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Abstract
OBJECTIVE Spontaneous or experimentally induced high blood pressure (BP) is associated with reduced pain perception, known as BP-related hypoalgesia. Despite its clinical implications, such as the interference with early detection of myocardial infarction in 'at risk' groups, the size of the association between high BP and pain has not yet been quantified. Moreover, the distinct association between high BP and physiological or psychological components of pain has not yet been considered so far. The aim of this study was to overcome this gap by performing separate meta-analyses on nociceptive response versus quantifiable perceptual measures of pain in relation to high BP. METHODS PubMed and Web of Knowledge databases were searched for English language studies conducted in humans. Fifty-nine studies were eligible for the analyses. Pooled effect sizes (Hedges' g) were compared. Random effect models were used. Results show that higher BP is significantly associated with lower nociceptive response (g = 0.38; k = 6) and reduced pain perception, assessed by quantifiable measures (g = 0.48; k = 59). RESULTS The association between BP and pain perception, derived from highly heterogeneous studies, was characterized by significant publication bias. BP assessment, pain assessment, site of pain stimulation, percentage of female participants in the sample, and control for potential confounders were significant moderators. CONCLUSION Current meta-analytic results confirm the presence of BP-related hypoalgesia and point towards the need for a better understanding of its underlying mechanisms.
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Finke JB, Zhang X, Plein D, Schilling TM, Schächinger H, Larra MF. Combining mental and physical stress: Synergy or interference? Physiol Behav 2021; 233:113365. [PMID: 33600808 DOI: 10.1016/j.physbeh.2021.113365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/23/2022]
Abstract
Both cognitive stressors (such as mental arithmetic tasks) and physical stressors (such as the cold pressor test, CP) are among the most widely employed tools in acute stress research, and there is growing evidence for a high degree of stimulus-response specificity, rather than uniformity, in the human stress response. However, little is known about potential synergistic or interfering effects during concurrent administration. While cognitive tasks have been hypothesized to attenuate pain perception during CP, they are also thought to enhance physiological reactivity. Conversely, physical stress might interfere with effective stress induction by cognitive challenges. To address these questions, 56 participants underwent either the CP (3-min ice-water immersion of feet) or a warm-water control condition. In half of the sample, the Paced Auditory Serial Addition Task (PASAT) was performed simultaneously (fully crossed interventions). Salivary cortisol, cardiovascular parameters, and subjective ratings as well as voice pitch (F0) were assessed. Results show that cortisol responses, self-reported pain and subjective arousal were mainly driven by cold exposure, which also led to increased F0. The PASAT incrementally enhanced cardiovascular reactions, but did not affect pain ratings nor cortisol responses to the CP. However, intra-individual concordance between elevated blood pressure and other reactivity measures was enhanced by PASAT administration during the CP. Importantly, performance decrements in the mental-arithmetic task were not associated with diminished stress responses. In conclusion, our results speak against any strong interference when administering cognitive and painful physical stressors simultaneously, pointing rather to specific additive effects, particularly regarding cardiovascular reactivity.
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Affiliation(s)
- Johannes B Finke
- Department of Clinical Psychology, University of Siegen, Siegen, Germany
| | - Xinwei Zhang
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Debora Plein
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Thomas M Schilling
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Hartmut Schächinger
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Mauro F Larra
- IfADo - Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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3
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Li K, Rüdiger H, Ziemssen T. Spectral Analysis of Heart Rate Variability: Time Window Matters. Front Neurol 2019; 10:545. [PMID: 31191437 PMCID: PMC6548839 DOI: 10.3389/fneur.2019.00545] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 05/07/2019] [Indexed: 12/22/2022] Open
Abstract
Spectral analysis of heart rate variability (HRV) is a valuable tool for the assessment of cardiovascular autonomic function. Fast Fourier transform and autoregressive based spectral analysis are two most commonly used approaches for HRV analysis, while new techniques such as trigonometric regressive spectral (TRS) and wavelet transform have been developed. Short-term (on ECG of several minutes) and long-term (typically on ECG of 1–24 h) HRV analyses have different advantages and disadvantages. This article reviews the characteristics of spectral HRV studies using different lengths of time windows. Short-term HRV analysis is a convenient method for the estimation of autonomic status, and can track dynamic changes of cardiac autonomic function within minutes. Long-term HRV analysis is a stable tool for assessing autonomic function, describe the autonomic function change over hours or even longer time spans, and can reliably predict prognosis. The choice of appropriate time window is essential for research of autonomic function using spectral HRV analysis.
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Affiliation(s)
- Kai Li
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.,Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Heinz Rüdiger
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Tjalf Ziemssen
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.,Department of Neurology, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
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4
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Booth JN, Anstey DE, Bello NA, Jaeger BC, Pugliese DN, Thomas SJ, Deng L, Shikany JM, Lloyd‐Jones D, Schwartz JE, Lewis CE, Shimbo D, Muntner P. Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study. J Clin Hypertens (Greenwich) 2019; 21:184-192. [PMID: 30719843 PMCID: PMC6375074 DOI: 10.1111/jch.13474] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/15/2018] [Accepted: 10/30/2018] [Indexed: 01/02/2023]
Abstract
Nocturnal hypertension and non-dipping blood pressure are each associated with increased risk of cardiovascular disease. We determined differences in nocturnal hypertension and non-dipping systolic/diastolic blood pressure among black and white men and women who underwent 24-hour ambulatory blood pressure monitoring at the Coronary Artery Risk Development in Young Adults study Year 30 Exam in 2015-2016. Asleep and awake periods were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as mean asleep systolic/diastolic blood pressure ≥ 120/70 mm Hg. Non-dipping systolic and diastolic blood pressure, separately, were defined as a decline in awake-to-asleep blood pressure < 10%. Among 767 participants, the prevalence of nocturnal hypertension was 18.4% and 44.4% in white and black women, respectively, and 36.4% and 59.9% in white and black men, respectively. After multivariable adjustment and compared with white women, the prevalence ratio (95% confidence interval) for nocturnal hypertension was 1.65 (1.18-2.32) for black women, 1.63 (1.14-2.33) for white men, and 2.01 (1.43-2.82) for black men. The prevalence of non-dipping systolic blood pressure was 21.5% and 41.0% in white and black women, respectively, and 20.2% and 37.9% in white and black men, respectively. Compared with white women, the multivariable-adjusted prevalence ratio (95% confidence interval) for non-dipping systolic blood pressure was 1.66 (1.18-2.32), 0.91 (0.58-1.42) and 1.66 (1.15-2.39) among black women, white men, and black men, respectively. Non-dipping diastolic blood pressure did not differ by race-sex groups following multivariable adjustment. In conclusion, black women and men have a high prevalence of nocturnal hypertension and non-dipping systolic blood pressure.
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Affiliation(s)
- John N. Booth
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | | | | | - Byron C. Jaeger
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabama
| | | | | | - Luqin Deng
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - James M. Shikany
- Division of Preventive MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | | | - Joseph E. Schwartz
- Department of MedicineColumbia UniversityNew YorkNew York
- Department of PsychiatryStony Brook UniversityNew YorkNew York
| | - Cora E. Lewis
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Daichi Shimbo
- Department of MedicineColumbia UniversityNew YorkNew York
| | - Paul Muntner
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
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5
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Carnevali L, Ottaviani C, Williams DP, Kapuku G, Thayer JF, Hill LK. Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress. Biol Psychol 2018; 141:17-24. [PMID: 30599210 DOI: 10.1016/j.biopsycho.2018.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/09/2018] [Accepted: 12/05/2018] [Indexed: 12/21/2022]
Abstract
Increased vascular reactivity to stress has been suggested to contribute to the greater risk for developing hypertension in African Americans. Here, we examined the way (hemodynamic profile) and the extent to which (compensation deficit) cardiac output and total peripheral resistance compensate for each other in determining blood pressure responses to a physical (orthostasis) and a mental (anger recall) stress task, in normotensive African American (AA, n = 30) and European American (EA, n = 48) college students. Blood pressure stress reactivity did not differ as a function of race. However, AAs showed a prominent vascular hemodynamic profile and a significant compensation deficit in response to both tasks, while EAs showed no hemodynamic response to orthostasis and a mixed profile in response to anger recall. The present findings demonstrate a more prominent vascular hemodynamic reactivity to stress in AAs, which could contribute to the pathogenesis of hypertension in this ethnic group.
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Affiliation(s)
- Luca Carnevali
- Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Italy.
| | | | | | - Gaston Kapuku
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - LaBarron K Hill
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Center for Biobehavioral Health Disparities Research, Duke University, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
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6
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Onal EM, Afsar B, Covic A, Vaziri ND, Kanbay M. Gut microbiota and inflammation in chronic kidney disease and their roles in the development of cardiovascular disease. Hypertens Res 2018; 42:123-140. [PMID: 30504819 DOI: 10.1038/s41440-018-0144-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 02/06/2023]
Abstract
The health and proper functioning of the cardiovascular and renal systems largely depend on crosstalk in the gut-kidney-heart/vessel triangle. Recent evidence suggests that the gut microbiota has an integral function in this crosstalk. Mounting evidence indicates that the development of chronic kidney and cardiovascular diseases follows chronic inflammatory processes that are affected by the gut microbiota via various immune, metabolic, endocrine, and neurologic pathways. Additionally, deterioration of the function of the cardiovascular and renal systems has been reported to disrupt the original gut microbiota composition, further contributing to the advancement of chronic cardiovascular and renal diseases. Considering the interaction between the gut microbiota and the renal and cardiovascular systems, we can infer that interventions for the gut microbiota through diet and possibly some medications can prevent/stop the vicious cycle between the gut microbiota and the cardiovascular/renal systems, leading to a decrease in chronic cardiovascular and renal diseases.
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Affiliation(s)
- Emine M Onal
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Department of Medicine, Division of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Nosratola D Vaziri
- Division of Nephrology and Hypertension, Schools of Medicine and Biological Science, University of California, California, CA, USA
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
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7
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Li K, Rüdiger H, Haase R, Ziemssen T. An Innovative Technique to Assess Spontaneous Baroreflex Sensitivity with Short Data Segments: Multiple Trigonometric Regressive Spectral Analysis. Front Physiol 2018; 9:10. [PMID: 29403393 PMCID: PMC5786552 DOI: 10.3389/fphys.2018.00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/05/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: As the multiple trigonometric regressive spectral (MTRS) analysis is extraordinary in its ability to analyze short local data segments down to 12 s, we wanted to evaluate the impact of the data segment settings by applying the technique of MTRS analysis for baroreflex sensitivity (BRS) estimation using a standardized data pool. Methods: Spectral and baroreflex analyses were performed on the EuroBaVar dataset (42 recordings, including lying and standing positions). For this analysis, the technique of MTRS was used. We used different global and local data segment lengths, and chose the global data segments from different positions. Three global data segments of 1 and 2 min and three local data segments of 12, 20, and 30 s were used in MTRS analysis for BRS. Results: All the BRS-values calculated on the three global data segments were highly correlated, both in the supine and standing positions; the different global data segments provided similar BRS estimations. When using different local data segments, all the BRS-values were also highly correlated. However, in the supine position, using short local data segments of 12 s overestimated BRS compared with those using 20 and 30 s. In the standing position, the BRS estimations using different local data segments were comparable. There was no proportional bias for the comparisons between different BRS estimations. Conclusion: We demonstrate that BRS estimation by the MTRS technique is stable when using different global data segments, and MTRS is extraordinary in its ability to evaluate BRS in even short local data segments (20 and 30 s). Because of the non-stationary character of most biosignals, the MTRS technique would be preferable for BRS analysis especially in conditions when only short stationary data segments are available or when dynamic changes of BRS should be monitored.
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Affiliation(s)
- Kai Li
- Autonomic and Neuroendocrinological Lab, Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany.,Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Heinz Rüdiger
- Autonomic and Neuroendocrinological Lab, Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Rocco Haase
- Autonomic and Neuroendocrinological Lab, Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Autonomic and Neuroendocrinological Lab, Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany
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8
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Fonkoue IT, Schwartz CE, Wang M, Carter JR. Sympathetic neural reactivity to mental stress differs in black and non-Hispanic white adults. J Appl Physiol (1985) 2018; 124:201-207. [PMID: 28970198 DOI: 10.1152/japplphysiol.00134.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Black adults have a higher risk of hypertension compared with non-Hispanic white (NHW) adults, but physiological mechanisms underlying this predisposition remain unclear. This study compared muscle sympathetic nerve activity (MSNA) responses to mental stress in a group of young black and NHW participants. We hypothesized that the sympathoexcitation associated with mental stress would be greater in black adults compared with NHW participants. Thirty-five male adults (19 black, 23 ± 1 yr; 16 NHW, 22 ± 1 yr) were examined during 5-min supine baseline and 5 min of mental stress (via mental arithmetic). Baseline mean arterial pressure (80 ± 2 vs. 82 ± 1 mmHg), heart rate (61 ± 4 vs. 61 ± 2 beats/min), MSNA (13 ± 1 vs. 15 ± 2 bursts/min), and sympathetic baroreflex sensitivity (-1.1 ± 0.4 vs. -1.5 ± 0.3 bursts·100 heart beats-1·mmHg-1) were not significantly different between NHW and black adults ( P > 0.05), respectively. MSNA reactivity to mental stress was significantly higher in NHW compared with black adults (time × race, P = 0.006), with a particularly divergent responsiveness during the first minute of mental stress in NHW (Δ4 ± 1 burst/min) and black (Δ-2 ± 2 burst/min; P = 0.022) men. Blood pressure and heart rate reactivity to mental stress were similar between groups. In summary, black participants demonstrated a lower MSNA responsiveness to mental stress compared with NHW adults. These findings suggest that, despite a higher prevalence of hypertension, black subjects do not appear to have higher neural and cardiovascular responsiveness to mental stress compared with NHW. NEW & NOTEWORTHY Black men have a blunted muscle sympathetic nerve activity response to mental stress compared with non-Hispanic white (NHW) men, especially at the onset of mental stress when muscle sympathetic nerve activity decreased in blacks and increased in NHW men. Thus, despite a high prevalence of hypertension in blacks, normotensive NHW men display a greater peripheral sympathetic neural reactivity to mental stress than black men.
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Affiliation(s)
| | | | - Min Wang
- 1 Michigan Technological University
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9
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Li K, Konofalska U, Akgün K, Reimann M, Rüdiger H, Haase R, Ziemssen T. Modulation of Cardiac Autonomic Function by Fingolimod Initiation and Predictors for Fingolimod Induced Bradycardia in Patients with Multiple Sclerosis. Front Neurosci 2017; 11:540. [PMID: 29075174 PMCID: PMC5643482 DOI: 10.3389/fnins.2017.00540] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 09/15/2017] [Indexed: 12/19/2022] Open
Abstract
Objective: It is well-known that initiation of fingolimod induces a transient decrease of heart rate. However, the underlying cardiac autonomic regulation is poorly understood. We aimed to investigate the changes of autonomic activity caused by the first dose of fingolimod using a long-term multiple trigonometric spectral analysis for the first time. In addition, we sought to use the continuous Holter ECG recording to find predictors for fingolimod induced bradycardia. Methods: Seventy-eight patients with relapsing-remitting multiple sclerosis (RRMS) were included. As a part of the START study (NCT01585298), continuous electrocardiogram was recorded before fingolimod initiation, and until no <6 h post medication. Time domain and frequency domain heart rate variability (HRV) parameters were computed hourly to assess cardiac autonomic regulation. A long-term multiple trigonometric regressive spectral (MTRS) analysis was applied on successive 1-h-length electrocardiogram recordings. Decision tree analysis was used to find predictors for bradycardia following fingolimod initiation. Results: Most of the HRV parameters representing parasympathetic activities began to increase since the second hour after fingolimod administration. These changes of autonomic regulations were in accordance with the decline of heart rate. Baseline heart rate was highly correlated with nadir heart rate, and was the only significant predicting factor for fingolimod induced bradycardia among various demographic, clinical and cardiovascular variables in the decision tree analysis. Conclusions: The first dose application of fingolimod enhances the cardiac parasympathetic activity during the first 6 h post medication, which might be the underlying autonomic mechanism of reduced heart rate. Baseline heart rate is a powerful predictor for bradycardia caused by fingolimod.
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Affiliation(s)
- Kai Li
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.,Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Urszula Konofalska
- MS Center, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Katja Akgün
- MS Center, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Manja Reimann
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Heinz Rüdiger
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Rocco Haase
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Tjalf Ziemssen
- Autonomic and Neuroendocrinological Lab, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.,MS Center, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
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10
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Möller M, Malan L, Magnusson M, Mels CMC, Malan NT. Defensive coping and essential amino acid markers as possible predictors for structural vascular disease in an African and Caucasian male cohort: The SABPA study. Psychophysiology 2017; 54:696-705. [PMID: 28218795 DOI: 10.1111/psyp.12833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 12/18/2016] [Indexed: 01/21/2023]
Abstract
Defensive coping (DefS), oxidative stress, inflammation, and related amino acids (phenylalanine [Phe] and tyrosine [Tyr]) have been implicated in cardiovascular disease. This study assessed whether inflammation, oxidative stress, changes in essential amino acids, and altered coping strategies are correlated with subclinical vascular changes in African (n = 82) and Caucasian (n = 100) men from the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study. The Coping Strategy Indicator questionnaire identified DefS participants. Ambulatory blood pressure (BP) was monitored for 24 h, whereas carotid intima media thickness (CIMT) and cross-sectional wall area (CSWA) were determined ultrasonically. Essential amino acids were analyzed with a liquid chromatography tandem mass spectrometry method. Oxidative-inflammatory markers were measured by spectrophotometry. African men had poorer health than Caucasian men, including higher alcohol abuse, elevated BP, abdominal obesity, physical inactivity, and elevated inflammation. Phe (p < .001) and Phe/Tyr ratio (p = .006) as well as CIMT (p = .032) were higher in African men. DefS African men had higher levels of Phe (p = .002) and Phe/Tyr (p = .009) compared to DefS Caucasian men; these differences were not observed in non-DefS men. Systolic BP and inflammation (C-reactive protein) were positively associated with left (L-) CSWA, while Phe/Tyr was negatively associated with L-CSWA in DefS African men. African males presented with elevated Phe and Phe/Tyr ratio, catecholamine precursors, worsening during DefS-possibly driven by inflammation and BP contributing to structural vascular abnormalities.
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Affiliation(s)
- Marisa Möller
- Department of Pharmacology, North-West University, Potchefstroom, South Africa
| | - Leoné Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Martin Magnusson
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Carina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Nico T Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
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11
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Abdalla M, Booth JN, Seals SR, Spruill TM, Viera AJ, Diaz KM, Sims M, Muntner P, Shimbo D. Masked Hypertension and Incident Clinic Hypertension Among Blacks in the Jackson Heart Study. Hypertension 2016; 68:220-6. [PMID: 27185746 PMCID: PMC4900933 DOI: 10.1161/hypertensionaha.115.06904] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/21/2016] [Indexed: 12/21/2022]
Abstract
Masked hypertension, defined as nonelevated clinic blood pressure (BP) and elevated out-of-clinic BP may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic BP and masked hypertension using ambulatory BP monitoring with incident clinic hypertension in the Jackson Heart Study, a prospective cohort of blacks. Analyses included 317 participants with clinic BP <140/90 mm Hg, complete ambulatory BP monitoring, who were not taking antihypertensive medication at baseline in 2000 to 2004. Masked daytime hypertension was defined as mean daytime blood pressure ≥135/85 mm Hg, masked night-time hypertension as mean night-time BP ≥120/70 mm Hg, and masked 24-hour hypertension as mean 24-hour BP ≥130/80 mm Hg. Incident clinic hypertension, assessed at study visits in 2005 to 2008 and 2009 to 2012, was defined as the first visit with clinic systolic/diastolic BP ≥140/90 mm Hg or antihypertensive medication use. During a median follow-up of 8.1 years, there were 187 (59.0%) incident cases of clinic hypertension. Clinic hypertension developed in 79.2% and 42.2% of participants with and without any masked hypertension, 85.7% and 50.4% with and without masked daytime hypertension, 79.9% and 43.7% with and without masked night-time hypertension, and 85.7% and 48.2% with and without masked 24-hour hypertension, respectively. Multivariable-adjusted hazard ratios (95% confidence interval) of incident clinic hypertension for any masked hypertension and masked daytime, night-time, and 24-hour hypertension were 2.13 (1.51-3.02), 1.79 (1.24-2.60), 2.22 (1.58-3.12), and 1.91 (1.32-2.75), respectively. These findings suggest that ambulatory BP monitoring can identify blacks at increased risk for developing clinic hypertension.
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Affiliation(s)
- Marwah Abdalla
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.).
| | - John N Booth
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Samantha R Seals
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Tanya M Spruill
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Anthony J Viera
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Keith M Diaz
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Mario Sims
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Paul Muntner
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
| | - Daichi Shimbo
- From the Department of Medicine, Columbia University Medical Center, New York, NY (M.A., K.M.D., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics, Department of Preventive Medicine (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; Department of Population Health, NYU School of Medicine, NY (T.M.S.); and Hypertension Research Program, Department of Family Medicine, University of North Carolina at Chapel Hill (A.J.V.)
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12
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Pieterse C, Schutte R, Schutte AE. Leptin relates to prolonged cardiovascular recovery after acute stress in Africans: The SABPA study. Nutr Metab Cardiovasc Dis 2016; 26:45-52. [PMID: 26645796 DOI: 10.1016/j.numecd.2015.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/29/2015] [Accepted: 10/27/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Heightened cardiovascular reactivity and delayed recovery to stress are associated with an increased risk of cardiovascular disease. Africans, who are more prone to develop hypertension, show greater cardiovascular reactivity to stress. However, causal factors underlying individual and ethnic differences in stress reactivity and recovery remain largely unexplored. Leptin, which is known for its sympatho-activating effects, is higher in Africans compared to Caucasians for any given body mass index. We compared how cardiovascular reactivity and recovery relate to leptin in African (n = 200) and Caucasian (n = 209) teachers. METHODS AND RESULTS We measured leptin in serum and cardiovascular baseline and reactivity continuously with the Finometer device during the cold pressor test for 1 min, and recovery at intervals of 1, 3 and 5 min. Africans had higher body mass index, leptin and blood pressure (all P < 0.001). After full adjustment in multiple regression analyses, associations were seen mainly at the 5 min recovery interval. In Africans, cardiac output reactivity (β = -0.335; P = 0.0018) and arterial compliance- (β = -0.241; P = 0.048) associated negatively and total peripheral resistance- (β = 0.227; P = 0.047) positively with leptin. In Caucasians, diastolic blood pressure correlated positively with leptin (β = 0.200; P = 0.015). CONCLUSION In Africans, higher circulating leptin levels associated with prolonged cardiovascular recovery after exposure to stress which could explain their increased vulnerability to hypertension development.
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Affiliation(s)
- C Pieterse
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - R Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - A E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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13
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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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14
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Alipour H, Goldust M. The association between blood pressure components and cognitive functions and cognitive reserve. Clin Exp Hypertens 2015; 38:95-9. [DOI: 10.3109/10641963.2015.1047946] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Houman Alipour
- Faculty of Medicine, Tabriz University of Medical Sciences, Aras Branch, Tabriz, Iran and
| | - Mohamad Goldust
- Young Researchers and Elite Club, Qaemshahr Branch, Islamic Azad University, Qaemshahr, Iran
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15
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Plasma renin and cardiovascular responses to the cold pressor test differ in black and white populations: The SABPA study. J Hum Hypertens 2015; 30:346-51. [DOI: 10.1038/jhh.2015.88] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/08/2015] [Accepted: 07/14/2015] [Indexed: 11/08/2022]
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16
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Muntner P, Lewis CE, Diaz KM, Carson AP, Kim Y, Calhoun D, Yano Y, Viera AJ, Shimbo D. Racial differences in abnormal ambulatory blood pressure monitoring measures: Results from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Am J Hypertens 2015; 28:640-8. [PMID: 25376639 PMCID: PMC4415060 DOI: 10.1093/ajh/hpu193] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/03/2014] [Accepted: 09/05/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Several ambulatory blood pressure monitoring (ABPM) measures have been associated with increased cardiovascular disease risk independent of clinic blood pressure (BP). African Americans have higher clinic BP compared with Whites but few data are available on racial differences in ABPM measures. METHODS We compared ABPM measures between African American (n = 178) and White (n = 103) participants at the Year 5 Coronary Artery Risk Development in Young Adults study visit. BP was measured during a study visit and the second and third measurements were averaged. ABPM was conducted over the following 24 hours. RESULTS Mean ± SD age of participants was 29.8 ± 3.8 years and 30.8 ± 3.5 years for African Americans and Whites, respectively. Mean daytime systolic BP (SBP) was 3.90 (SD 1.18) mm Hg higher among African Americans compared with Whites (P < 0.001) after age-gender adjustment and 1.71 (SD 1.03) mm Hg higher after multivariable adjustment including mean clinic SBP (P = 0.10). After multivariable adjustment including mean clinic SBP, nighttime SBP was 4.83 (SD 1.11) mm Hg higher among African Americans compared with Whites (P < 0.001). After multivariable adjustment, the African Americans were more likely than Whites to have nocturnal hypertension (prevalence ratio: 2.44, 95% CI: 0.99-6.05) and nondipping (prevalence ratio: 2.50, 95% CI: 1.39-4.48). The prevalence of masked hypertension among African Americans and Whites was 4.4% and 2.1%, respectively, (P = 0.49) and white coat hypertension was 3.3% and 3.9%, respectively (P = 0.99). Twenty-four hour BP variability on ABPM was higher among African Americans compared with Whites. CONCLUSIONS These data suggest racial differences in several ABPM measures exist.
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Affiliation(s)
- Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA;
| | - Cora E Lewis
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Keith M Diaz
- Department of Medicine, Columbia University, New York, New York, USA
| | - April P Carson
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yongin Kim
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David Calhoun
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Anthony J Viera
- Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Daichi Shimbo
- Department of Medicine, Columbia University, New York, New York, USA
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17
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Cheung SS. Responses of the hands and feet to cold exposure. Temperature (Austin) 2015; 2:105-20. [PMID: 27227009 PMCID: PMC4843861 DOI: 10.1080/23328940.2015.1008890] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/09/2015] [Accepted: 01/09/2015] [Indexed: 11/19/2022] Open
Abstract
An initial response to whole-body or local exposure of the extremities to cold is a strong vasoconstriction, leading to a rapid decrease in hand and foot temperature. This impairs tactile sensitivity, manual dexterity, and muscle contractile characteristics while increasing pain and sympathetic drive, decreasing gross motor function, occupational performance, and survival. A paradoxical and cyclical vasodilatation often occurs in the fingers, toes, and face, and this has been termed the hunting response or cold-induced vasodilatation (CIVD). Despite being described almost a century ago, the mechanisms of CIVD are still disputed; research in this area has remained largely descriptive in nature. Recent research into CIVD has brought increased standardization of methodology along with new knowledge about the impact of mediating factors such as hypoxia and physical fitness. Increasing mechanistic analysis of CIVD has also emerged along with improved modeling and prediction of CIVD responses. The present review will survey work conducted during this century on CIVD, its potential mechanisms and modeling, and also the broader context of manual function in cold conditions.
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Affiliation(s)
- Stephen S Cheung
- Environmental Ergonomics Laboratory; Department of Kinesiology ; Brock University; St. Catharines , Canada
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18
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Joosten L, Malan L, Uys AS, Alkerwi A, Malan NT. Acute cardiometabolic responses facilitating a state of chronic hyperglycemia and renal impairment. Cardiovasc Endocrinol 2014. [DOI: 10.1097/xce.0000000000000019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Malan NT, Stalder T, Schlaich MP, Lambert GW, Hamer M, Schutte AE, Huisman HW, Schutte R, Smith W, Mels CMC, van Rooyen JM, Malan L. Chronic distress and acute vascular stress responses associated with ambulatory blood pressure in low-testosterone African men: the SABPA Study. J Hum Hypertens 2013; 28:393-8. [DOI: 10.1038/jhh.2013.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 11/09/2022]
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Effects of acute and chronic stress on the L-arginine nitric oxide pathway in black and white South Africans: the sympathetic activity and ambulatory blood pressure in Africans study. Psychosom Med 2013; 75:751-8. [PMID: 23960161 DOI: 10.1097/psy.0b013e3182a3e465] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study investigated the impact of stress on effectors of the L-arginine/nitric oxide (NO) system including the endogenous inhibitor asymmetric dimethylarginine (ADMA). METHODS Black (n = 168) and white (n = 206) South African teachers were exposed to a mental and a physical stressor for 1 minute, respectively. Serum samples for determination of l-arginine, NO metabolites, ADMA, and symmetric dimethylarginine (SDMA) were obtained at rest and during stress exposure. Perception of task stressfulness was assessed on a 7-point Likert scale, and psychological distress was estimated by the General Health Questionnaire. RESULTS Black South Africans exhibited higher resting levels of NO metabolites (adjusted mean [standard error of the mean] = 11.3 [1.3] versus 3.9 [1.1] μmol/l, p < .001) but lower circulating ADMA (0.62 [0.02] versus 0.70 [0.02] μmol/l, p = .004) and SDMA (0.41 [0.01] versus 0.53 [0.01] μmol/l, p < .001) than did white South Africans. Ethnicity-by-psychological distress interaction was observed for resting levels of ADMA (p = .002), SDMA (p = .038), and L-arginine (p = .048). Ethnic differences in responses to experimental stress were evident for NO metabolites (blacks versus whites: 5.94 [1.55] versus -0.74 [1.25] μmol/l, p = .004) and SDMA (blacks versus whites: -0.02 [0.01] versus 0.02 [0.01] μmol/l, p = .004). Ethnicity-by-psychological distress interaction for stress responses was found for l-arginine/ADMA ratio (p = .027). CONCLUSIONS The l-arginine/NO system is affected by psychosocial distress with higher susceptibility in black South Africans. This interaction may contribute to the higher cardiovascular disease risk in black South Africans.
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Kupper N, Pelle A, Denollet J. Association of Type D personality with the autonomic and hemodynamic response to the cold pressor test. Psychophysiology 2013; 50:1194-201. [PMID: 24016046 DOI: 10.1111/psyp.12133] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 06/28/2013] [Indexed: 01/13/2023]
Abstract
Mechanisms relating Type D personality to poor health are largely unknown, with autonomic nervous system function being a candidate. This study examined the physiologic response to cold stress. Undergraduates (N = 101, 84% female) underwent a cold pressor test. An electrocardiogram, impedance cardiogram, and blood pressure were recorded. Type D personality was assessed by self-report questionnaire. Type D was associated with increased systolic and diastolic blood pressure reactivity. Exploratory analyses showed Type D men to respond with increased respiratory sinus arrhythmia (i.e., higher parasympathetic activity), and decreased pre-ejection period (i.e., larger sympathetic activity), while Type D women showed a reciprocal response pattern. In conclusion, Type D personality was associated with an exaggerated hemodynamic response to cold stress, which may contribute to an increased risk of hypertension in Type D individuals.
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Affiliation(s)
- Nina Kupper
- Department of Medical Psychology and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Trigonometric regressive spectral analysis: an innovative tool for evaluating the autonomic nervous system. J Neural Transm (Vienna) 2013; 120 Suppl 1:S27-33. [PMID: 23812502 DOI: 10.1007/s00702-013-1054-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/11/2013] [Indexed: 01/01/2023]
Abstract
Biological rhythms, describing the temporal variation of biological processes, are a characteristic feature of complex systems. The analysis of biological rhythms can provide important insights into the pathophysiology of different diseases, especially, in cardiovascular medicine. In the field of the autonomic nervous system, heart rate variability (HRV) and baroreflex sensitivity (BRS) describe important fluctuations of blood pressure and heart rate which are often analyzed by Fourier transformation. However, these parameters are stochastic with overlaying rhythmical structures. R-R intervals as independent variables of time are not equidistant. That is why the trigonometric regressive spectral (TRS) analysis--reviewed in this paper--was introduced, considering both the statistical and rhythmical features of such time series. The data segments required for TRS analysis can be as short as 20 s allowing for dynamic evaluation of heart rate and blood pressure interaction over longer periods. Beyond HRV, TRS also estimates BRS based on linear regression analyses of coherent heart rate and blood pressure oscillations. An additional advantage is that all oscillations are analyzed by the same (maximal) number of R-R intervals thereby providing a high number of individual BRS values. This ensures a high confidence level of BRS determination which, along with short recording periods, may be of profound clinical relevance. The dynamic assessment of heart rate and blood pressure spectra by TRS allows a more precise evaluation of cardiovascular modulation under different settings as has already been demonstrated in different clinical studies.
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Schapkin SA, Freude G. Cardiovascular costs of working memory performance: effects of age and performance feedback. INDUSTRIAL HEALTH 2013; 51:386-397. [PMID: 23518605 DOI: 10.2486/indhealth.2012-0203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Ageing is associated with impaired working memory (WM) performance that may increase cardiovascular costs in older workers. Performance feedback (FB) was assumed to compensate for performance decline and reduce cardiovascular costs. Forty-eight younger (29 ± 3 yr) and 45 older (55 ± 4 yr) healthy workers had to perform a 0-back task (low WM load), 2-back task (high WM load) and 2-back task with FB (high WM load & FB). Age-related performance decline and enhanced blood pressure (BP) reactivity to WM load were found. The baroreflex sensitivity (BRS) decreased under high WM load in older workers compared to younger workers. The FB abolished age differences in omission rate and increased low frequency heart rate variability (HRV) in both age groups. Moreover, FB reduced heart rate in older workers and increased BRS as well as high frequency HRV in younger workers. The results suggest that older workers compensate for WM performance decline at cost of heightened BP due to age-related reductions of vagal tone and impairments of the baroreflex mechanism. The performance FB helps older workers to partly compensate for performance deficits and reduce cardiovascular costs by moderate decreases in sympathetic tone.
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