? Attach Hum Dev 2021; 23:643-664. [PMID: 33107784 PMCID: PMC8076343 DOI: 10.1080/14616734.2020.1836858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Increasingly, attachment representations are being assessed via secure base script knowledge - the degree to which individuals show awareness of the temporal-causal schema that summarizes the basic features of seeking and receiving effective support from caregivers during times of need. Limited research has assessed the links between secure base script knowledge and aspects of adult functioning and the role that secure base script knowledge may play in accounting for associations between early caregiving quality and adulthood functioning. We used follow-up assessments of the NICHD Study of Early Child Care and Youth Development cohort (N = 585) to examine whether secure base script knowledge at age 18 years: (a) is associated with later romantic relationship quality, depressive symptoms, and body mass index (BMI) at age 26 years, and (b) mediates expected associations between the quality of maternal and paternal sensitivity across the first 15 years of life and age-26 outcomes. More access to, and elaborated knowledge of the secure base script predicted less extreme hostility with romantic partners, and better emotional and physical health. Moreover, secure base script knowledge mediated the links between early maternal and paternal sensitivity and both later romantic partner hostility and depressive symptoms, but not BMI.
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Affiliation(s)
- Or Dagan
- Department of Psychology, Stony Brook University, New York, NY, USA
| | | | - Marissa D. Nivison
- Institute of Child Development, University of Minnesota, Minnesota, MN, USA
| | | | - Brian E. Vaughn
- Department of Human Development and Family Studies, Auburn University, Auburn, AL, USA
| | - Kelly K. Bost
- Human and Community Development, University of Illinois, Champaign, IL, USA
| | - Maria E. Bleil
- School of Nursing, University of Washington, Seattle, WA, USA
| | | | | | - Glenn I. Roisman
- Institute of Child Development, University of Minnesota, Minnesota, MN, USA
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14
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β-blockade prevents coronary macro- and microvascular dysfunction induced by a high salt diet and insulin resistance in the Goto-Kakizaki rat. Clin Sci (Lond) 2021; 135:327-346. [PMID: 33480422 DOI: 10.1042/cs20201441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 01/01/2023]
Abstract
A high salt intake exacerbates insulin resistance, evoking hypertension due to systemic perivascular inflammation, oxidative-nitrosative stress and endothelial dysfunction. Angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blockers (ARBs) have been shown to abolish inflammation and redox stress but only partially restore endothelial function in mesenteric vessels. We investigated whether sympatho-adrenal overactivation evokes coronary vascular dysfunction when a high salt intake is combined with insulin resistance in male Goto-Kakizaki (GK) and Wistar rats treated with two different classes of β-blocker or vehicle, utilising synchrotron-based microangiography in vivo. Further, we examined if chronic carvedilol (CAR) treatment preserves nitric oxide (NO)-mediated coronary dilation more than metoprolol (MET). A high salt diet (6% NaCl w/w) exacerbated coronary microvessel endothelial dysfunction and NO-resistance in vehicle-treated GK rats while Wistar rats showed modest impairment. Microvascular dysfunction was associated with elevated expression of myocardial endothelin, inducible NO synthase (NOS) protein and 3-nitrotyrosine (3-NT). Both CAR and MET reduced basal coronary perfusion but restored microvessel endothelium-dependent and -independent dilation indicating a role for sympatho-adrenal overactivation in vehicle-treated rats. While MET treatment reduced myocardial nitrates, only MET treatment completely restored microvessel dilation to dobutamine (DOB) stimulation in the absence of NO and prostanoids (combined inhibition), indicating that MET restored the coronary flow reserve attributable to endothelium-derived hyperpolarisation (EDH). In conclusion, sympatho-adrenal overactivation caused by high salt intake and insulin resistance evoked coronary microvessel endothelial dysfunction and diminished NO sensitivity, which were restored by MET and CAR treatment in spite of ongoing inflammation and oxidative-nitrosative stress presumably caused by uninhibited renin-angiotensin-aldosterone system (RAAS) overactivation.
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15
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Patlar Akbulut F, Ikitimur B, Akan A. Wearable sensor-based evaluation of psychosocial stress in patients with metabolic syndrome. Artif Intell Med 2020; 104:101824. [PMID: 32499003 DOI: 10.1016/j.artmed.2020.101824] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/14/2020] [Accepted: 02/17/2020] [Indexed: 12/30/2022]
Abstract
The prevalence of metabolic disorders has increased rapidly as such they become a major health issue recently. Despite the definition of genetic associations with obesity and cardiovascular diseases, they constitute only a small part of the incidence of disease. Environmental and physiological effects such as stress, behavioral and metabolic disturbances, infections, and nutritional deficiencies have now revealed as contributing factors to develop metabolic diseases. This study presents a multivariate methodology for the modeling of stress on metabolic syndrome (MES) patients. We have developed a supporting system to cope with MES patients' anxiety and stress by means of several biosignals such as ECG, GSR, body temperature, SpO2, glucose level, and blood pressure that are measured by a wearable device. We employed a neural network model to classify emotions with HRV analysis in the detection of stressor moments. We have accurately recognized the stressful situations using physiological responses to stimuli by utilizing our proposed affective state detection algorithm. We evaluated our system with a dataset of 312 biosignal records from 30 participants and the results showed that our proposed method achieved an average accuracy of 92% and 89% in distinguishing stress level in MES and other groups respectively. Both being the focus of an MES group and others proved to be highly arousing experiences which were significantly reflected in the physiological signal. Exposure to the stress in MES and cardiovascular heart disease patients increases the chronic symptoms. An early stage of comprehensive intervention may reduce the risk of general cardiovascular events in these particular groups. In this context, the use of e-health applications such as our proposed system facilitates these processes.
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Affiliation(s)
- Fatma Patlar Akbulut
- Department of Computer Engineering, Istanbul Kültür University, Istanbul, Turkey.
| | - Baris Ikitimur
- Department of Cardiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey.
| | - Aydin Akan
- Department of Electrical and Electronics Engineering, Izmir University of Economics, Izmir, Turkey.
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16
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Thorsdottir D, Cruickshank NC, Einwag Z, Hennig GW, Erdos B. BDNF downregulates β-adrenergic receptor-mediated hypotensive mechanisms in the paraventricular nucleus of the hypothalamus. Am J Physiol Heart Circ Physiol 2019; 317:H1258-H1271. [PMID: 31603352 DOI: 10.1152/ajpheart.00478.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is upregulated in the paraventricular nucleus of the hypothalamus (PVN) in response to hypertensive stimuli such as stress and hyperosmolality, and BDNF acting in the PVN plays a key role in elevating sympathetic activity and blood pressure. However, downstream mechanisms mediating these effects remain unclear. We tested the hypothesis that BDNF increases blood pressure, in part by diminishing inhibitory hypotensive input from nucleus of the solitary tract (NTS) catecholaminergic neurons projecting to the PVN. Male Sprague-Dawley rats received bilateral PVN injections of viral vectors expressing either green fluorescent protein (GFP) or BDNF and bilateral NTS injections of vehicle or anti-dopamine-β-hydroxylase-conjugated saporin (DSAP), a neurotoxin that selectively lesions noradrenergic and adrenergic neurons. BDNF overexpression in the PVN without NTS lesioning significantly increased mean arterial pressure (MAP) in awake animals by 18.7 ± 1.8 mmHg. DSAP treatment also increased MAP in the GFP group, by 9.8 ± 3.2 mmHg, but failed to affect MAP in the BDNF group, indicating a BDNF-induced loss of NTS catecholaminergic hypotensive effects. In addition, in α-chloralose-urethane-anesthetized rats, hypotensive responses to PVN injections of the β-adrenergic agonist isoprenaline were significantly attenuated by BDNF overexpression, whereas PVN injections of phenylephrine had no effect on blood pressure. BDNF treatment was also found to significantly reduce β1-adrenergic receptor mRNA expression in the PVN, whereas expression of other adrenergic receptors was unaffected. In summary, increased BDNF expression in the PVN elevates blood pressure, in part by downregulating β-receptor signaling and diminishing hypotensive catecholaminergic input from the NTS to the PVN.NEW & NOTEWORTHY We have shown that BDNF, a key hypothalamic regulator of blood pressure, disrupts catecholaminergic signaling between the NTS and the PVN by reducing the responsiveness of PVN neurons to inhibitory hypotensive β-adrenergic input from the NTS. This may be occurring partly via BDNF-mediated downregulation of β1-adrenergic receptor expression in the PVN and results in an increase in blood pressure.
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Affiliation(s)
| | | | - Zachary Einwag
- Department of Pharmacology, University of Vermont, Burlington, Vermont
| | - Grant W Hennig
- Department of Pharmacology, University of Vermont, Burlington, Vermont
| | - Benedek Erdos
- Department of Pharmacology, University of Vermont, Burlington, Vermont
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17
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Kwon HB, Yoon H, Choi SH, Choi JW, Lee YJ, Park KS. Heart rate variability changes in major depressive disorder during sleep: Fractal index correlates with BDI score during REM sleep. Psychiatry Res 2019; 271:291-298. [PMID: 30513461 DOI: 10.1016/j.psychres.2018.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 11/10/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023]
Abstract
We investigated the relationship between autonomic nervous system activity during each sleep stage and the severity of depressive symptoms in patients with major depressive disorder (MDD) and healthy control subjects. Thirty patients with MDD and thirty healthy control subjects matched for sex, age, and body mass index completed standard overnight polysomnography. Depression severity was assessed using the Beck Depression Inventory (BDI). Time- and frequency-domain, and fractal HRV parameters were derived from 5-min electrocardiogram segments during light sleep, deep sleep, rapid eye movement (REM) sleep, and the pre- and post-sleep wake periods. Detrended fluctuation analysis (DFA) alpha-1 values during REM sleep were significantly higher in patients with MDD than in control subjects, and a significant correlation existed between DFA alpha-1 and BDI score in all subjects. DFA alpha-1 was the strongest predictor for the BDI score, along with REM density as a covariate. This study found that compared with controls, patients with MDD show reduced complexity in heart rate during REM sleep, which may represent lower cardiovascular adaptability in these patients, and could lead to cardiac disease. Moreover, DFA alpha-1 values measured during REM sleep may be useful as an indicator for the diagnosis and monitoring of depression.
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Affiliation(s)
- Hyun Bin Kwon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
| | - Heenam Yoon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea
| | - Sang Ho Choi
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea
| | - Jae-Won Choi
- Department of Neuropsychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul 01830, Republic of Korea
| | - Yu Jin Lee
- Department of Neuropsychiatry and the Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Kwang Suk Park
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
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18
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Merino-Jiménez C, Miguel F, Feria Pliego JA, Zetina Rosales ME, Cifuentes F, Morales MA. Sympathetic Hyperactivity and Age Affect Segregation and Expression of Neurotransmitters. Front Cell Neurosci 2018; 12:411. [PMID: 30483061 PMCID: PMC6243098 DOI: 10.3389/fncel.2018.00411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/22/2018] [Indexed: 01/13/2023] Open
Abstract
Sympathetic neurons of the rat superior cervical ganglion (SCG) can segregate their neurotransmitters and co-transmitters to separate varicosities of single axons. We have shown that transmitter segregation is a plastic phenomenon and that it is correlated with the strength of synaptic transmission. Here, we determined whether sympathetic dysfunction occurring in stress and hypertension was correlated with plastic changes of neurotransmitter segregation. We characterized the expression of the markers, L-glutamic acid decarboxylase of 67 kDa (GAD67) and vesicular acetylcholine (ACh) transporter (VAChT) in the SCG of cold stressed and spontaneously hypertensive rats (SHR). Considering that the SCG comprises a heterogeneous neuronal population, we explored whether the expression and segregation of neurotransmitters would also have an intraganglionic heterogeneous distribution in ganglia of stressed and hypertensive rats. Furthermore, since hypertension in SHR is detected around 8–10 weeks, we evaluated expression and segregation of ACh and GABA in adult hypertensive (12-week old (wo)) and young pre-hypertensive (6-wo) SHR. We found an increase in segregation of ACh and GABA with no change in transmitter expression in ganglia of stressed animals. In contrast, in SHR, there was an increase in GABA expression, although segregation did not vary. Segregation showed a caudo-rostral gradient in controls but not in the ganglia of stressed animals. GABA expression showed a rostro-caudal gradient in adult SHR, which was not present in young 6-wo rats. In young SHR, ACh increased and, unexpectedly, segregation of ACh and GABA was higher than in adults. Data suggest that ACh and GABA segregation increases in acute sympathetic hyperactivity like stress, but does not vary in chronic hyperactivity such as in hypertension. Changes in segregation are age-dependent and might be involved in the mechanisms underlying stress and hypertension.
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Affiliation(s)
- Candelaria Merino-Jiménez
- Departamento de Biología Celular & Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Filiberto Miguel
- Departamento de Biología Celular & Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Jessica Abigail Feria Pliego
- Departamento de Biología Celular & Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - María Elena Zetina Rosales
- Departamento de Biología Celular & Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Fredy Cifuentes
- Departamento de Biología Celular & Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Miguel Angel Morales
- Departamento de Biología Celular & Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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Michels N, Matthys D, Thumann B, Marild S, De Henauw S. Children's stress-related reports and stress biomarkers interact in their association with metabolic syndrome risk. Stress Health 2018; 34:523-533. [PMID: 29733496 DOI: 10.1002/smi.2813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 01/27/2023]
Abstract
The purpose was to examine the cross-sectional associations of stress-related reports and stress biomarkers with metabolic syndrome (MetS) risk in children while also testing the interaction between stress biomarkers and stress reports. In 353 children (5-10 years old, 7.9% overweight/obese), MetS risk was measured by blood pressure, waist circumference, glucose homeostasis, triglycerides, and high-density cholesterol. Stress was measured by stress-related reports (events, emotions, and internalizing/externalizing problems) and two biomarkers: salivary cortisol (total-day and morning output) and heart rate variability (percentage of consecutive normal RR intervals differing more than 50 ms and low-to-high-frequency ratio). Cross-sectional regression analyses with z scored total MetS risk as outcome were adjusted for age, sex, and socio-economic status. Only internalizing problems were directly related to a higher MetS risk score (β = 0.236). Cortisol and heart rate variability were significant moderators: High cortisol morning output resulted in a positive (unfavourable) report-MetS relationship (β = 0.259-0.552), whereas low percentage of consecutive normal RR intervals differing more than 50 ms resulted in a negative (favourable) report-MetS relationship (β = -0.298) and low low-to-high-frequency ratio in a positive (unfavourable) report-MetS relationship (β = 0.478). In conclusion, stress can sometimes be a disadvantageous factor in metabolic health of otherwise healthy children. The cortisol biomarker seems relevant because metabolic risk was highest when stress-related reports were accompanied by high morning cortisol output.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dante Matthys
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Barbara Thumann
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Staffan Marild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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20
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Ostroumova OD, Kochetkov AI. Worksite hypertension as a model of stress-induced arterial hypertension. TERAPEVT ARKH 2018; 90:123-132. [PMID: 30701746 DOI: 10.26442/terarkh2018909123-132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The review presents a modern view on stress as a risk factor for the development of arterial hypertension (AH). A variety pathogenic mechanisms responsible for increase of blood pressure during stress exposure are described in detail. The importance of the sympathetic activation as a key link in the development of stress-induced AH and initiation of a cascade of pathophysiological reactions that realize their adverse effects at the level of the whole organism is underlined. Particular attention is paid to worksite AH as a variant of stress-induced hypertension due to its wide prevalence and association with an increased risk of cardiovascular complications, primarily myocardial infarction and stroke. Epidemiological data and results of recent metanalysis are presented, indicating the high significance of job strain as a risk factor for adverse cardiovascular events. The actual psychological stress reduction programs are described. Possibilities of using β-blockers in patients with stress-induced hypertension as drugs affecting the central pathogenetic trigger of this disease are considered. The advantages of using bisoprolol as a highly selective β-blocker are considered taking into account the available body of evidence for its effectiveness in patients with worksite AH, as well as its metabolic neutrality and target-organ protective properties.
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Affiliation(s)
- O D Ostroumova
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov First Moscow State Medical University), Moscow, Russia
| | - A I Kochetkov
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia
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21
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Byrne CJ, Khurana S, Kumar A, Tai TC. Inflammatory Signaling in Hypertension: Regulation of Adrenal Catecholamine Biosynthesis. Front Endocrinol (Lausanne) 2018; 9:343. [PMID: 30013513 PMCID: PMC6036303 DOI: 10.3389/fendo.2018.00343] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/07/2018] [Indexed: 12/24/2022] Open
Abstract
The immune system is increasingly recognized for its role in the genesis and progression of hypertension. The adrenal gland is a major site that coordinates the stress response via the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal system. Catecholamines released from the adrenal medulla function in the neuro-hormonal regulation of blood pressure and have a well-established link to hypertension. The immune system has an active role in the progression of hypertension and cytokines are powerful modulators of adrenal cell function. Adrenal medullary cells integrate neural, hormonal, and immune signals. Changes in adrenal cytokines during the progression of hypertension may promote blood pressure elevation by influencing catecholamine biosynthesis. This review highlights the potential interactions of cytokine signaling networks with those of catecholamine biosynthesis within the adrenal, and discusses the role of cytokines in the coordination of blood pressure regulation and the stress response.
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Affiliation(s)
- Collin J. Byrne
- Department of Biology, Laurentian University, Sudbury, ON, Canada
| | - Sandhya Khurana
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON, Canada
| | - Aseem Kumar
- Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON, Canada
- Biomolecular Sciences Program, Laurentian University, Sudbury, ON, Canada
| | - T. C. Tai
- Department of Biology, Laurentian University, Sudbury, ON, Canada
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON, Canada
- Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON, Canada
- Biomolecular Sciences Program, Laurentian University, Sudbury, ON, Canada
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22
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Myburgh CE, Malan L, Wentzel A, Scheepers JDW, Malan NT. Coping and Cardiac Troponin T - A Risk for Hypertension and Sub-Clinical ECG Left Ventricular Hypertrophy: The SABPA Study. Heart Lung Circ 2018; 28:908-916. [PMID: 29895484 DOI: 10.1016/j.hlc.2018.05.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/16/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Defensive coping (DefS) was associated with cardiovascular disease (CVD) susceptibility in Blacks. Whether coping strategies will associate with sub-clinical left ventricular hypertrophy (electrocardiographic-left ventricular hypertrophy [ECG-LVH] or Cornell product), cardiomyocyte injury and blood pressure (BP), is unclear. Therefore, we assessed relationships between ECG-LVH, cardiac troponin T (cTnT) and 24-hour BP in bi-ethnic groups when habitually utilising a certain coping style, and these groups when having a stress-related cTnT cut-point of 4.2ng/L. METHODS A target population study included a Black (n=190) and White (n=204) teachers' gender cohort (20-65years) from South Africa. The Coping Strategy Indicator determined DefS, social support and avoidance coping scores. Fasting blood samples, 10-lead ECG, 24-hour BP and ECG data were obtained. RESULTS Interaction effects showed no gender, social support and avoidance coping differences. Stratification of groups was done for ethnicity and DefS. Blacks sought more social support, used less avoidance coping and presented with higher CVD susceptibility. Hypertension prevalence and ECG-LVH levels in DefS Blacks (63%) were higher compared to DefS Whites (40%). Multivariate regression analyses showed positive associations between Cornell product, cTnT and BP [p≤0.05] in DefS Blacks only. Their 24-hour systolic blood pressure (SBP) was associated with time-domain depressed heart-rate-variability and prolonged ST-segment-depression especially when applying an established stress-related cTnT ≥ 4.2ng/L cut-point. CONCLUSIONS Defensive coping facilitated autonomic hyperactivity, myocardial injury and subsequent compensatory BP elevations as possible homeostatic reflexes to alleviate myocardial perfusion deficits. The resulting pressure overload increased sub-clinical wall remodelling and ischaemic heart disease risk in Blacks utilising habitual defensiveness. We therefore recommend regular ECG and high sensitivity cTnT screening in asymptomatic patients with emotional stress susceptibility. Longitudinal evidence is needed to confirm causality and progression of cardiomyopathy risk.
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Affiliation(s)
| | - Leoné Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa.
| | - Annemarie Wentzel
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
| | - Jacobus De Wet Scheepers
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
| | - Nicolaas Theodor Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
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Abbott PW, Gumusoglu SB, Bittle J, Beversdorf DQ, Stevens HE. Prenatal stress and genetic risk: How prenatal stress interacts with genetics to alter risk for psychiatric illness. Psychoneuroendocrinology 2018; 90:9-21. [PMID: 29407514 DOI: 10.1016/j.psyneuen.2018.01.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/20/2018] [Accepted: 01/21/2018] [Indexed: 02/07/2023]
Abstract
Risk for neuropsychiatric disorders is complex and includes an individual's internal genetic endowment and their environmental experiences and exposures. Embryonic development captures a particularly complex period, in which genetic and environmental factors can interact to contribute to risk. These environmental factors are incorporated differently into the embryonic brain than postnatal one. Here, we comprehensively review the human and animal model literature for studies that assess the interaction between genetic risks and one particular environmental exposure with strong and complex associations with neuropsychiatric outcomes-prenatal maternal stress. Gene-environment interaction has been demonstrated for stress occurring during childhood, adolescence, and adulthood. Additional work demonstrates that prenatal stress risk may be similarly complex. Animal model studies have begun to address some underlying mechanisms, including particular maternal or fetal genetic susceptibilities that interact with stress exposure and those that do not. More specifically, the genetic underpinnings of serotonin and dopamine signaling and stress physiology mechanisms have been shown to be particularly relevant to social, attentional, and internalizing behavioral changes, while other genetic factors have not, including some growth factor and hormone-related genes. Interactions have reflected both the diathesis-stress and differential susceptibility models. Maternal genetic factors have received less attention than those in offspring, but strongly modulate impacts of prenatal stress. Priorities for future research are investigating maternal response to distinct forms of stress and developing whole-genome methods to examine the contributions of genetic variants of both mothers and offspring, particularly including genes involved in neurodevelopment. This is a burgeoning field of research that will ultimately contribute not only to a broad understanding of psychiatric pathophysiology but also to efforts for personalized medicine.
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Affiliation(s)
- Parker W Abbott
- Department of Psychiatry, University of Iowa Carver College of Medicine, 1310 PBDB, 169 Newton Rd., Iowa City, IA, 52246, USA.
| | - Serena B Gumusoglu
- Department of Psychiatry, University of Iowa Carver College of Medicine, 1310 PBDB, 169 Newton Rd., Iowa City, IA, 52246, USA; Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA, 52242, USA.
| | - Jada Bittle
- Department of Psychiatry, University of Iowa Carver College of Medicine, 1310 PBDB, 169 Newton Rd., Iowa City, IA, 52246, USA; Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA, 52242, USA.
| | - David Q Beversdorf
- Interdisciplinary Neuroscience Program, Interdisciplinary Intercampus Research Program, Thompson Center for Autism and Neurodevelopment Disorders, Departments of Radiology, Neurology and Psychological Sciences, University of Missouri, Columbia, MO, USA.
| | - Hanna E Stevens
- Department of Psychiatry, University of Iowa Carver College of Medicine, 1310 PBDB, 169 Newton Rd., Iowa City, IA, 52246, USA; Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA, 52242, USA; Iowa Neuroscience Institute, University of Iowa Carver College of Medicine, 2312 PBDB, 169 Newton Rd., Iowa City, IA, 52246, USA.
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Michels N, Sioen I, Schraven K, De Decker A, van Aart C, De Henauw S. Children’s cortisol and externalizing stress symptoms are predictors of adiponectin evolution over two years. Biol Psychol 2018; 131:89-95. [DOI: 10.1016/j.biopsycho.2017.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 04/06/2017] [Accepted: 05/28/2017] [Indexed: 01/08/2023]
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Johnson AD, McQuoid DR, Steffens DC, Payne ME, Beyer JL, Taylor WD. Effects of stressful life events on cerebral white matter hyperintensity progression. Int J Geriatr Psychiatry 2017; 32:e10-e17. [PMID: 28029184 PMCID: PMC5489375 DOI: 10.1002/gps.4644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Exposure to stressful events is associated with both occurrence of depression and also vascular disease. The objective of this study was to determine whether higher levels of stress exposure was related to measures of pathological brain aging, specifically white matter hyperintensity volumes, in older adults with and without depression. METHODS The sample included 130 depressed and 110 never-depressed older adults aged 60 years or older enrolled in a longitudinal study at an academic medical center. Participants completed clinical assessments, assessment of stressful event exposure and perceived stress, and magnetic resonance imaging at baseline and after 2 years. Analyses examined both cross-sectional and longitudinal relationships between stress measures and white matter hyperintensity volumes. RESULTS There were no statistically significant relationships observed between cross-sectional baseline stress measures and either baseline hyperintensity volume or 2-year change in hyperintensity volume. However, after controlling for demographic variables and baseline measures, change in stressor exposure was associated with change in hyperintensity volumes. In this analysis, increased stressor exposure was associated with greater increases in white matter hyperintensity volume, while reductions in stressor exposure were associated with less increase in hyperintensity volume. This relationship did not significantly differ based on the presence of either depression or medical comorbidities. CONCLUSIONS This work adds to a growing literature associating exposure to stressful events in later life with more rapid pathological brain aging. Work is needed to understand the physiological mechanisms by which stress exposure has this effect and examine whether stress reduction techniques may modify these observed outcomes. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Anne D. Johnson
- The Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Douglas R. McQuoid
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Martha E. Payne
- Office of Research Development, Duke University School of Medicine, Durham, NC, 27710, USA
| | - John L. Beyer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - Warren D. Taylor
- The Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, 37212, USA,Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, 37212, USA
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Trudel X, Milot A, Gilbert-Ouimet M, Duchaine C, Guénette L, Dalens V, Brisson C. Effort-Reward Imbalance at Work and the Prevalence of Unsuccessfully Treated Hypertension Among White-Collar Workers. Am J Epidemiol 2017; 186:456-462. [PMID: 28486615 DOI: 10.1093/aje/kwx116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/03/2016] [Indexed: 01/01/2023] Open
Abstract
We examined the association between effort-reward imbalance (ERI) exposure at work and unsuccessfully treated hypertension among white-collar workers from a large cohort in Quebec City, Canada. The study used a repeated cross-sectional design involving 3 waves of data collection (2000-2009). The study sample was composed of 474 workers treated for hypertension, accounting for 739 observations. At each observation, ERI was measured using validated scales, and ambulatory blood pressure (BP) was measured every 15 minutes during the working day. Unsuccessfully treated hypertension was defined as daytime ambulatory BP of at least 135/85 mm Hg and was further divided into masked and sustained hypertension. Adjusted prevalence ratios and 95% confidence intervals were estimated. Participants in the highest tertile of ERI exposure had a higher prevalence of unsuccessfully treated hypertension (prevalence ratio = 1.45, 95% confidence interval: 1.16, 1.81) after adjustment for gender, age, education, family history of cardiovascular diseases, body mass index, diabetes, smoking, sedentary behaviors, and alcohol intake. The present study supports the effect of adverse psychosocial work factors from the ERI model on BP control in treated workers. Reducing these frequent exposures at work might lead to substantial benefits on BP control at the population level.
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Greaney JL, Kenney WL. Measuring and quantifying skin sympathetic nervous system activity in humans. J Neurophysiol 2017; 118:2181-2193. [PMID: 28701539 DOI: 10.1152/jn.00283.2017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/10/2017] [Accepted: 07/10/2017] [Indexed: 01/23/2023] Open
Abstract
Development of the technique of microneurography has substantially increased our understanding of the function of the sympathetic nervous system (SNS) in health and in disease. The ability to directly record signals from peripheral autonomic nerves in conscious humans allows for qualitative and quantitative characterization of SNS responses to specific stimuli and over time. Furthermore, distinct neural outflow to muscle (MSNA) and skin (SSNA) can be delineated. However, there are limitations and caveats to the use of microneurography, measurement criteria, and signal analysis and interpretation. MSNA recordings have a longer history and are considered relatively more straightforward from a measurement and analysis perspective. This brief review provides an overview of the development of the technique as used to measure SSNA. The focus is on the utility of measuring sympathetic activity directed to the skin, the unique issues related to analyzing and quantifying multiunit SSNA, and the challenges related to its interpretation.
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Affiliation(s)
- Jody L Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - W Larry Kenney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
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Abstract
Hypertension is an important risk factor of cardiovascular diseases, the leading cause of death worldwide. Adverse effects of psychosocial factors at work might increase the risk of masked hypertension, but evidences are still scarce. The objective of this study is then to determine whether adverse psychosocial work factors from the effort-reward imbalance (ERI) model are associated with the prevalence of masked hypertension in a population of white-collar workers. White-collar workers were recruited from three public organizations. Blood pressure was measured at the workplace for manually operated measurements (mean of the first three readings taken by a trained assistant) followed by ambulatory measurements (mean of all subsequent readings taken during the working day). Masked hypertension was defined as manually operated BP<140/90 mm Hg and ambulatory BP ⩾135/85 mm Hg. ERI exposure at work was measured using Siegrist's validated questionnaire. Blood pressure readings were obtained from 2369 workers (participation proportion: 85%). ERI exposure (OR: 1.53 (95% CI: 1.16-2.02) and high efforts at work (OR: 1.61 (95% CI: 1.13-1.29) were associated with masked hypertension, after adjusting for sociodemographic and cardiovascular risk factors. Workers exposed to an imbalance between efforts spent at work and reward had a higher prevalence of masked hypertension. High efforts at work might be of particular importance in explaining this association. Future studies should be designed to investigate how clinicians can include questions on psychosocial work factors to screen for masked hypertension and how workplace interventions can decrease adverse psychosocial exposures to lower BP.
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Liu MY, Li N, Li WA, Khan H. Association between psychosocial stress and hypertension: a systematic review and meta-analysis. Neurol Res 2017; 39:573-580. [PMID: 28415916 DOI: 10.1080/01616412.2017.1317904] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mei-Yan Liu
- Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Na Li
- Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - William A. Li
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hajra Khan
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
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Cozma S, Dima-Cozma L, Ghiciuc C, Pasquali V, Saponaro A, Patacchioli F. Salivary cortisol and α-amylase: subclinical indicators of stress as cardiometabolic risk. Braz J Med Biol Res 2017; 50:e5577. [PMID: 28177057 PMCID: PMC5390531 DOI: 10.1590/1414-431x20165577] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023] Open
Abstract
Currently, the potential for cardiovascular (CV) stress-induced risk is primarily based on the theoretical (obvious) side effects of stress on the CV system. Salivary cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response, are still not included in the routine evaluation of CV risk and require additional and definitive validation. Therefore, this article overviews studies published between 2010 and 2015, in which salivary cortisol and α-amylase were measured as stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk) clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science and Scopus electronic databases was performed, and 54 key articles related to the use of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR factors, including studies that emphasized methodological biases that could influence the accuracy of study outcomes, were ultimately identified. Overall, the biological impact of stress measured by salivary cortisol and α-amylase was associated with CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as potential diagnostic tools for detecting stress-induced cardiac diseases and especially to describe the mechanisms by which stress potentially contributes to the pathogenesis and outcomes of CV diseases.
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Affiliation(s)
- S. Cozma
- Department of Otorhinolaryngology, School of Medicine, University of
Medicine and Pharmacy “Grigore T. Popa”, Iasi, Romania
| | - L.C. Dima-Cozma
- Department of Internal Medicine, School of Medicine, University of
Medicine and Pharmacy “Grigore T. Popa”, Iasi, Romania
| | - C.M. Ghiciuc
- Department of Pharmacology, School of Medicine, University of
Medicine and Pharmacy “Grigore T. Popa”, Iasi, Romania
| | - V. Pasquali
- Department of Psychology, Sapienza University of Rome, Rome,
Italy
| | - A. Saponaro
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza
University of Rome, Rome, Italy
| | - F.R. Patacchioli
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza
University of Rome, Rome, Italy
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Sikora M, Konopelski P, Pham K, Wyczalkowska-Tomasik A, Ufnal M. Repeated restraint stress produces acute and chronic changes in hemodynamic parameters in rats. Stress 2016; 19:621-629. [PMID: 27696923 DOI: 10.1080/10253890.2016.1244667] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Noninvasive hemodynamic measurements in rats require placing animals in restrainers. To minimize restraint stress-induced artifacts several habituation protocols have been proposed, however, the results are inconclusive. Here, we evaluated if a four-week habituation is superior to a shorter habituation, or no habituation. This is the first study comparing different habituation protocols with the use of four-week continuous telemetry measurements. We did the experiments on male, 16-week old, Sprague-Dawley rats. Continuous recordings of mean arterial blood pressure (MABP) and heart rate (HR) were made before and during habituation protocols. Rats were subjected either to control (four weeks of restraint-free recordings, n = 5) or two-week (seven restraints, n = 6) or four-week (14 restraints, n = 6) restraint sessions. The restraint protocols included placement of rats in the middle of the dark phase into plastic restrainers as used for tail-cuff measurements. Restraint lasted for 60 min, and was repeated every second day. Each restraint significantly increased MABP (by 15-25 mmHg) and HR (by 40-120 beats/min). Exposure to the restraint protocols decreased diurnal variation in MABP. There was no hemodynamic adaptation to repeated restraint, and no significant difference in hemodynamic response to restraint among controls, the two-week and the four-week groups. In conclusion, our study indicates that measurements in restrained rats are not likely being made without stress-induced changes in MABP. Moreover, in hemodynamic studies in repeatedly restrained rats longer habituation is not superior to shorter habituation.
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Affiliation(s)
- Mariusz Sikora
- a Department of Experimental Physiology and Pathophysiology, Laboratory of Center for Preclinical Research , Medical University of Warsaw , Warsaw , Poland
| | - Piotr Konopelski
- a Department of Experimental Physiology and Pathophysiology, Laboratory of Center for Preclinical Research , Medical University of Warsaw , Warsaw , Poland
| | - Kinga Pham
- a Department of Experimental Physiology and Pathophysiology, Laboratory of Center for Preclinical Research , Medical University of Warsaw , Warsaw , Poland
| | | | - Marcin Ufnal
- a Department of Experimental Physiology and Pathophysiology, Laboratory of Center for Preclinical Research , Medical University of Warsaw , Warsaw , Poland
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Chamarthi B, Ezrokhi M, Rutty D, Cincotta AH. Impact of bromocriptine-QR therapy on cardiovascular outcomes in type 2 diabetes mellitus subjects on metformin. Postgrad Med 2016; 128:761-769. [PMID: 27687032 DOI: 10.1080/00325481.2016.1243003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) is associated with a substantially increased risk of cardiovascular disease (CVD). Bromocriptine-QR (B-QR), a quick release sympatholytic dopamine D2 receptor agonist, is a FDA-approved therapy for T2DM which may provide CVD risk reduction. Metformin is considered to be an agent with a potential cardioprotective benefit. This large placebo controlled clinical study assessed the impact of B-QR addition to existing metformin therapy on CVD outcomes in T2DM subjects. METHODS 1791 subjects (1208 B-QR; 583 placebo) on metformin ± another anti-diabetes therapy at baseline derived from the Cycloset Safety Trial, a 12-month, randomized, multicenter, placebo-controlled, double-blind study in T2DM, were included in this study. The primary CVD endpoint evaluated was treatment impact on CVD event rate, prespecified as a composite of time to first myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina/congestive heart failure. Impact on glycemic control was evaluated as a secondary analysis. RESULTS The composite CVD end point occurred in 16/1208 B-QR treated (1.3%) and 18/583 placebo treated (3.1%) subjects resulting in a 55% CVD hazard risk reduction (intention-to-treat, Cox regression analysis; HR: 0.45 [0.23-0.88], p = 0.028). Kaplan-Meier curves demonstrated a significantly lower cumulative incidence rate of the CVD endpoint in the B-QR treatment group (Log-Rank p = 0.017). In subjects with poor glycemic control (HbA1c ≥ 7.5) at baseline, B-QR therapy relative to placebo resulted in a significant mean %HbA1c reduction of -0.59 at week 12 and -0.51 at week 52 respectively (p < 0.001 for both) and a 10 fold higher percent of subjects achieving HbA1c goal of ≤7% by week 52 (B-QR 30%, placebo 3%; p = 0.003). CONCLUSION These findings suggest that in T2DM subjects on metformin, BQR therapy may represent an effective strategy for reducing CVD risk. Cycloset Safety Trial registration: ClinicalTrials.gov Identifier: NCT00377676.
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Affiliation(s)
- Bindu Chamarthi
- a VeroScience, LLC , Tiverton , RI , USA.,b Division of Endocrinology, Diabetes and Hypertension , Brigham and Women's Hospital , Boston , MA , USA.,c Department of Medicine , Harvard Medical School , Boston , MA , USA
| | | | - Dean Rutty
- d Statistical Operations , Everest Clinical Research Services Inc , Markham , Canada
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Soliz J, Tam R, Kinkead R. Neonatal Maternal Separation Augments Carotid Body Response to Hypoxia in Adult Males but Not Female Rats. Front Physiol 2016; 7:432. [PMID: 27729873 PMCID: PMC5037225 DOI: 10.3389/fphys.2016.00432] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/12/2016] [Indexed: 12/20/2022] Open
Abstract
Perinatal exposure to adverse experiences disrupts brain development, including the brainstem network that regulates breathing. At adulthood, rats previously subjected to stress (in the form of neonatal maternal separation; NMS) display features reported in patients suffering from sleep disordered breathing, including an increased hypoxic ventilatory response and hypertension. This effect is also sex-specific (males only). Based on these observations, we hypothesized that NMS augments the carotid body's O2-chemosensitivity. Using an isolated and perfused ex vivo carotid body preparation from adult rats we compared carotid sinus nerve (CSN) responses to hypoxia and hypercapnia in carotid bodies harvested from adult rats that either experienced control conditions (no experimental manipulation) or were subjected to NMS (3 h/day from postnatal days 3 to 12). In males, the CSN response to hypoxia measured in preparations from NMS males was 1.5 fold higher than controls. In control rats, the female's response was similar to that of males; however, the increase in CSN activity measured in NMS females was 3.0 times lower than controls. The CSN response to hypercapnia was not influenced by stress or sex. We conclude that NMS is sufficient to have persistent and sex-specific effects on the carotid body's response to hypoxia. Because NMS also has sex-specific effects on the neuroendocrine response to stress, we propose that carotid body function is influenced by stress hormones. This, in turn, leads to a predisposition toward cardio-respiratory disorders.
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Affiliation(s)
| | | | - Richard Kinkead
- Department of Pediatrics, Centre de Recherche du CHU de Québec, Hôpital St-François d'Assise, Université LavalQuébec, QC, Canada
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Hu MX, Lamers F, Hiles SA, Penninx BWJH, de Geus EJC. Basal autonomic activity, stress reactivity, and increases in metabolic syndrome components over time. Psychoneuroendocrinology 2016; 71:119-26. [PMID: 27262344 DOI: 10.1016/j.psyneuen.2016.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/29/2016] [Accepted: 05/18/2016] [Indexed: 12/31/2022]
Abstract
CONTEXT Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to stress remains unclear. OBJECTIVE To examine cross-sectionally and longitudinally to what extent ANS basal level and stress reactivity are related to MetS. DESIGN 2-year and 6-year data from a prospective cohort: the Netherlands Study of Depression and Anxiety. SETTING Participants were recruited from the general community, primary care, and mental health care organizations. PARTICIPANTS 1922 respondents (mean age=43.7years). MAIN OUTCOME MEASURES Indicators of ANS functioning were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). ANS stress reactivity was measured during a cognitively challenging stressor and a personal-emotional stressor. MetS components included triglycerides, high-density lipoprotein cholesterol, blood pressure, glucose and waist circumference. RESULTS Cross-sectional analyses indicated that higher basal HR, lower basal values of RSA and PEP, and higher RSA reactivity during cognitive challenge were related to less favorable values of almost all individual MetS components. Longitudinal analyses showed that higher basal HR and shorter basal PEP predicted 4-year increase in many MetS abnormalities. Higher RSA stress reactivity during cognitive challenge predicted 4-year increase in number of MetS components. CONCLUSION Higher basal sympathetic, lower basal parasympathetic activity, and increased parasympathetic withdrawal during stress are associated with multiple MetS components, and higher basal sympathetic activity predicts an increase in metabolic abnormalities over time. These findings support a role for ANS dysregulation in the risk for MetS and, consequently, the development of cardiovascular disease.
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Affiliation(s)
- Mandy X Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Sarah A Hiles
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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Sex, the brain and hypertension: brain oestrogen receptors and high blood pressure risk factors. Clin Sci (Lond) 2015; 130:9-18. [DOI: 10.1042/cs20150654] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Hypertension is a major contributor to worldwide morbidity and mortality rates related to cardiovascular disease. There are important sex differences in the onset and rate of hypertension in humans. Compared with age-matched men, premenopausal women are less likely to develop hypertension. However, after age 60, the incidence of hypertension increases in women and even surpasses that seen in older men. It is thought that changes in levels of circulating ovarian hormones as women age may be involved in the increase in hypertension in older women. One of the key mechanisms involved in the development of hypertension in both men and women is an increase in sympathetic nerve activity (SNA). Brain regions important for the regulation of SNA, such as the subfornical organ, the paraventricular nucleus and the rostral ventral lateral medulla, also express specific subtypes of oestrogen receptors. Each of these brain regions has also been implicated in mechanisms underlying risk factors for hypertension such as obesity, stress and inflammation. The present review brings together evidence that links actions of oestrogen at these receptors to modulate some of the common brain mechanisms involved in the ability of hypertensive risk factors to increase SNA and blood pressure. Understanding the mechanisms by which oestrogen acts at key sites in the brain for the regulation of SNA is important for the development of novel, sex-specific therapies for treating hypertension.
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Garafova A, Penesova A, Cizmarova E, Marko A, Vlcek M, Jezova D. Cardiovascular and sympathetic responses to a mental stress task in young patients with hypertension and/or obesity. Physiol Res 2015; 63:S459-67. [PMID: 25669677 DOI: 10.33549/physiolres.932931] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Present study was aimed to investigate sympathetic responses to mental stress with hypothesis that the presence of obesity in patients with hypertension has a modifying effect. Young male subjects, 8 with hypertension grade I, with BMI 25 kg/m(2) (HT), 10 with hypertension grade I, and BMI 30 kg/m(2) (HT OB), 14 healthy controls with BMI 30 kg/m(2) (OB), and 13 healthy controls with BMI 25 kg/m(2) (C) underwent the Stroop test. ECG was recorded continuously to evaluate heart rate variability (HRV). Blood pressure (BP) and catecholamine concentrations were measured at baseline, at the end of mental stress test and 15 min thereafter. Patients with HT demonstrated increased adrenaline concentrations and enhanced stress-induced noradrenaline release compared to that in healthy controls. In obese subjects, stress-induced increase of systolicBP was lower compared to lean individuals. Stress exposure induced a significant rise in the low frequency power component of HRV, however the increase was lower in the HT OB group compared to C. Obesity in patients with hypertension did not lead to a different reaction in comparison with lean hypertensive subjects. The present data demonstrate higher sympathoadrenal activity in early-stage of hypertension. Obesity is connected with higher resting systolicBP and modifies the HRV response to mental stress.
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Affiliation(s)
- A Garafova
- Laboratory of Human Endocrinology, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovak Republic.
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Darviri C, Artemiadis AK, Protogerou A, Soldatos P, Kranioutou C, Vasdekis S, Varvogli L, Nasothimiou E, Vasilopoulou E, Karantzi E, Linardatou A, Michou M, Chrousos GP. A HEALth Promotion and STRESS Management Program (HEAL-STRESS study) for prehypertensive and hypertensive patients: a quasi-experimental study in Greece. J Hum Hypertens 2015; 30:397-403. [DOI: 10.1038/jhh.2015.99] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/14/2015] [Accepted: 08/24/2015] [Indexed: 11/09/2022]
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Weiss JW, Tamisier R, Liu Y. Sympathoexcitation and arterial hypertension associated with obstructive sleep apnea and cyclic intermittent hypoxia. J Appl Physiol (1985) 2015; 119:1449-54. [PMID: 26251511 DOI: 10.1152/japplphysiol.00315.2015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/03/2015] [Indexed: 12/15/2022] Open
Abstract
Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction during sleep. These obstructive episodes are characterized by cyclic intermittent hypoxia (CIH), by sleep fragmentation, and by hemodynamic instability, and they result in sustained sympathoexcitation and elevated arterial pressure that persist during waking, after restoration of normoxia. Early studies established that 1) CIH, rather than sleep disruption, accounts for the increase in arterial pressure; 2) the increase in arterial pressure is a consequence of the sympathoactivation; and 3) arterial hypertension after CIH exposure requires an intact peripheral chemoreflex. More recently, however, evidence has accumulated that sympathoactivation and hypertension after CIH are also dependent on altered central sympathoregulation. Furthermore, although many molecular pathways are activated in both the carotid chemoreceptor and in the central nervous system by CIH exposure, two specific neuromodulators-endothelin-1 and angiotensin II-appear to play crucial roles in mediating the sympathetic and hemodynamic response to intermittent hypoxia.
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Affiliation(s)
- J Woodrow Weiss
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts;
| | - Renaud Tamisier
- Sleep Laboratory and EFCR, Pôle Rééducation et Physiologie, University Hospital, HP2 Laboratory (Hypoxia: Pathophysiology) INSERM ERI 17, EA 3745 Joseph Fourier University, Grenoble, France; and
| | - Yuzhen Liu
- First Afflicted Hospital of Xinxiang Medical University, Xinxiang, Henan, China
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Lambert EA, Straznicky NE, Dixon JB, Lambert GW. Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity? Am J Physiol Heart Circ Physiol 2015; 309:H244-58. [DOI: 10.1152/ajpheart.00096.2015] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/11/2015] [Indexed: 02/03/2023]
Abstract
The sympathetic nervous system (SNS) plays a key role in both cardiovascular and metabolic regulation; hence, disturbances in SNS regulation are likely to impact on both cardiovascular and metabolic health. With excess adiposity, in particular when visceral fat accumulation is present, sympathetic activation commonly occurs. Experimental investigations have shown that adipose tissue releases a large number of adipokines, cytokines, and bioactive mediators capable of stimulating the SNS. Activation of the SNS and its interaction with adipose tissue may lead to the development of hypertension and end-organ damage including vascular, cardiac, and renal impairment and in addition lead to metabolic abnormalities, especially insulin resistance. Lifestyle changes such as weight loss and exercise programs considerably improve the cardiovascular and metabolic profile of subjects with obesity and decrease their cardiovascular risk, but unfortunately weight loss is often difficult to achieve and sustain. Pharmacological and device-based approaches to directly or indirectly target the activation of the SNS may offer some benefit in reducing the cardiometabolic consequences of obesity. Preliminary evidence is encouraging, but more trials are needed to investigate whether sympathetic inhibition could be used in obesity to reverse or prevent cardiometabolic disease development. The purpose of this review article is to highlight the current knowledge of the role that SNS plays in obesity and its associated metabolic disorders and to review the potential benefits of sympathoinhibition on metabolic and cardiovascular functions.
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Affiliation(s)
- Elisabeth A. Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Physiology, Monash University, Clayton, Australia
| | - Nora E. Straznicky
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - John B. Dixon
- Clinical Obesity Research Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; and
| | - Gavin W. Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
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Mischel NA, Subramanian M, Dombrowski MD, Llewellyn-Smith IJ, Mueller PJ. (In)activity-related neuroplasticity in brainstem control of sympathetic outflow: unraveling underlying molecular, cellular, and anatomical mechanisms. Am J Physiol Heart Circ Physiol 2015; 309:H235-43. [PMID: 25957223 DOI: 10.1152/ajpheart.00929.2014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 05/08/2015] [Indexed: 02/07/2023]
Abstract
More people die as a result of physical inactivity than any other preventable risk factor including smoking, high cholesterol, and obesity. Cardiovascular disease, the number one cause of death in the United States, tops the list of inactivity-related diseases. Nevertheless, the vast majority of Americans continue to make lifestyle choices that are creating a rapidly growing burden of epidemic size and impact on the United States healthcare system. It is imperative that we improve our understanding of the mechanisms by which physical inactivity increases the incidence of cardiovascular disease and how exercise can prevent or rescue the inactivity phenotype. The current review summarizes research on changes in the brain that contribute to inactivity-related cardiovascular disease. Specifically, we focus on changes in the rostral ventrolateral medulla (RVLM), a critical brain region for basal and reflex control of sympathetic activity. The RVLM is implicated in elevated sympathetic outflow associated with several cardiovascular diseases including hypertension and heart failure. We hypothesize that changes in the RVLM contribute to chronic cardiovascular disease related to physical inactivity. Data obtained from our translational rodent models of chronic, voluntary exercise and inactivity suggest that functional, anatomical, and molecular neuroplasticity enhances glutamatergic neurotransmission in the RVLM of sedentary animals. Collectively, the evidence presented here suggests that changes in the RVLM resulting from sedentary conditions are deleterious and contribute to cardiovascular diseases that have an increased prevalence in sedentary individuals. The mechanisms by which these changes occur over time and their impact are important areas for future study.
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Affiliation(s)
- Nicholas A Mischel
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; and
| | - Madhan Subramanian
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; and
| | - Maryetta D Dombrowski
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; and
| | - Ida J Llewellyn-Smith
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; and Cardiovascular Medicine, Physiology and Centre for Neuroscience, School of Medicine, Flinders University, Bedford Park, South Australia, Australia
| | - Patrick J Mueller
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; and
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Abstract
PURPOSE To determine the impact of noise on heart rate variability (HRV) in men, with a focus on the noise type rather than on noise intensity. MATERIALS AND METHODS Forty college-going male volunteers were enrolled in this study and were randomly divided into four groups according to the type of noise they were exposed to: background, traffic, speech, or mixed (traffic and speech) noise. All groups except the background group (35 dB) were exposed to 45 dB sound pressure levels. We collected data on age, smoking status, alcohol consumption, and disease status from responses to self-reported questionnaires and medical examinations. We also measured HRV parameters and blood pressure levels before and after exposure to noise. The HRV parameters were evaluated while patients remained seated for 5 minutes, and frequency and time domain analyses were then performed. RESULTS After noise exposure, only the speech noise group showed a reduced low frequency (LF) value, reflecting the activity of both the sympathetic and parasympathetic nervous systems. The low-to-high frequency (LF/HF) ratio, which reflected the activity of the autonomic nervous system (ANS), became more stable, decreasing from 5.21 to 1.37; however, this change was not statistically significant. CONCLUSION These results indicate that 45 dB(A) of noise, 10 dB(A) higher than background noise, affects the ANS. Additionally, the impact on HRV activity might differ according to the noise quality. Further studies will be required to ascertain the role of noise type.
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Affiliation(s)
- Chang Sun Sim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Joo Hyun Sung
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sang Hyeon Cheon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jang Myung Lee
- Department of Mechanical Engineering, University of Ulsan College of Engineering, Ulsan, Korea
| | - Jae Won Lee
- Indoor Environment & Noise Research Division, National Institute of Environmental Research, Incheon, Korea
| | - Jiho Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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Frisbee JC, Goodwill AG, Frisbee SJ, Butcher JT, Wu F, Chantler PD. Microvascular perfusion heterogeneity contributes to peripheral vascular disease in metabolic syndrome. J Physiol 2014; 594:2233-43. [PMID: 25384789 DOI: 10.1113/jphysiol.2014.285247] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 11/02/2014] [Indexed: 12/20/2022] Open
Abstract
A major challenge facing public health is the increased incidence and prevalence of the metabolic syndrome, a clinical condition characterized by excess adiposity, impaired glycaemic control, dyslipidaemia and moderate hypertension. The greatest concern for this syndrome is the profound increase in risk for development of peripheral vascular disease (PVD) in afflicted persons. However, ongoing studies suggest that reductions in bulk blood flow to skeletal muscle may not be the primary contributor to the premature muscle fatigue that is a hallmark of PVD. Compelling evidence has been provided suggesting that an increasingly spatially heterogeneous and temporally stable distribution of blood flow at successive arteriolar bifurcations in metabolic syndrome creates an environment where a large number of the pre-capillary arterioles have low perfusion, low haematocrit, and are increasingly confined to this state, with limited ability to adapt perfusion in response to a challenged environment. Single pharmacological interventions are unable to significantly restore function owing to a divergence in their spatial effectiveness, although combined therapeutic approaches to correct adrenergic dysfunction, elevated oxidant stress and increased thromboxane A2 improve perfusion-based outcomes. Integrated, multi-target therapeutic interventions designed to restore healthy network function and flexibility may provide for superior outcomes in subjects with metabolic syndrome-associated PVD.
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Affiliation(s)
- Jefferson C Frisbee
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, WV, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, WV, USA
| | - Adam G Goodwill
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, WV, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, WV, USA
| | - Stephanie J Frisbee
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, WV, USA.,Department of Health Policy, Management and Leadership, West Virginia University Health Sciences Center, Morgantown, WV, USA
| | - Joshua T Butcher
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, WV, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, WV, USA
| | - Fan Wu
- Novartis Institutes for BioMedical Research, Drug Metabolism and Pharmacokinetics, East Hanover, NJ, USA
| | - Paul D Chantler
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, WV, USA.,Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, WV, USA
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Schutte AE, Ware LJ, Huisman HW, Fourie CM, Greeff M, Khumalo T, Wissing MP. Psychological Distress and the Development of Hypertension Over 5 Years in Black South Africans. J Clin Hypertens (Greenwich) 2014; 17:126-33. [PMID: 25496159 DOI: 10.1111/jch.12455] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/05/2014] [Accepted: 09/14/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Aletta E. Schutte
- Hypertension in Africa Research Team (HART); North-West University; Potchefstroom South Africa
| | - Lisa J. Ware
- Hypertension in Africa Research Team (HART); North-West University; Potchefstroom South Africa
| | - Hugo W. Huisman
- Hypertension in Africa Research Team (HART); North-West University; Potchefstroom South Africa
| | - Carla M.T. Fourie
- Hypertension in Africa Research Team (HART); North-West University; Potchefstroom South Africa
| | - Minrie Greeff
- Africa Unit for Transdisciplinary Health Research (AUTHeR); North-West University; Potchefstroom South Africa
| | - Tumi Khumalo
- Africa Unit for Transdisciplinary Health Research (AUTHeR); North-West University; Potchefstroom South Africa
| | - Marie P. Wissing
- Africa Unit for Transdisciplinary Health Research (AUTHeR); North-West University; Potchefstroom South Africa
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Charkoudian N, Wallin BG. Sympathetic neural activity to the cardiovascular system: integrator of systemic physiology and interindividual characteristics. Compr Physiol 2014; 4:825-50. [PMID: 24715570 DOI: 10.1002/cphy.c130038] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The sympathetic nervous system is a ubiquitous, integrating controller of myriad physiological functions. In the present article, we review the physiology of sympathetic neural control of cardiovascular function with a focus on integrative mechanisms in humans. Direct measurement of sympathetic neural activity (SNA) in humans can be accomplished using microneurography, most commonly performed in the peroneal (fibular) nerve. In humans, muscle SNA (MSNA) is composed of vasoconstrictor fibers; its best-recognized characteristic is its participation in transient, moment-to-moment control of arterial blood pressure via the arterial baroreflex. This property of MSNA contributes to its typical "bursting" pattern which is strongly linked to the cardiac cycle. Recent evidence suggests that sympathetic neural mechanisms and the baroreflex have important roles in the long term control of blood pressure as well. One of the striking characteristics of MSNA is its large interindividual variability. However, in young, normotensive humans, higher MSNA is not linked to higher blood pressure due to balancing influences of other cardiovascular variables. In men, an inverse relationship between MSNA and cardiac output is a major factor in this balance, whereas in women, beta-adrenergic vasodilation offsets the vasoconstrictor/pressor effects of higher MSNA. As people get older (and in people with hypertension) higher MSNA is more likely to be linked to higher blood pressure. Skin SNA (SSNA) can also be measured in humans, although interpretation of SSNA signals is complicated by multiple types of neurons involved (vasoconstrictor, vasodilator, sudomotor and pilomotor). In addition to blood pressure regulation, the sympathetic nervous system contributes to cardiovascular regulation during numerous other reflexes, including those involved in exercise, thermoregulation, chemoreflex regulation, and responses to mental stress.
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Affiliation(s)
- N Charkoudian
- U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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Egger G, Dixon J. Beyond obesity and lifestyle: a review of 21st century chronic disease determinants. BIOMED RESEARCH INTERNATIONAL 2014; 2014:731685. [PMID: 24804239 PMCID: PMC3997940 DOI: 10.1155/2014/731685] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 03/10/2014] [Indexed: 01/08/2023]
Abstract
The obesity epidemic and associated chronic diseases are often attributed to modern lifestyles. The term "lifestyle" however, ignores broader social, economic, and environmental determinants while inadvertently "blaming the victim." Seen more eclectically, lifestyle encompasses distal, medial, and proximal determinants. Hence any analysis of causality should include all these levels. The term "anthropogens," or "…man-made environments, their by-products and/or lifestyles encouraged by these, some of which may be detrimental to human health" provides a monocausal focus for chronic diseases similar to that which the germ theory afforded infectious diseases. Anthropogens have in common an ability to induce a form of chronic, low-level systemic inflammation ("metaflammation"). A review of anthropogens, based on inducers with a metaflammatory association, is conducted here, together with the evidence for each in connection with a number of chronic diseases. This suggests a broader view of lifestyle and a focus on determinants, rather than obesity and lifestyle per se as the specific causes of modern chronic disease. Under such an analysis, obesity is seen more as "a canary in a mineshaft" signaling problems in the broader environment, suggesting that population obesity management should be focused more upstream if chronic diseases are to be better managed.
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Affiliation(s)
- Garry Egger
- School of Health and Human Sciences, Southern Cross University, P.O. Box 313, Balgowlah, Lismore, NSW 2093, Australia
| | - John Dixon
- Clinical Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
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Gil JS, Drager LF, Guerra-Riccio GM, Mostarda C, Irigoyen MC, Costa-Hong V, Bortolotto LA, Egan BM, Lopes HF. The impact of metabolic syndrome on metabolic, pro-inflammatory and prothrombotic markers according to the presence of high blood pressure criterion. Clinics (Sao Paulo) 2013; 68:1495-501. [PMID: 24473506 PMCID: PMC3840365 DOI: 10.6061/clinics/2013(12)04] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 06/11/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We explored whether high blood pressure is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome. METHODS We evaluated 135 consecutive overweight/obese patients. From this group, we selected 75 patients who were not under the regular use of medications for metabolic syndrome as defined by the current Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults criteria. The patients were divided into metabolic syndrome with and without high blood pressure criteria (≥130/≥85 mmHg). RESULTS Compared to the 45 metabolic syndrome patients without high blood pressure, the 30 patients with metabolic syndrome and high blood pressure had significantly higher glucose, insulin, homeostasis model assessment insulin resistance index, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, uric acid and creatinine values; in contrast, these patients had significantly lower high-density lipoprotein-cholesterol values. Metabolic syndrome patients with high blood pressure also had significantly higher levels of retinol-binding protein 4, plasminogen activator inhibitor 1, interleukin 6 and monocyte chemoattractant protein 1 and lower levels of adiponectin. Moreover, patients with metabolic syndrome and high blood pressure had increased surrogate markers of sympathetic activity and decreased baroreflex sensitivity. Logistic regression analysis showed that high-density lipoprotein, retinol-binding protein 4 and plasminogen activator inhibitor-1 levels were independently associated with metabolic syndrome patients with high blood pressure. There is a strong trend for an independent association between metabolic syndrome patients with high blood pressure and glucose levels. CONCLUSIONS High blood pressure, which may be related to the autonomic dysfunction, is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome.
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Affiliation(s)
- Juliana S Gil
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Luciano F Drager
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | | | - Cristiano Mostarda
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Maria C Irigoyen
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Valeria Costa-Hong
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Luiz A Bortolotto
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Brent M Egan
- Medical University of South Carolina, CharlestonSC, USA
| | - Heno F Lopes
- Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
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Abstract
Oxygen consumption varies with physical and mental activity as well as pathological conditions. Although there is a strong relationship between yoga and metabolic parameters, the relationship between yoga and oxygen consumption has not yet been formally reviewed. This systematic review attempted to include all studies of yoga that also measured oxygen consumption or metabolic rate as an outcome. A total of 58 studies were located involving between 1 and 104 subjects (average 21). The studies were generally of poor methodological quality and demonstrated great heterogeneity with different experimental designs, yoga practices, time periods, and small sample sizes. Studies report yoga practices to have profound metabolic effects producing both increase and decrease in oxygen consumption, ranging from 383% increase with cobra pose to 40% decrease with meditation. Compared to nonpractitioners, basal oxygen consumption is reported to be up to 15% less in regular yoga practitioners, and regular yoga practice is reported to have a training effect with oxygen consumption during submaximal exercise decreasing by 36% after 3 months. Yoga breathing practices emphasize breathing patterns and retention ratios as well as unilateral nostril breathing, and these factors appear critical in influencing oxygen consumption. A number of studies report extraordinary volitional control over metabolism in advanced yoga practitioners who appear to be able to survive extended periods in airtight pits and to exceed the limits of normal human endurance. More rigorous research with standardized practices is required to determine the mechanisms of yoga’s metabolic effects and the relevance of yoga practices in different clinical populations.
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Affiliation(s)
| | - Marc Cohen
- RMIT University, Bundoora, Victoria, Australia
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Abstract
INTRODUCTION Chronic stress is known to have negative effects on reproduction, but little is known about how it affects the sexual response cycle. The present study examined the relationship between chronic stress and sexual arousal and the mechanisms that mediate this relationship. AIM The aim of this study is to test the relationship between chronic stress and sexual arousal and identify mechanisms that may explain this relationship. We predicted that women experiencing high levels of chronic stress would show lower levels of genital arousal and dehydroepiandrosterone (DHEAS) and higher levels of cortisol and cognitive distraction compared with women with average levels of stress. METHODS Women who were categorized as high in chronic stress (high stress group; n=15) or average in chronic stress (average stress group; n=15) provided saliva samples and watched an erotic film while having their genital and psychological arousal measured. MAIN OUTCOME MEASURES Main outcome measures were vaginal pulse amplitude, psychological arousal, salivary cortisol, salivary DHEAS, and heart rate and compared them between women with high and average levels of chronic stress. RESULTS Women in the high stress group had lower levels of genital, but not psychological arousal, had higher levels of cortisol, and reported more distraction during the erotic film than women in the average stress group. The main predictor of decreased genital sexual arousal was participants' distraction scores. CONCLUSIONS High levels of chronic stress were related to lower levels of genital sexual arousal. Both psychological (distraction) and hormonal (increased cortisol) factors were related to the lower levels of sexual arousal seen in women high in chronic stress, but distraction was the only significant predictor when controlling for other variables.
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Affiliation(s)
- Lisa Dawn Hamilton
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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Hering D, Kara T, Kucharska W, Somers VK, Narkiewicz K. High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests. Blood Press 2013; 22:183-7. [PMID: 23356493 DOI: 10.3109/08037051.2012.759689] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE High-normal blood pressure (BP) increases the risk of cardiovascular (CV) disease. The mechanisms underlying this increased risk are not clear. Sympathetic activation appears to be a potential mechanism linking high-normal BP to CV disease. This study examined whether high-normal BP compared with optimal BP is linked to sympathoexcitation at rest and/or during laboratory stressors. METHODS Heart rate (HR), BP and muscle sympathetic nerve activity (MSNA) were obtained at rest and during stress tests (sustained handgrip and mental stress) in 18 subjects (15 males and three females) with high-normal BP (systolic BP of 130-139 mmHg, diastolic BP of 85-89 mmHg, or both) and in 12 subjects (10 males and two females) with optimal BP (< 120/80 mmHg) matched for age (34 ± 3 years in both groups) and body mass index (25 ± 2 kg/m(2) in both groups). RESULTS Despite the higher resting BP levels, MSNA was higher in subjects with high-normal BP than in the optimal BP group (26 ± 3 vs 18 ± 2 bursts/min, p< 0.05). During sustained handgrip, MSNA increased by 37 ± 14% in high-normal BP group compared with an increase of 49 ± 15% in optimal BP group (p = 0.55). Changes during mental stress were 50 ± 28% and 37 ± 12%, respectively (p = 0.73). There were no significant differences in SBP responses to handgrip and mental stress between the high-normal and optimal BP groups. Baseline HR and chronotropic responses to stress tests were comparable between the two groups. CONCLUSION In comparison with optimal BP, high-normal BP is associated with increased resting MSNA, but normal neural and circulatory responses to stress tests. These findings suggest that tonic activation of the sympathetic nervous system may precede overt arterial hypertension and contribute to an excess risk of CV disease in subjects with high-normal BP.
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Affiliation(s)
- Dagmara Hering
- Department of Hypertension and Diabetology, Medical University of Gdansk, 80-952 Gdansk, Poland.
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Jiménez JA, Shivpuri S, de los Monteros KE, Matthews KA, Mills PJ, Gallo LC. Associations between socioeconomic status and catecholamine levels vary by acculturation status in Mexican-American women. Ann Behav Med 2012; 44:129-35. [PMID: 22555944 DOI: 10.1007/s12160-012-9365-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Lower socioeconomic status (SES) is associated with poorer health, possibly through activation of the sympathetic nervous system. PURPOSE This study aimed to examine the association between SES and catecholamine levels, and variations by acculturation. METHODS Three hundred one Mexican-American women underwent examination with a 12-h urine collection. Analyses tested associations of SES, acculturation (language and nativity), and their interaction with norepinephrine (NOREPI) and epinephrine (EPI). RESULTS No main effects for SES or the acculturation indicators emerged. Fully adjusted models revealed a significant SES by language interaction for NOREPI (p< .01) and EPI (p< .05), and a SES by nativity interaction approached significance for NOREPI (p= .05). Simple slope analyses revealed that higher SES related to lower catecholamine levels in Spanish-speaking women, and higher NOREPI in English-speaking women. Although nonsignificant, similar patterns were observed for nativity. CONCLUSIONS Associations between SES and catecholamines may vary by acculturation, and cultural factors should be considered when examining SES health effects in Hispanics.
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Affiliation(s)
- Jessica A Jiménez
- San Diego Joint Doctoral Program in Public Health, San Diego State University/University of California, San Diego, CA, USA.
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