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Saraiva BTC, Franchini E, Ribeiro AS, Gobbo LA, Correia MA, Vanderlei LCM, Ferrari G, Tebar WR, Christofaro DGD. Effects of 12 weeks of functional training vs. Muay Thai on cardiac autonomic modulation and hemodynamic parameters in older adults: a randomized clinical trial. BMC Cardiovasc Disord 2024; 24:433. [PMID: 39153977 PMCID: PMC11330007 DOI: 10.1186/s12872-024-04096-3] [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] [Received: 03/26/2024] [Accepted: 08/02/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND The elevated blood pressure (BP) and lower cardiac autonomic modulation (CAM) are associated with higher morbidity mortality risk among older adults. Although exercise is an important intervention for cardiovascular promotion, it is unclear whether combat sports training could benefit cardiovascular outcomes as much as autonomic in this population. This study compared the effects of 12 weeks of Muay Thai (MT) training against functional training (FT) on CAM and hemodynamic parameters in older adults. METHODS The sample consisted of 50 older adults (41 women; 66.0 ± 5.3 years old), who were equaly randomized into FT (n = 25) and MT (n = 25) intervention groups. CAM was measured by 30-min rest heart rate variability. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and resting heart rate (RHR) were measured using an automatic oscillometric device. Pulse pressure (PP) and the double product (DP) were also calculated. The interventions were carried out three times a week, with 60-min length per session, during 12 consecutive weeks. The intensity of the interventions was measured using the subjective perception of exertion scale and by accelerometer. Two-factor repeated measures analysis of covariance was used for groups comparison, considering intervention group and body mass as factors. The 95% confidence interval of the difference (95%CIdif) was also calculated and the effect size was measured using partial eta squared (η2p). RESULTS CAM indices did not show significant changes across moments and intervention groups. In hemodynamic parameters, only in DBP was there an effect of the moment (F1,39 = 8.206; P = 0.007; η2p = 0.174, large) and interaction effect between group*moment (F1,39 = 7.950; P = 0.008; η2p = 0.169, large). Specifically, the MT group at the post-training moment showed lower DBP (P = 0.010; 95%CIdif = -13.3; -1.89) in relation to the FT group. Furthermore, the MT group showed a decrease in DBP during training (P = 0.002; 95%CIdif = -10.3; -2.6). Also, an increase in training intensity was also found over the 12 weeks in FT, with no difference between the groups. CONCLUSION After 12 weeks of MT practice there was a reduction in DBP compared to FT in older adults. TRIAL REGISTRATION NCT03919968 Registration date: 01/02/2019.
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Affiliation(s)
- Bruna T C Saraiva
- School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, (SP), Brazil.
- Departamento de Educação Física, Faculdade de Ciências E Tecnologia, Universidade de São Paulo (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, (SP), Brasil.
| | - Emerson Franchini
- Department of Physical Education, School of Physical Education and Sport, São Paulo University (USP), São Paulo, (SP), Brazil
| | - Alex S Ribeiro
- Department of Physical Education, Faculty of Sport Science and Physical Education, University of Coimbra (UC), Coimbra, Portugal
| | - Luís A Gobbo
- Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, (SP), Brazil
| | - Marília A Correia
- Department of Physical Education, University of Nine July (UNINOVE), Campus Vergueiro, São Paulo, (SP), Brazil
| | - Luiz C M Vanderlei
- Department of Physiotherapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, (SP), Brazil
| | - Gerson Ferrari
- Facultad de Ciencias de La Salud, Universidad Autónoma de Chile, Providencia, Chile
| | - William R Tebar
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, (SP), Brazil
| | - Diego G D Christofaro
- Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, (SP), Brazil
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Liu J, Zhang F. Autonomic Nervous System and Sarcopenia in Elderly Patients: Insights from Long-Term Heart Rate Variability Monitoring in a Hospital Setting. Int J Gen Med 2024; 17:3467-3477. [PMID: 39156877 PMCID: PMC11328863 DOI: 10.2147/ijgm.s472913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024] Open
Abstract
Background Emerging evidence suggests a link between muscle health and the autonomic nervous system, but research is scarce. This study examines the connection between long-term heart rate variability (HRV) measured autonomic function and sarcopenia in the elderly, focusing on muscle mass and strength. Patients and Methods This retrospective cross-sectional study comprised 132 elderly hospitalized patients. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, involving reduced muscle mass and strength. HRV was assessed using standard deviation of NN intervals (SDNN), with values below 100 milliseconds indicating reduced HRV. Multivariate logistic regression and Pearson's correlation analyses were conducted to explore the associations between sarcopenia, muscle metrics, and HRV parameters. Results Among elderly hospitalized patients, 45.45% had reduced HRV, with sarcopenia patients showing a fivefold higher risk (OR: 5.042; p = 0.034). Grip strength and SARC-CalF scores were independent factors associated with reduced HRV. Moderate correlations were noted between grip strength and HRV indices, particularly with SDNN (r = 0.393, p = 0.001) and the triangular index (r = 0.385, p < 0.001), while a weaker correlation was found with very low frequency power (VLF) (r = 0.283, p = 0.006). No significant correlations were identified between HRV and muscle mass. Regression analyses revealed significant independent associations between HRV parameters and the decline in muscle strength and the onset of sarcopenia. Conclusion Reduced HRV is closely linked to sarcopenia and diminished muscle strength in the elderly, with the triangular index and SDNN as key indicators, highlighting HRV's potential in muscle health assessment.
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Affiliation(s)
- Jia Liu
- Department of Geriatrics, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Fan Zhang
- Department of Geriatrics, Peking University Third Hospital, Beijing, People’s Republic of China
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Zheng K, Wang Z, Han P, Chen C, Huang C, Wu Y, Wang Y, Guo J, Tao Q, Zhai J, Zhao S, Zhang J, Shen N, Guo Q. Lower heart rate variability is associated with loss of muscle mass and sarcopenia in community-dwelling older Chinese adults. J Formos Med Assoc 2024; 123:571-577. [PMID: 37996320 DOI: 10.1016/j.jfma.2023.10.010] [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: 07/20/2023] [Revised: 09/14/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND/PURPOSE Autonomic nervous system (ANS) disorders may occur in skeletal muscle disease, but the link between them has not been fully established. Studying the relationship between them may yield insights into the mechanisms and treatment of disease. This study aimed to explore the association between heart rate variability (HRV), sarcopenia, and subscales of sarcopenia (muscle mass, muscle strength, and physical mobility). METHODS 2514 community-dwelling older Chinese participants were included in this study. The Asian Working Group for Sarcopenia guidelines were used to define sarcopenia. HRV was measured by 90-s electrocardiogram RR interval data. All HRV parameters were transformed using natural logarithms. Multiple regression analysis and multivariate linear regression was performed using potential correlates. RESULTS The overall prevalence of sarcopenia was 15.1 % (18.5 % in males and 12.6 % in females). In the logistic regression analysis model, there was a significant association between log-transformed standard deviation of RR interval (lnSDNN) (OR = 0.736, p = 0.019), log-transformed coefficient of variation of RR intervals (lnCVRR) (OR = 0.751, p = 0.020), log-transformed low-frequency power (lnLF) (OR = 0.861, p = 0.008), log-transformed high-frequency power (lnHF) (OR = 0.864, p = 0.003) and sarcopenia in the general population after adjusting for age, sex, body mass index (BMI), daily activity levels, hypertension, heart disease and cardiac drugs. In addition, in multivariate linear regression, lnSDNN (β = 0.146, p = 0.001), lnCVRR (β = 0.120, p = 0.010), lnLF (β = 0.066, p = 0.002) and lnHF (β = 0.065, p < 0.001) remained significantly positively associated with muscle mass, but there were no significant differences in grip strength and walking speed. CONCLUSION Sarcopenia was independently associated with lower heart rate variability in a community-dwelling elderly Chinese population. In addition, muscle mass was positively associated with heart rate variability in the elderly.
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Affiliation(s)
- Kai Zheng
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Zhongkai Wang
- Department of Pain and Rehabilitation, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Cheng Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China; School of Health, Fujian Medical University, Fujian, Fuzhou, China
| | - Chuanjun Huang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yahui Wu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yue Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jiangling Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China; Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qiongying Tao
- Jiading Subdistrict Community Health Center, Shanghai, China
| | - Jiayi Zhai
- Jiading Subdistrict Community Health Center, Shanghai, China
| | - Suyan Zhao
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jiayao Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Nijia Shen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
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Christofaro DGD, Tebar WR, Mota J, Delfino LD, Santos AB, Ritti-Dias RM, Fernandes RA, Ferrari G, Vanderlei LCM. Association of Sports Practice in Childhood and Adolescence with Cardiac Autonomic Modulation in Adulthood: A Retrospective Epidemiological Study. SPORTS MEDICINE - OPEN 2024; 10:41. [PMID: 38625654 PMCID: PMC11021389 DOI: 10.1186/s40798-024-00707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Practicing sports during childhood and adolescence provides benefits to cardiac autonomic modulation (CAM) at these stages of life. However, it is not known whether these benefits to CAM persist into adulthood. Therefore, the objective of this study was to analyze the association of early sports practice (sports practice in childhood and/or adolescence) with CAM in adult life, regardless of habitual moderate-to-vigorous PA. METHODS The sample of the present study consisted of 242 adults (141 women and 101 men; age: 41.99 ± 16.24). The assessment of CAM was performed using heart rate variability indices. Sports practice in childhood and adolescence was assessed using a questionnaire. The intensity of physical activity was assessed using accelerometry. To analyze the association between previous sports practice (childhood and/or adolescence) and CAM, the Generalized Linear Model was adopted, considering CAM indices as continuous variables and early sports practice as a 3-fold factor (no sports practice; sports practice in childhood or adolescence; and sports practice in both childhood and adolescence) adjusted by sex, age, socioeconomic condition, and moderate to vigorous PA. RESULTS Sports practice in childhood was associated with the average standard deviation of all normal RR intervals expressed in milliseconds (SDNN): β = 5.89; 95%CI: 0.25;11.52, and the standard deviation of the long-term intervals between consecutive heartbeats (SD2): β = 7.63; 95%CI:1.04; 14.23 indices. Sports practice in adolescence was associated in adulthood with the SD2 index: β = 7.37; 95%CI: 0.71;14.04. Sports practice in at least one of the periods (childhood or adolescence) was significantly associated with the square root of the mean square of the differences between adjacent normal RR intervals for a period of time expressed in milliseconds (RMSSD) (β = 8.86; 95%CI = 0.71;17.01), and the standard deviation of the instantaneous beat to beat variability (SD1) (β = 6.21; 95%CI = 0.45;11.97). Sports practice at both stages of life was significantly associated with better SDNN (β = 7.70; 95%CI = 1.16;14.23) and SD2 (β = 10.18; 95%CI = 2.51;17.85). CONCLUSION Early sports practice was associated with better CAM in adulthood, independently of the current physical activity level. Based on these findings, sports practice is encouraged from childhood and adolescence, for benefits to CAM in adult life.
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Affiliation(s)
- Diego Giulliano Destro Christofaro
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil.
| | - William R Tebar
- Centre of Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, São Paulo, Brazil
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Leandro D Delfino
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Amanda B Santos
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Raphael M Ritti-Dias
- Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Rômulo A Fernandes
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Luiz Carlos M Vanderlei
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
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Palma MR, Vanderlei LCM, Tosello G, Fregonesi C, Ribeiro FE, Cucato GG, Ritti-Dias RM, Tebar WR, Christofaro DGD. Association Between Physical Activity Levels in Different Domains and Cardiac Autonomic Modulation in Breast Cancer Survivors: A Cross-sectional Study. Cancer Nurs 2024; 47:E57-E64. [PMID: 36480343 DOI: 10.1097/ncc.0000000000001169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Breast cancer survivors frequently present cardiac autonomic dysfunction. Physical activity (PA) has been associated with better cardiac autonomic modulation (CAM) in breast cancer survivors. OBJECTIVE This study aimed to analyze the association between CAM and PA levels performed in different domains (work and occupation, sport and exercise, and leisure time and commuting) in breast cancer survivors. METHODS This is a cross-sectional study with 99 breast cancer survivors (age, 55.3 ± 10.4 years). Cardiac autonomic modulation was assessed by heart rate variability, and PA levels at work and occupation, sport and exercise, and leisure time and commuting were assessed using the Baecke PA questionnaire. The sum of these 3 domains provided the total PA. The Mann-Whitney test was used to compare CAM between active and inactive women in different domains of PA. RESULTS Cardiac autonomic modulation was similar between active and inactive women in the different domains ( P > .05). However, when considering the total PA, active breast cancer survivors presented higher SDNN (average standard deviation of all normal RR intervals) (20.0 ± 13.4 vs 28.8 ± 14.0; P = .008) and SD2 (standard deviation of the long-term intervals between consecutive heartbeats) indices (29.2 ± 17.3 vs 38.7 ± 19.9; P = .005) compared with their inactive counterparts. CONCLUSION Breast cancer survivors with higher total PA presented better CAM compared with their less active peers. IMPLICATIONS FOR PRACTICE The results of this study are promising and show the importance of increasing PA levels in different domains for the maintenance of cardiovascular health among breast cancer survivors.
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Affiliation(s)
- Mariana R Palma
- Author Affiliations: Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente-SP, Brazil (Drs Palma, Vanderlei, Fregonesi, and Ribeiro); Department of Medicine, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente-SP, Brazil (Dr Tosello); InCOP-Instituto do Câncer do Oeste Paulista, Presidente Prudente-SP, Brazil (Dr Tosello); Department of Sport, Exercise, and Rehabilitation, Northumbria University, Newcastle, United Kingdom (Dr Cucato); Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil (Dr Ritti-Dias); and Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente-SP, Brazil (Drs Tebar and Christofaro)
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Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042457. [PMID: 35206647 PMCID: PMC8875183 DOI: 10.3390/ijerph19042457] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 02/06/2023]
Abstract
The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with SARS-CoV-2 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with SARS-CoV-2 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken, and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in the post-COVID-19 group was increased (stress index; p = 0.0273). They also presented lower values of parasympathetic activity (p < 0.05). Overweight/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p < 0.05). Physically inactive subjects in the post-COVID-19 group presented significantly higher sympathetic activity than active subjects in the control group. Parasympathetic activity was significantly increased in physically active subjects in the control group compared to the physically inactive post-COVID-19 group (p < 0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by overweight/obesity and physical activity levels.
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Christofaro DGD, Tebar WR, Vanderlei LCM, Fernandes RA, Mota J, Mielke GI, Ritti-Dias RM. Association of cardiac autonomic modulation with different intensities of physical activity in a small Brazilian inner city: a gender analysis. Eur J Sport Sci 2022; 23:649-655. [PMID: 35184676 DOI: 10.1080/17461391.2022.2044913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractPhysical activity has been linked to higher cardiac autonomic modulation. However, it is not clear in the literature which type of intensity of physical activity (sedentary, light, moderate, or vigorous) could be related to better cardiac autonomic modulation and whether this relationship is similar in men and women. The aim of this study was to analyze the relationship between cardiac autonomic modulation and the different intensities of physical activity in men and women. The sample included 100 men and 131 women. Cardiac autonomic modulation was obtained by heart rate variability (SDNN, RMSSD, LF un, HF un, SD1, and SD2). Time spent in different intensities (sedentary, light, moderate, and vigorous intensity physical activity) was measured using a waist-worn accelerometer for seven days. Linear regression was used to verify the relationship between physical activity and cardiac autonomic modulation, considering the adjustment for age, ethnicity, and socioeconomic level. Among men, a significant relationship of moderate intensity was observed with SDNN (β=2.442; p = 0.021) and SD2 (β=2.936, p = 0.028), and of vigorous intensity with SDNN (β=12.826, p = 0.028), RMSSD (β=16.370, p = 0.018), and SD1 (β=12.344, p = 0.025) indices. Among women, light-intensity physical activity was significantly related with LFnu (β= .655, p = 0.005) and HFnu (β= -.590, p = 0.010). Moderate and vigorous physical activity was associated with better cardiac autonomic modulation in men. Light physical activity was associated with lower sympathetic modulation in women.
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Affiliation(s)
- Diego G D Christofaro
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, Brazil
| | - William R Tebar
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (USP), Sao Paulo, Brazil
| | - Luiz Carlos M Vanderlei
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, Brazil
| | - Rômulo A Fernandes
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Gregore I Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Christofaro DGD, Tebar WR, Saraiva BTC, Silva GCR, Vanderlei LCM. Effect of very vigorous physical activity on cardiac autonomic modulation in smokers and nonsmokers: an epidemiological study. ACTA ACUST UNITED AC 2021; 47:e20200479. [PMID: 33656093 PMCID: PMC8332670 DOI: 10.36416/1806-3756/e20200479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Diego G D Christofaro
- . Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista - Unesp - Presidente Prudente (SP) Brasil
| | - William R Tebar
- . Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista - Unesp - Presidente Prudente (SP) Brasil
| | - Bruna T C Saraiva
- . Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista - Unesp - Presidente Prudente (SP) Brasil
| | - Gabriela C R Silva
- . Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista - Unesp - Presidente Prudente (SP) Brasil
| | - Luiz Carlos M Vanderlei
- . Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista - Unesp - Presidente Prudente (SP) Brasil
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Farah BQ, Christofaro DGD, Andrade-Lima A, Saraiva BTC, de Barros MVG, do Prado WL, Ritti-Dias RM. Association between sedentary recreational time and cardiac autonomic modulation in adolescent boys: cross-sectional study. SPORT SCIENCES FOR HEALTH 2020. [DOI: 10.1007/s11332-020-00641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tebar WR, Ritti-Dias RM, Mota J, Farah BQ, Saraiva BTC, Damato TMM, Delfino LD, Aguilar BAS, Dos Santos AB, Silva SCB, Vanderlei LCM, Christofaro DGD. Relationship between domains of physical activity and cardiac autonomic modulation in adults: a cross-sectional study. Sci Rep 2020; 10:15510. [PMID: 32968194 PMCID: PMC7511906 DOI: 10.1038/s41598-020-72663-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/06/2020] [Indexed: 12/25/2022] Open
Abstract
This study aimed to analyze the relationship of physical activity in different domains with cardiac autonomic modulation in adults. A sample of 252 adults was randomly selected, with mean age of 42.1 (± 16.5) years, being 58% of women. Cardiac autonomic modulation was assessed through indexes of heart rate variability in time (SDNN, RMSSD) and frequency (LF, HF) domains for linear method, and by Poincaré plot for non-linear method (SD1, SD2 components). Domains of PA (occupation, sport, leisure time/commuting, and total) were assessed by Baecke's questionnaire. Variables of age, gender, socioeconomic status (questionnaire) and body mass index (objectively measures) were covariates. Occupational PA was positively related to LF (β = 2.39, 95% CI 0.24; 4.54), sports PA was positively related to SDNN (β = 3.26, 95% CI 0.18; 7.05), RMSSD (β = 4.07, 95% CI 0.31; 7.85), and SD1 (β = 2.85, 95% CI 0.11; 5.81), and leisure time/commuting PA was positively related to SDNN (β = 3.36, 95% CI 0.28; 6.70) and RMSSD (β = 3.53, 95% CI 0.46; 7.52) indexes. Total PA was related to RMSSD (β = 1.70, 95% CI 0.04; 3.72). Sports, leisure time/commuting, and total PA were related to higher parasympathetic modulation, while occupational PA was related to higher sympathetic modulation to the heart in adults.
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Affiliation(s)
- William R Tebar
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | | | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Breno Q Farah
- Universidade Rural de Pernambuco, Recife, PE, Brazil
| | - Bruna T C Saraiva
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Tatiana M M Damato
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Leandro D Delfino
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Beatriz A S Aguilar
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Amanda B Dos Santos
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Stefany C B Silva
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Luiz Carlos M Vanderlei
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Diego G D Christofaro
- School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, Brazil. .,Department of Physical Education, São Paulo State University, Roberto Simonsen Street, Number 305, Presidente Prudente, 19060-900, Brazil.
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Lever-van Milligen BA, Lamers F, Smit JH, Penninx BWJH. Physiological stress markers, mental health and objective physical function. J Psychosom Res 2020; 133:109996. [PMID: 32229341 DOI: 10.1016/j.jpsychores.2020.109996] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The observed poorer physical function in persons with mental disorders could partly be due to dysregulation in physiological stress systems. However, an integrated picture of the role of physiological stress systems on objective physical function is lacking. This study examined the association of multiple physiological stress systems with objective physical function, and explored whether these stress systems contribute to the relationship between depression/anxiety and poorer physical function. METHODS Data of 2860 persons of the Netherlands Study of Depression and Anxiety was used. Physical function was indicated by hand grip strength assessed using a hand-held dynamometer and lung function assessed using a peak flow meter. Inflammatory markers (CRP, IL-6, TNF-α), salivary cortisol (cortisol awakening response (AUCg, AUCi), evening cortisol) and ANS markers (heartrate, PEP, RSA) were determined. Depression/anxiety disorders were determined using psychiatric interviews. Linear regression analyses were adjusted for sociodemographics, health and lifestyle factors. RESULTS Higher inflammation levels were associated with lower hand grip strength (BCRP = -0.21(SE = 0.06), p < .001) and lower lung function (BCRP = -2.07(SE = 0.66), p = .002), BTNF-α = -3.35(SE = 1.42), p = .022). Higher salivary cortisol levels were associated with lower lung function (Bevening cortisol = -2.22(SE = 0.59), p < .001). The association, in women, between depression/anxiety disorders and poorer physical function did not significantly diminish after adjustment for physiological stress markers. CONCLUSION This large cohort study showed that stress system dysfunction (especially the immune-inflammatory system and HPA-axis) contributes to poorer objective physical function. Stress system dysfunction did not explain the poorer physical function observed in persons with depression/anxiety disorders, suggesting that other pathways are involved to explain that association.
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Affiliation(s)
- Bianca A Lever-van Milligen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands.
| | - Femke Lamers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands
| | - Johannes H Smit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands
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12
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Santana MDR, Garner DM, de Moraes YM, Mangueira LB, Alcantara GC, da Silva JRA, Raimundo RD, Oliveira FR, Valenti VE. Association Between Hospital Anxiety Depression Scale and Autonomic Recovery Following Exercise. J Clin Psychol Med Settings 2019; 27:295-304. [PMID: 31776757 DOI: 10.1007/s10880-019-09683-7] [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] [Indexed: 11/26/2022]
Abstract
The hospital anxiety depression scale (HADS) is a benchmark used to investigate possible and probable cases of psychosomatic illness. Its affiliation with autonomic recovery after exercise is unclear and, as a technique applied to evaluate cardiovascular risk. We assessed a possible link between HADS and autonomic recovery after exercise. We studied healthy subjects split into two groups: Low HADS (n = 20) and High HADS (n = 21). Subjects consented to moderate aerobic exercise on a treadmill at 60% to 65% of the maximum heart rate (HR) for 30 min. We studied HR variability (HRV) before and during 30 min after exercise. Subjects with higher HADS values presented delayed recovery of HR and root-mean square of differences between adjacent normal RR intervals (RMSSD) after submaximal exercise. RMSSD during recovery from exercise had a significant association with HADS. In summary, subjects with higher HADS presented slower vagal recovery following exercise.
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Affiliation(s)
- Milana D R Santana
- Physiological and Pharmaceutical Sciences Nucleus, School of Juazeiro do Norte, R. São Francisco, 1224 - São Miguel, Juazeiro Do Norte, CE, 63010-475, Brazil
| | - David M Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford, OX3 0BP, UK
| | - Yasmim M de Moraes
- Physiological and Pharmaceutical Sciences Nucleus, School of Juazeiro do Norte, R. São Francisco, 1224 - São Miguel, Juazeiro Do Norte, CE, 63010-475, Brazil
| | - Luana B Mangueira
- Physiological and Pharmaceutical Sciences Nucleus, School of Juazeiro do Norte, R. São Francisco, 1224 - São Miguel, Juazeiro Do Norte, CE, 63010-475, Brazil
| | - Guilherme C Alcantara
- Physiological and Pharmaceutical Sciences Nucleus, School of Juazeiro do Norte, R. São Francisco, 1224 - São Miguel, Juazeiro Do Norte, CE, 63010-475, Brazil
| | - José R A da Silva
- Physiological and Pharmaceutical Sciences Nucleus, School of Juazeiro do Norte, R. São Francisco, 1224 - São Miguel, Juazeiro Do Norte, CE, 63010-475, Brazil
| | - Rodrigo D Raimundo
- Design of Studies and Scientific Writing Laboratory, ABC School of Medicine, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André, SP, CEP: 09060-870, Brazil.
| | - Fernando R Oliveira
- Department of Epidemiology, School of Public Health, University of São Paulo, USP, Av. Dr. Arnaldo, 715 - Cerqueira César, Sao Paulo, SP, Brazil
| | - Vitor E Valenti
- Autonomic Nervous System Center, UNESP, Av. Hygino Muzzi Filho, 737, Bairro: Mirante, Marília, SP, 17.525-900, Brazil
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13
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Graham SA, Jeste DV, Lee EE, Wu TC, Tu X, Kim HC, Depp CA. Associations Between Heart Rate Variability Measured With a Wrist-Worn Sensor and Older Adults' Physical Function: Observational Study. JMIR Mhealth Uhealth 2019; 7:e13757. [PMID: 31647469 PMCID: PMC6913722 DOI: 10.2196/13757] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 02/06/2023] Open
Abstract
Background Heart rate variability (HRV), or variation in beat-to-beat intervals of the heart, is a quantitative measure of autonomic regulation of the cardiovascular system. Low HRV derived from electrocardiogram (ECG) recordings is reported to be related to physical frailty in older adults. Recent advances in wearable technology offer opportunities to more easily integrate monitoring of HRV into regular clinical geriatric health assessments. However, signals obtained from ECG versus wearable photoplethysmography (PPG) devices are different, and a critical first step preceding their widespread use is to determine whether HRV metrics derived from PPG devices also relate to older adults’ physical function. Objective This study aimed to investigate associations between HRV measured with a wrist-worn PPG device, the Empatica E4 sensor, and validated clinical measures of both objective and self-reported physical function in a cohort of older adults living independently within a continuing care senior housing community. Our primary hypothesis was that lower HRV would be associated with lower physical function. In addition, we expected that HRV would explain a significant proportion of variance in measures of physical health status. Methods We evaluated 77 participants from an ongoing study of older adults aged between 65 and 95 years. The assessments encompassed a thorough examination of domains typically included in a geriatric health evaluation. We collected HRV data with the Empatica E4 device and examined bivariate correlations between HRV quantified with the triangular index (HRV TI) and 3 widely used and validated measures of physical functioning—the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), and Medical Outcomes Study Short Form 36 (SF-36) physical composite scores. We further investigated the additional predictive power of HRV TI on physical health status, as characterized by SF-36 physical composite scores and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) scores, using generalized estimating equation regression analyses with backward elimination. Results We observed significant associations of HRV TI with SPPB (n=52; Spearman ρ=0.41; P=.003), TUG (n=51; ρ=−0.40; P=.004), SF-36 physical composite scores (n=49; ρ=0.37; P=.009), and CIRS-G scores (n=52, ρ=−0.43; P=.001). In addition, the HRV TI explained a significant proportion of variance in SF-36 physical composite scores (R2=0.28 vs 0.11 without HRV) and CIRS-G scores (R2=0.33 vs 0.17 without HRV). Conclusions The HRV TI measured with a relatively novel wrist-worn PPG device was related to both objective (SPPB and TUG) and self-reported (SF-36 physical composite) measures of physical function.
In addition, the HRV TI explained additional variance in self-reported physical function and cumulative illness severity beyond traditionally measured aspects of physical health. Future steps include longitudinal tracking of changes in both HRV and physical function, which will add important insights regarding the predictive value of HRV as a biomarker of physical health in older adults.
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Affiliation(s)
- Sarah Anne Graham
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Dilip V Jeste
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California San Diego, La Jolla, CA, United States
| | - Ellen E Lee
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Tsung-Chin Wu
- Department of Mathematics, University of California San Diego, La Jolla, CA, United States
| | - Xin Tu
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research - Almaden, San Jose, CA, United States
| | - Colin A Depp
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
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14
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Tebar WR, Ritti-Dias RM, Saraiva BTC, Gil FCS, Delfino LD, Damato TMM, Aguilar BAS, Silva SCB, Mota J, Vanderlei LCM, Christofaro DG. The relationship between physical activity intensity and domains with cardiac autonomic modulation in adults: An observational protocol study. Medicine (Baltimore) 2019; 98:e17400. [PMID: 31593091 PMCID: PMC6799861 DOI: 10.1097/md.0000000000017400] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Cardiac autonomic modulation is an important marker of cardiovascular health and the practice of physical activity is a fundamental tool for good maintenance or increments in this marker. However, it is not clear in the literature whether different intensities and different domains of physical activity are related in the same way to cardiac autonomic modulation. OBJECTIVES This randomized epidemiologic study will examine the relationship between cardiac autonomic modulation and different intensities and domains of physical activity in a representative sample of adults. METHODS The sample of study will consist of 252 subjects aged from 18 years and above. The sample will be randomized through census sectors in which the neighborhoods, streets, and houses will also be randomized. Cardiac autonomic modulation will be assessed by heart rate variability and the intensity (mild, moderate, intense) of physical activity will be evaluated by means of accelerometers, while the different domains of physical activity (physical activity at work, occupational activities) will be evaluated through a questionnaire. The relationship between cardiac autonomic modulation and different physical activity intensities, as well as the different domains will be analyzed by linear regression, considering a statistical significance of 5% and a 95% confidence interval. This research protocol is registered in ClinicalTrials.gov at number NCT03986879.
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Affiliation(s)
- William R. Tebar
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | | | - Bruna T. C. Saraiva
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | - Fernanda C. S. Gil
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | - Leandro D. Delfino
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | - Tatiana M. M. Damato
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | - Beatriz A. S. Aguilar
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | - Stéfany C. B. Silva
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | | | - Diego G.D. Christofaro
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente
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15
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Effects of 9 Months of Martial Arts Training on Cardiac Autonomic Modulation in Healthy Children and Adolescents. Pediatr Exerc Sci 2018; 30:487-494. [PMID: 30336749 DOI: 10.1123/pes.2017-0083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of the study was to evaluate the cardiac autonomic modulation after 9 months of martial arts practice in healthy children and adolescents. METHOD The study included 59 children and adolescents who were divided into 3 groups: judo, Muay Thai, and control. Heart rate variability was measured by a heart rate monitor, model Polar RS800CX. The intervention occurred twice a week on nonconsecutive days, lasting 60 minutes each session. A 1-way analysis of variance was used to compare participants at baseline. The comparisons between groups at baseline and after the intervention were carried out by a 2-way analysis of variance for repeated measures. RESULTS After 9 months of intervention, significant increases were observed for root mean square successive differences, with higher values post compared with baseline (19.5%; P = .04). For SD1, an interaction effect was observed, with increased posttraining values compared with baseline (24.1%; P = .04) for the judo group. Qualitative analysis of the Poincaré plot showed greater dispersion of RR intervals, mainly beat to beat, after the judo intervention compared with the baseline. The Muay Thai and control groups presented no improvement. CONCLUSION After 9 months of intervention, there were increases in cardiac autonomic modulation of children and adolescents participating in judo training. The practice of martial arts, such as judo, can be encouraged from an early age to improve cardiovascular system functioning, possibly providing protection against cardiovascular problems.
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16
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Antonino D, Teixeira AL, Maia-Lopes PM, Souza MC, Sabino-Carvalho JL, Murray AR, Deuchars J, Vianna LC. Non-invasive vagus nerve stimulation acutely improves spontaneous cardiac baroreflex sensitivity in healthy young men: A randomized placebo-controlled trial. Brain Stimul 2017; 10:875-881. [DOI: 10.1016/j.brs.2017.05.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/09/2017] [Accepted: 05/17/2017] [Indexed: 01/06/2023] Open
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17
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Teixeira AL, Ramos PS, Vianna LC, Ricardo DR. Heart rate variability across the menstrual cycle in young women taking oral contraceptives. Psychophysiology 2015; 52:1451-5. [PMID: 26332575 DOI: 10.1111/psyp.12510] [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: 03/25/2015] [Accepted: 06/09/2015] [Indexed: 12/24/2022]
Abstract
Previous studies have shown that resting heart rate variability (HRV) is modified by different phases of the menstrual cycle in nonusers of oral contraceptive pills (OCP); however, the effect of OCP on autonomic control of the heart remains unclear. The purpose of this study was to investigate HRV during the low hormone (LH-not taking OCP) and during the high hormone (HH-active OCP use) phases of the menstrual cycle in young women. Seventeen healthy women (19-31 years) taking OCP for at least 6 consecutive months were enrolled in this study. Plasma estradiol and progesterone were verified at each visit. HRV was assessed by using one-lead electrocardiography in time and frequency domains, in which participants rested in the supine position for a 20-min period with a breathing rate of 15 cycles/min. In addition, resting heart rate, and systolic and diastolic blood pressure were obtained. Both plasma estradiol (LH: 19.8 ± 4.2 pg/mL vs. HH: 12.4 ± 1.5 pg/mL; p > .05) and progesterone (LH: 0.247 ± 0.58 ng/mL vs. HH: 0.371 ± 0.08 ng/mL; p > .05) (mean ± SE) levels were similar in both phases. No significant difference was obtained for any component of HRV, heart rate, or blood pressure between the LH and HH phases (p > .05). These results provide preliminary evidence that use of OCP does not affect HRV during the menstrual cycle in healthy women.
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Affiliation(s)
- André L Teixeira
- Maternity Hospital Therezinha de Jesus, Faculty of Medical and Health Sciences-SUPREMA, Juiz de Fora, Brazil.,Postgraduate program, Exercise and Sports Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Plínio S Ramos
- Maternity Hospital Therezinha de Jesus, Faculty of Medical and Health Sciences-SUPREMA, Juiz de Fora, Brazil
| | - Lauro C Vianna
- Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | - Djalma R Ricardo
- Maternity Hospital Therezinha de Jesus, Faculty of Medical and Health Sciences-SUPREMA, Juiz de Fora, Brazil
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18
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Intrinsic and extrinsic mortality reunited. Exp Gerontol 2015; 67:48-53. [PMID: 25916736 DOI: 10.1016/j.exger.2015.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 04/16/2015] [Accepted: 04/23/2015] [Indexed: 11/23/2022]
Abstract
Intrinsic and extrinsic mortality are often separated in order to understand and measure aging. Intrinsic mortality is assumed to be a result of aging and to increase over age, whereas extrinsic mortality is assumed to be a result of environmental hazards and be constant over age. However, allegedly intrinsic and extrinsic mortality have an exponentially increasing age pattern in common. Theories of aging assert that a combination of intrinsic and extrinsic stressors underlies the increasing risk of death. Epidemiological and biological data support that the control of intrinsic as well as extrinsic stressors can alleviate the aging process. We argue that aging and death can be better explained by the interaction of intrinsic and extrinsic stressors than by classifying mortality itself as being either intrinsic or extrinsic. Recognition of the tight interaction between intrinsic and extrinsic stressors in the causation of aging leads to the recognition that aging is not inevitable, but malleable through the environment.
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