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Terol-Úbeda AC, Fernández-González JF, Roldán-Hernández CA, Martín ML, Morán A, García-Domingo M, García-Pedraza JÁ. Sex influence on serotonergic modulation of the vascular noradrenergic drive in rats. Br J Pharmacol 2025; 182:1025-1037. [PMID: 39489611 DOI: 10.1111/bph.17380] [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: 04/30/2024] [Revised: 07/26/2024] [Accepted: 09/29/2024] [Indexed: 11/05/2024] Open
Abstract
BACKGROUND AND PURPOSE In male rats, the serotonergic system modulates sympathetic outflow at vascular levels, causing sympatho-inhibition and sympatho-excitation, mainly via 5-HT1D/1A and 5-HT3 receptors, respectively. However, sex influence on vascular serotonergic regulation has not yet been elucidated. This study aimed to analyse the 5-HT sympatho-modulatory role in female rats, characterising the 5-HT receptors involved. EXPERIMENTAL APPROACH Female Wistar (14- to 16-week-old) rats were prepared for sympathetic stimulation. Mean blood pressure (MBP) and heart rate (HR) were continuously measured. Vasopressor responses were obtained by electrical stimulation of the sympathetic outflow (0.1-5 Hz) or i.v. noradrenaline (0.01-0.5 μg·kg-1). 5-HT-related drug effects on adrenergic system were determined. Age-matched male rats were used as control. KEY RESULTS Basal MBP in females was lower than in male rats, whereas electrical-induced increases in MBP were similar. In females, 5-HT exerted a dose-dependent inhibition on the sympathetic-evoked vasoconstrictions, that was reproduced by some agonists; 5-CT (5-HT1/5/7) and L-694,247 (5-HT1D), whereas the selective 5-HT2A/2B/2C (α-methyl-5-HT) and 5-HT3 agonist (1-PBG) increased the electrically-produced vasopressor responses. None of the other drugs tested (targeting 5-HT1A/1B/1F, 5-HT2B/2C, 5-HT4, 5-HT5A or 5-HT7) modified these vasoconstrictions. Only 1-PBG (5-HT3) modified the vasoconstrictions induced by exogenous noradrenaline. CONCLUSIONS AND IMPLICATIONS In female rats, vascular serotonergic sympatholytic effects are due to prejunctional 5-HT1D receptor activation, whereas pre and/or postjunctional 5-HT3 and prejunctional 5-HT2A receptor activation is involved in the potentiating effect of vascular sympathetic neurotransmission. These findings may open novel sex-differential therapeutic strategies for treating cardiovascular conditions.
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Affiliation(s)
- Anaïs Clara Terol-Úbeda
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Juan Francisco Fernández-González
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Carlos Andrés Roldán-Hernández
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - María Luisa Martín
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Asunción Morán
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Mónica García-Domingo
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - José Ángel García-Pedraza
- Laboratorio de Farmacología. Departamento de Fisiología y Farmacología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
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Brguljan Hitij J, Gaciong Z, Simić D, Vajer P, Zelveian P, Chazova IE, Jelaković B. Differences in sex and age response to single pill combination based antihypertensive therapy reflecting in blood pressure and arterial stiffness. J Hypertens 2024:00004872-990000000-00566. [PMID: 39445609 DOI: 10.1097/hjh.0000000000003901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 09/29/2024] [Indexed: 10/25/2024]
Abstract
OBJECTIVE There are noticeable sex differences in the treatment response to antihypertensives, with limited data on the response to single pill combinations. The aim of the PRECIOUS trial was to assess the treatment response to perindopril/amlodipine and perindopril/amlodipine/indapamide dual and triple single-pill combination in men and women. METHODS Four hundred and forty adults with essential hypertension were assessed in the 16-week interventional, open-label, prospective, international, multicentre trial. Based on the previous antihypertensive therapy, patients were assigned to either perindopril/amlodipine 4/5 mg or perindopril/amlodipine/indapamide 4/5/1.25 mg, with the initial dose up-titrated in 4-week intervals in case of uncontrolled blood pressure. An additional analysis was performed for sex- and age-related differences on the blood pressure response and arterial stiffness in men and women aged 35-74 years. RESULTS Women achieved better overall blood pressure control in all age groups, except for the 35-44 age group. Women presented higher average 24 h aortic augmentation indexes than men, but had more pronounced decreasing trends. The pulse wave velocity was only age-dependent, with reductions slightly greater in women. Both the aortic augmentation index and pulse wave velocity were significantly decreased in all groups compared to baseline. CONCLUSIONS The results of the PRECIOUS trial contribute significant data to the expanding body of evidence on sex differences in hypertension, including the aspect of age-related changes during the life course of women. The differences between same-aged men and women tend to be smaller with advancing age, but with a greater treatment response in women in all age groups for all observed blood pressure parameters and arterial stiffness. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT03738761.
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Affiliation(s)
- Jana Brguljan Hitij
- University Medical Centre Ljubljana, Department of Hypertension, Medical University Ljubljana, Slovenia
| | - Zbigniew Gaciong
- University Clinical Center of the Medical University of Warsaw, Department of Internal Medicine, Hypertension and Vascular Diseases, Warsaw, Poland
| | | | - Péter Vajer
- Semmelweis University Budapest, Family Medicine Department, Budapest, Hungary
| | - Parounak Zelveian
- Center of Preventive Cardiology, Research Institute of Cardiology, Yerevan, Armenia
| | - Irina E Chazova
- Federal State Budgetary Institution "National Research Medical Center for Cardiology" of the Ministry of Health, Moscow, Russian Federation
| | - Bojan Jelaković
- University Hospital Centre Zagreb, Department of Internal Medicine, Department of Nephrology, Arterial hypertension, Dialysis and Transplantation, Zagreb, Croatia
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Konecny F, Kamar L, Zimmerman I, Whitehead SN, Goldman D, Frisbee JC. Early elevations in arterial pressure: a contributor to rapid depressive symptom emergence in female Zucker rats with metabolic disease? J Appl Physiol (1985) 2024; 137:1324-1340. [PMID: 39359187 PMCID: PMC11573269 DOI: 10.1152/japplphysiol.00586.2024] [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: 07/26/2024] [Revised: 09/09/2024] [Accepted: 09/30/2024] [Indexed: 10/04/2024] Open
Abstract
One of the growing challenges to public health and clinical outcomes is the emergence of cognitive impairments, particularly depressive symptom severity, because of chronic elevations in metabolic disease and cerebrovascular disease risk. To more clearly delineate these relationships and to assess the potential for sexual dimorphism, we used lean (LZR) and obese Zucker rats (OZR) of increasing age to determine relationships between internal carotid artery (ICA) hemodynamics, cerebral vasculopathies, and the emergence of depressive symptoms. Male OZR exhibited progressive elevations in perfusion pressure within the ICA, which were paralleled by endothelial dysfunction, increased cerebral arterial myogenic activation, and reduced cerebral cortex microvessel density. In contrast, female OZR exhibited a greater degree of ICA hypertension than male OZR but maintained normal endothelial function, myogenic activation, and microvessel density to an older age range than did males. Although both male and female OZR exhibited significant and progressive elevations in depressive symptom severity, these were significantly worse in females. Finally, plasma cortisol concentration was elevated higher and at a younger age in female OZR as compared with males, and this difference was maintained to final animal usage at ∼17 wk of age. These results suggest that an increased severity of blood pressure waves may penetrate the cerebral circulation more deeply in female OZR than in males, which may predispose the females to a more severe emergence of depressive symptoms with chronic metabolic disease, whereas males may be more predisposed to more direct cerebral vasculopathies (e.g., stroke, transient ischemic attack).NEW & NOTEWORTHY We provide novel insight that the superior maintenance of cerebrovascular endothelial function in female versus male rats with chronic metabolic disease buffers myogenic activation of cerebral resistance arteries/arterioles despite worsening hypertension. As hypertension development is earlier and more severe in females, potentially due to an elevated stress response, the blunted myogenic activation allows greater arterial pressure wave penetrance into the cerebral microcirculation and is associated with accelerated emergence/severity of depressive symptoms in obese female rats.
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Affiliation(s)
- Filip Konecny
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Lujaina Kamar
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario, Canada
| | - Isabel Zimmerman
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - Daniel Goldman
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
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Kim HR, Jeong JK, Young CN. Cellular Profile of Subfornical Organ Insulin Receptors in Mice. Biomolecules 2024; 14:1256. [PMID: 39456189 PMCID: PMC11506324 DOI: 10.3390/biom14101256] [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: 09/06/2024] [Revised: 09/30/2024] [Accepted: 09/30/2024] [Indexed: 10/28/2024] Open
Abstract
Brain insulin receptor signaling is strongly implicated in cardiovascular and metabolic physiological regulation. In particular, we recently demonstrated that insulin receptors within the subfornical organ (SFO) play a tonic role in cardiovascular and metabolic regulation in mice. The SFO is a forebrain sensory circumventricular organ that regulates cardiometabolic homeostasis due to its direct exposure to the circulation and thus its ability to sense circulating factors, such as insulin. Previous work has demonstrated broad distribution of insulin receptor-expressing cells throughout the entire SFO, indirectly indicating insulin receptor expression in multiple cell types. Based on this, we sought to determine the cellular phenotypes that express insulin receptors within the SFO by combining immunohistochemistry with genetically modified reporter mouse models. Interestingly, SFO neurons, including both excitatory and inhibitory types, were the dominant cell site for insulin receptor expression, although a weak degree of insulin receptor expression was also detected in astrocytes. Moreover, SFO angiotensin type 1a receptor neurons also expressed insulin receptors. Collectively, these anatomical findings indicate the existence of potentially complex cellular networks within the SFO through which insulin signaling can influence physiology and further point to the SFO as a possible brain site for crosstalk between angiotensin-II and insulin.
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Affiliation(s)
| | | | - Colin N. Young
- Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA; (H.-R.K.); (J.-K.J.)
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Mirzohreh ST, Panahi P, Heidari F. Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis. Syst Rev 2024; 13:194. [PMID: 39049099 PMCID: PMC11271026 DOI: 10.1186/s13643-024-02617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES Polycystic ovary syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. It has significant implications for female endocrine function, reproductive health, and metabolic disturbances, including insulin resistance, impaired glucose tolerance, and dyslipidemia. Studies have shown that decreased heart rate variability (HRV), a marker of autonomic dysfunction, is associated with adverse cardiovascular events. Recent research has focused on investigating autonomic function in PCOS, and some studies have suggested altered autonomic drive in these patients. The aim of this systematic review and meta-analysis was to evaluate cardiac autonomic function by analyzing HRV in women with PCOS. METHODS This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I for non-RCTs. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked. A random effect model was used and calculated a pooled standardized mean difference (SMD) with a 95% confidence interval (CI). RESULTS Seventeen articles were included in the final analysis, varied in quality, ranging from a "low" to a "high risk of bias". Combined analyses indicated a notable decrease in HRV among individuals with PCOS compared to the control group. Significant changes were observed in SDNN (SMD: -0.763, 95%CI [-1.289 to -0.237], p=0.004), PNN50 (SMD: -1.245, 95%CI [-2.07, -0.419], p=0.003), LF/HF ratio (SMD: 0.670, 95%CI [0.248, 1.091], p=0.002), HFnu (SMD: -0.873, 95%CI [-1.257, -0.489], p=0.000), LFnu (SMD: 0.840, 95%CI [0.428, 1.251], p=0.000) and TP (SMD: -1.997, 95%CI [-3.306, -0.687], p=0.003). The heterogeneity was partially explained by types of study design. Subgroup analysis revealed significant alterations of HRV in normal-weighted and overweight PCOS cases. Conversely, no significant changes in HRV were observed in obese PCOS cases. CONCLUSION The findings of this meta-analysis provide evidence suggesting diminished HRV in individuals with PCOS compared to non-PCOS control group.
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Affiliation(s)
| | - Padideh Panahi
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Heidari
- Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Kim MJ, Rhim G. Blood Pressure Response to the Head-Up Tilt Test in Benign Paroxysmal Positional Vertigo. J Clin Med 2023; 12:7725. [PMID: 38137794 PMCID: PMC10744299 DOI: 10.3390/jcm12247725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
The vestibular organ is involved in controlling blood pressure through vestibulosympathetic reflexes of the autonomic nervous system. This study aimed to investigate the effect of benign paroxysmal positional vertigo (BPPV) on blood pressure control by the autonomic nervous system by observing changes in blood pressure before and after BPPV treatment using the head-up tilt test (HUTT). A total of 278 patients who underwent the HUTT before and after treatment were included. The HUTT measured blood pressure repeatedly on the day of diagnosis and the day of complete recovery, and the results were analyzed using repeated measures analysis of variance. Regarding the difference in the systolic blood pressure of patients with BPPV, the blood pressure at 1, 2, and 3 min in the upright position after complete recovery was significantly lower than before treatment (p = 0.001, p = 0.001, and p = 0.012, respectively). Blood pressure at 1 and 2 min in the diastolic blood pressure of patients with BPPV in the upright position after complete recovery was significantly lower than before treatment (p = 0.001 and p = 0.034, respectively). This study shows that BPPV increases blood pressure during the initial response to standing in the HUTT.
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Affiliation(s)
- Moon-Jung Kim
- Department of Laboratory Medicine, Myongji Hospital, Hanyang University Medical Center, Goyang 10475, Republic of Korea;
| | - Guil Rhim
- Department of Otorhinolaryngology, One Otorhinolaryngology Clinic, Paju 10924, Republic of Korea
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Pae EK, Harper RM. Intermittent hypoxia in neonatal rodents affects facial bone growth. PLoS One 2023; 18:e0282937. [PMID: 37819881 PMCID: PMC10566710 DOI: 10.1371/journal.pone.0282937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/02/2023] [Indexed: 10/13/2023] Open
Abstract
Preterm human infants often show periodic breathing (PB) or apnea of prematurity (AOP), breathing patterns which are accompanied by intermittent hypoxia (IH). We examined cause-effect relationships between transient IH and reduced facial bone growth using a rat model. Neonatal pups from 14 timed pregnant Sprague-Dawley rats were randomly assigned to an IH condition, with oxygen altering between 10% and 21% every 4 min for 1 h immediately after birth, or to a litter-matched control group. The IH pups were compared with their age- and sex-matched control groups in body weight (WT), size of facial bones and nor-epinephrine (NE) levels in blood at 3, 4, and 5-weeks. Markedly increased activity of osteoclasts in sub-condylar regions of 3-week-old IH-treated animals appeared, as well as increased numbers of sympathetic nerve endings in the same region of tissue sections. Male IH-pups showed significantly higher levels of NE levels in sera at 3, 4 as well as 5-week-old time points. NE levels in 4- and-5-week-old female pups did not differ significantly. Intercondylar Width, Mandible Length and Intermolar Width measures consistently declined after IH insults in 3- and 4-week-old male as well as female animals. Three-week-old male IH-pups only showed a significantly reduced (p < 0.05) body weight compared to those of 3-week controls. However, female IH-pups were heavier than age-matched controls at all 3 time-points. Trabecular bone configuration, size of facial bones, and metabolism are disturbed after an IH challenge 1 h immediately after birth. The findings raise the possibility that IH, introduced by breathing patterns such as PB or AOP, induce significantly impaired bone development and metabolic changes in human newborns. The enhanced NE outflow from IH exposure may serve a major role in deficient bone growth, and may affect bone and other tissue influenced by that elevation.
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Affiliation(s)
- Eung-Kwon Pae
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Maryland, Baltimore, MA, United States of America
| | - Ronald M. Harper
- Department of Neurobiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States of America
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Zhou JJ, Shao JY, Chen SR, Pan HL. Brain α2δ-1-Bound NMDA Receptors Drive Calcineurin Inhibitor-Induced Hypertension. Circ Res 2023; 133:611-627. [PMID: 37605933 PMCID: PMC10529656 DOI: 10.1161/circresaha.123.322562] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Calcineurin is highly enriched in immune T cells and the nervous system. Calcineurin inhibitors, including cyclosporine and tacrolimus (FK506), are the cornerstone of immunosuppressive regimens for preserving transplanted organs and tissues. However, these drugs often cause persistent hypertension owing to excess sympathetic outflow, which is maintained by N-methyl-D-aspartate receptor (NMDAR)-mediated excitatory input to the hypothalamic paraventricular nucleus (PVN). It is unclear how calcineurin inhibitors increase NMDAR activity in the PVN to augment sympathetic vasomotor activity. α2δ-1 (encoded by the Cacna2d1 gene), known colloquially as a calcium channel subunit, is a newly discovered NMDAR-interacting protein. In this study, we determined whether α2δ-1 plays a role in calcineurin inhibitor-induced synaptic NMDAR hyperactivity in the PVN and hypertension development. METHODS Immunoblotting and coimmunoprecipitation assays were used to quantify synaptic protein levels and the physical interaction between GluN1 (the obligatory NMDAR subunit) and α2δ-1. Whole-cell patch-clamp recordings of retrogradely labeled, spinally projecting PVN were conducted in perfused brain slices to measure presynaptic and postsynaptic NMDAR activity. Radio-telemetry was implanted in rodents to continuously record arterial blood pressure in conscious states. RESULTS Prolonged treatment with FK506 in rats significantly increased protein levels of α2δ-1, GluN1, and the α2δ-1-GluN1 complex in PVN synaptosomes. These effects were blocked by inhibiting α2δ-1 with gabapentin or interrupting the α2δ-1-NMDAR interaction with an α2δ-1 C-terminus peptide. Treatment with FK506 potentiated the activity of presynaptic and postsynaptic NMDARs in spinally projecting PVN neurons; such effects were abolished by gabapentin, Cacna2d1 knockout, or α2δ-1 C-terminus peptide. Furthermore, microinjection of α2δ-1 C-terminus peptide into the PVN diminished renal sympathetic nerve discharges and arterial blood pressure that had been increased by FK506 treatment. Remarkably, concurrent administration of gabapentin prevented the development of FK506-induced hypertension in rats. Additionally, FK506 treatment induced sustained hypertension in wild-type mice but not in Cacna2d1 knockout mice. CONCLUSIONS α2δ-1 is essential for calcineurin inhibitor-induced increases in synaptic NMDAR activity in PVN presympathetic neurons and sympathetic outflow. Thus, α2δ-1 and α2δ-1-bound NMDARs represent new targets for treating calcineurin inhibitor-induced hypertension. Gabapentinoids (gabapentin and pregabalin) could be repurposed for treating calcineurin inhibitor-induced neurogenic hypertension.
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Affiliation(s)
- Jing-Jing Zhou
- Center for Neuroscience and Pain Research, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Jian-Ying Shao
- Center for Neuroscience and Pain Research, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Shao-Rui Chen
- Center for Neuroscience and Pain Research, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Hui-Lin Pan
- Center for Neuroscience and Pain Research, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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Shankhwar V, Urvec J, Steuber B, Schmid Zalaudek K, Bergauer A, Alsuwaidi H, Du Plessis S, Alsheikh-Ali A, Kellett C, Bayoumi R, Blaber AP, Goswami N. Association of gender with cardiovascular and autonomic responses to central hypovolemia. Front Cardiovasc Med 2023; 10:1211774. [PMID: 37719984 PMCID: PMC10501725 DOI: 10.3389/fcvm.2023.1211774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Lower body negative pressure (LBNP) eliminates the impact of weight-bearing muscles on venous return, as well as the vestibular component of cardiovascular and autonomic responses. We evaluated the hemodynamic and autonomic responses to central hypovolemia, induced by LBNP in both males and females. Methodology A total of 44 participants recruited in the study. However, 9 participants did not complete the study protocol. Data from the remaining 35 participants were analysed, 18 males (25.28 ± 3.61 years, 181.50 ± 7.43 cm height, 74.22 ± 9.16 kg weight) and 17 females (22.41 ± 2.73 years, 167.41 ± 6.29 cm height, 59.06 ± 6.91 kg weight). During the experimental protocol, participants underwent three phases, which included 30 min of supine rest, four 4 min intervals of stepwise increases in LBNP from -10 mmHg to -40 mmHg, and 5 min of supine recovery. Throughout the protocol, hemodynamic variables such as blood pressure, heart rate, stroke index, cardiac index, and total peripheral resistance index were continuously monitored. Autonomic variables were calculated from heart rate variability measures, using low and high-frequency spectra, as indicators of sympathetic and parasympathetic activity, respectively. Results At rest, males exhibited higher systolic (118.56 ± 9.59 mmHg and 110.03 ± 10.88 mmHg, p < 0.05) and mean arterial (89.70 ± 6.86 and 82.65 ± 9.78, p < 0.05) blood pressure as compared to females. Different levels of LBNP altered hemodynamic variables in both males and females: heart rate [F(1,16) = 677.46, p < 0.001], [F(1,16) = 550.87, p < 0.001]; systolic blood pressures [F(1,14) = 3,186.77, p < 0.001], [F(1,17) = 1,345.61, p < 0.001]; diastolic blood pressure [F(1,16) = 1,669.458, p < 0.001], [F(1,16) = 1,127.656, p < 0.001]; mean arterial pressures [F(1,16) = 2,330.44, p < 0.001], [F(1,16) = 1,815.68, p < 0.001], respectively. The increment in heart rates during LBNP was significantly different between both males and females (p = 0.025). The low and high-frequency powers were significantly different for males and females (p = 0.002 and p = 0.001, respectively), with the females having a higher increase in low-frequency spectral power. Conclusions and future directions Cardiovascular activity and autonomic function at rest are influenced by gender. During LBNP application, hemodynamic and autonomic responses differed between genders. These gender-based differences in responses during central hypovolemia could potentially be attributed to the lower sympathetic activity in females. With an increasing number of female crew members in space missions, it is important to understand the role sex-steroid hormones play in the regulation of cardiovascular and autonomic activity, at rest and during LBNP.
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Affiliation(s)
- Vishwajeet Shankhwar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Janez Urvec
- Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Bianca Steuber
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - Karin Schmid Zalaudek
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - Andrej Bergauer
- Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
- Department of Surgery, General Hospital (LKH Südsteiermark), Wagna, Austria
| | - Hanan Alsuwaidi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Stefan Du Plessis
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Alawi Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Catherine Kellett
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Riad Bayoumi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Andrew Phillip Blaber
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Nandu Goswami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
- Department of Integrative Medicine, Alma Mater Europea, Maribor, Slovenia
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Reckelhoff JF. Mechanisms of sex and gender differences in hypertension. J Hum Hypertens 2023; 37:596-601. [PMID: 36797338 DOI: 10.1038/s41371-023-00810-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/10/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
The mechanisms that control blood pressure are multifaceted including the sympathetic nervous system and the renin-angiotensin system leading to vasoconstriction and sodium reabsorption that causes a shift in the pressure-natriuesis relationship to higher blood pressures. Sex steroids can affect these mechanisms either directly or indirectly, and the effects may be different depending on the sex of the individual. This review will discuss some of the major blood pressure-controlling mechanisms and how sex steroids may affect them and the need for future studies to better clarify the mechanisms responsible for sex and gender differences in blood pressure control. New mechanisms that are identified, along with what is already known, will provide better tools for treatment of hypertension in men and women of all ethnicities and decrease the risk of cardiovascular disease in the future.
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Affiliation(s)
- Jane F Reckelhoff
- Department of Cell and Molecular Biology, Women's Health Research Center, Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS, USA.
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11
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Wang X, Zeng Q, Ma N, Peng L, Liu L, Hong F, Xu Y. Sex-specific differences in the association between metabolically healthy overweight/obesity and the risk of hypertension in Chinese ethnic minorities. Endocrine 2023; 80:317-327. [PMID: 36708464 DOI: 10.1007/s12020-023-03308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To estimate and compare sex-specific differences between metabolically healthy overweight/obesity (MHOO) and the risk of hypertension among Dong, Bouyei, and Miao adults in southwest China. METHODS MHOO was diagnosed when the patient had a body mass index ≥24 kg/m2 and the presence of ≤1 component of metabolic syndrome. The main outcome was the occurrence of hypertension after the diagnosis or measurement by a physician at the baseline survey. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between MHOO and the risk of hypertension. RESULTS We enrolled 16,433 Chinese Dong, Bouyei, and Miao adults. Using the metabolically healthy normal weight (MHNW) as a reference and after adjusting for confounders, the association between MHOO and the risk of hypertension was stronger in Dong (OR = 1.46, 95% CI: 1.07-2.00) and Miao (OR = 2.05, 95% CI: 1.48-2.85) men and did not exist in Bouyei men (OR = 1.14, 95% CI: 0.81-1.60). After adjusting for the age, the association between MHOO and the risk of hypertension was stronger in men than in women among Dong adults aged 30-59 years (OR = 1.64, 95% CI: 1.12-2.40) and did not differ between men and women among Dong adults aged 60-79 years or among Miao or Bouyei adults. CONCLUSION The results of this study demonstrated sex-specific differences in the association between MHOO and the risk of hypertension and that sex-specific differences further differed among Dong, Bouyei, and Miao adults.
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Affiliation(s)
- Xin Wang
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Qibing Zeng
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Nana Ma
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Lian Peng
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Leilei Liu
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Feng Hong
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
| | - Yuyan Xu
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
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12
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Lee E, Anselmo M, Tahsin CT, Vanden Noven M, Stokes W, Carter JR, Keller-Ross ML. Vasomotor symptoms of menopause, autonomic dysfunction, and cardiovascular disease. Am J Physiol Heart Circ Physiol 2022; 323:H1270-H1280. [PMID: 36367692 PMCID: PMC9744645 DOI: 10.1152/ajpheart.00477.2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
Cardiovascular disease (CVD), the leading cause of death among US adults, is more prevalent in menopausal females compared with age-matched males. Vasomotor symptoms of menopause (VMS; hot flashes/flushes and night sweats) are common among females undergoing menopausal transition and have been associated with elevated blood pressure (BP) and increased CVD risk. Autonomic dysregulation of BP has been posited as a contributing factor to the elevated CVD risk in menopausal females with VMS. This review includes 1) a brief overview of the relationship between VMS and CVD, 2) mechanisms of hot flushes and their potential impact on short- and long-term BP regulation, and 3) how the disruption of autonomic function associated with VMS might provide a mechanistic pathway to CVD development. Finally, this review will highlight knowledge gaps and future directions toward better understanding of hot flush physiology and VMS contributions to CVD.
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Affiliation(s)
- Emma Lee
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Miguel Anselmo
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Chowdhury Tasnova Tahsin
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota
| | | | - William Stokes
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas
| | - Manda L Keller-Ross
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota
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13
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Feasibility of Precision Medicine in Hypertension Management-Scope and Technological Aspects. J Pers Med 2022; 12:jpm12111861. [PMID: 36573720 PMCID: PMC9698650 DOI: 10.3390/jpm12111861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Personalized management of diseases by considering relevant patient features enables optimal treatment, instead of management according to an average patient. Precision management of hypertension is important, because both susceptibility to complications and response to treatment vary between individuals. While the use of genomic and proteomic personal features for widespread precision hypertension management is not practical, other features, such as age, ethnicity, and cardiovascular diseases, have been utilized in guidelines for hypertension management. In precision medicine, more blood-pressure-related clinical and physiological characteristics in the patient's profile can be utilized for the determination of the threshold of hypertension and optimal treatment. Several non-invasive and simple-to-use techniques for the measurement of hypertension-related physiological features are suggested for use in precision management of hypertension. In order to provide precise management of hypertension, accurate measurement of blood pressure is required, but the available non-invasive blood pressure measurement techniques, auscultatory sphygmomanometry and oscillometry, have inherent significant inaccuracy-either functional or technological-limiting the precision of personalized management of hypertension. A novel photoplethysmography-based technique for the measurement of systolic blood pressure that was recently found to be more accurate than the two available techniques can be utilized for more precise and personalized hypertension management.
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14
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D'Souza AW, Klassen SA, Badrov MB, Lalande S, Shoemaker JK. Aging is associated with enhanced central, but impaired peripheral arms of the sympathetic baroreflex arc. J Appl Physiol (1985) 2022; 133:349-360. [PMID: 35736951 DOI: 10.1152/japplphysiol.00045.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We tested the hypothesis that the baroreflex control of action potential (AP) subpopulations would be blunted in older compared to young adults. Integrated muscle sympathetic nerve activity (MSNA) and the underlying sympathetic APs were obtained using microneurography and a continuous wavelet analysis approach, respectively, during 5 minutes of supine rest in 13 older (45-75 years, 6 females) and 14 young (21-30 years, 7 females) adults. Baroreflex threshold relationships were quantified as the slope of the linear regression between MSNA burst probability (%) and diastolic blood pressure (mmHg), or AP cluster firing probability (%) and diastolic blood pressure (mmHg). Integrated MSNA baroreflex threshold gain was greater in older compared to young adults (older: -7.6±3.6 %/mmHg vs. Young: -3.5±1.5 %/mmHg, P<0.001). Similarly, the baroreflex threshold gain of AP clusters was modified by aging (group-by-cluster effect: P<0.001) such that older adults demonstrated greater baroreflex threshold gains of medium-sized AP clusters (e.g., Cluster 4, older: -8.2±3.2 %/mmHg vs. Young: -3.6±1.9 %/mmHg, P=0.003) but not for the smallest- (Cluster 1, older: -1.6±1.9 %/mmHg vs. Young: -1.0±1.7 %/mmHg, P>0.999) and largest-sized (Cluster 10, older: -0.5±0.5 %/mmHg vs. Young: -0.2±0.1 %/mmHg, P=0.819) AP clusters compared to young adults. In contrast, the peak change in mean arterial pressure (MAP) following a spontaneous MSNA burst (i.e., sympathetic transduction) was impaired with aging (older: -0.7±0.3 mmHg vs. Young: 1.8±1.2 mmHg, P<0.001). We conclude that aging is associated with elevated baroreflex control over high-probability AP content of sympathetic bursts that may compensate for impaired sympathetic neurovascular transduction.
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Affiliation(s)
- Andrew W D'Souza
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Stephen A Klassen
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada.,Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Mark B Badrov
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada.,University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sophie Lalande
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada.,Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - J Kevin Shoemaker
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
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15
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Caraballo C, Mahajan S, Gu J, Lu Y, Spatz ES, Dreyer RP, Zhang M, Sun N, Ren Y, Zheng X, Zhao H, Lu H, Ma ZJ, Krumholz HM. Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography. PLoS One 2022; 17:e0269777. [PMID: 35700163 PMCID: PMC9197037 DOI: 10.1371/journal.pone.0269777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background Whether there are sex differences in hemodynamic profiles among people with elevated blood pressure is not well understood and could guide personalization of treatment. Methods and results We described the clinical and hemodynamic characteristics of adults with elevated blood pressure in China using impedance cardiography. We included 45,082 individuals with elevated blood pressure (defined as systolic blood pressure of ≥130 mmHg or a diastolic blood pressure of ≥80 mmHg), of which 35.2% were women. Overall, women had a higher mean systolic blood pressure than men (139.0 [±15.7] mmHg vs 136.8 [±13.8] mmHg, P<0.001), but a lower mean diastolic blood pressure (82.6 [±9.0] mmHg vs 85.6 [±8.9] mmHg, P<0.001). After adjusting for age, region, and body mass index, women <50 years old had lower systemic vascular resistance index (beta-coefficient [β] -31.7; 95% CI: -51.2, -12.2) and higher cardiac index (β 0.07; 95% CI: 0.04, 0.09) than men of their same age group, whereas among those ≥50 years old women had higher systemic vascular resistance index (β 120.4; 95% CI: 102.4, 138.5) but lower cardiac index (β -0.15; 95% CI: -0.16, -0.13). Results were consistent with a propensity score matching sensitivity analysis, although the magnitude of the SVRI difference was lower and non-significant. However, there was substantial overlap between women and men in the distribution plots of these variables, with overlapping areas ranging from 78% to 88%. Conclusions Our findings indicate that there are sex differences in hypertension phenotype, but that sex alone is insufficient to infer an individual’s profile.
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Affiliation(s)
- César Caraballo
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Shiwani Mahajan
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Jianlei Gu
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Research Center for Big Data in Pediatric Precision Medicine, Shanghai, China
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
| | - Erica S. Spatz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Rachel P. Dreyer
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - MaoZhen Zhang
- iKang Healthcare Group, Inc., Shanghai, China
- Department of Cardiology, Xinhua Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - NingLing Sun
- Department of Hypertension at Heart Center, Peking University People’s Hospital, Beijing, China
| | - Yihong Ren
- The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xin Zheng
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyu Zhao
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Hui Lu
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Center for Biomedical Informatics, Shanghai Children’s Hospital, Shanghai, China
| | - Zheng J. Ma
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut, United States of America
- Beijing Li-Heng Medical Technologies, Ltd, Beijing, China
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America
- * E-mail:
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16
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Coovadia Y, Adler TE, Martin-Arrowsmith PW, Usselman CW. Sex differences in sympathetic neuro-vascular and neuro-hemodynamic relationships during the cold pressor test. Am J Physiol Regul Integr Comp Physiol 2022; 322:R411-R420. [PMID: 35293259 DOI: 10.1152/ajpregu.00223.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Muscle sympathetic nerve activity (MSNA) affects vascular resistance differently in women and men. However, whether this sex difference persists during pronounced increases in MSNA remains unclear. Therefore, the purpose of this study was to examine sex differences in neurovascular transduction during cold pressor test (CPT)-mediated sympatho-excitation. Integrated peroneal MSNA (microneurography) was measured at rest and during a 3-minute CPT in young healthy women (n=11) and men (n=10). Mean arterial pressure (MAP) was measured beat-by-beat (Finometer) and superficial femoral artery blood flow was measured using duplex ultrasound. Femoral vascular resistance (FVR) was quantified as MAP/femoral blood flow (mmHg/mL/min). Baseline MSNA was similar between women and men (14±9 vs 15±9 bursts/100hb, respectively; P=0.83), whereas MAP was lower (86±7 vs 92±4 mmHg; P=0.047), and FVR was greater in women than men (0.54±0.16 vs 0.36±0.15 mmHg/mL/min; P=0.02). CPT-induced increases in MSNA were similar between the sexes (+19±11 vs +26±14 bursts/100hb; P=0.26) while increases in MAP (+7±3 vs +10±3mmHg; P=0.03) and FVR (+3.2±18.6 vs +26.8±12.8%; P<0.01) were smaller in women than men. Within men, CPT- induced increases in MSNA predicted increases in MAP (R2=0.51, P=0.02) and FVR (R2=0.49, P=0.02). However, MSNA did not predict MAP (R2=0.11, P=0.35) or FVR (R2=0.07, P=0.46) in women. Our findings demonstrate that men experience robust CPT-induced MAP responses that are driven by both neuro-vascular (MSNA-FVR) and neuro-hemodynamic (MSNA-MAP) coupling. These relationships were not observed in women, indicating that even during pronounced increases in sympathetic outflow, MSNA is not predictive of vascular nor blood pressure outcomes in young healthy women.
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Affiliation(s)
- Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, McGill University, Montreal, Quebec, Canada
| | - Tessa E Adler
- Cardiovascular Health and Autonomic Regulation Laboratory, McGill University, Montreal, Quebec, Canada
| | - Patrick W Martin-Arrowsmith
- Exercise Metabolism and 6 Nutrition Research Lab, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Quebec, Canada
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Lanfranchi F, D'Amico F, Raffa S, Pennone M, Donegani MI, Miceli A, Chiola S, Maggio S, Delucchi C, Cossu V, Morbelli S, Bauckneht M, Sambuceti G, Marini C. Spleen Perfusion as an Index of Gender Impact on Sympathetic Nervous System Response to Exercise. Front Physiol 2021; 12:780713. [PMID: 34975534 PMCID: PMC8715039 DOI: 10.3389/fphys.2021.780713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: Sympathetic nervous system (SNS) reaction to exercise is gender dependent. Nevertheless, clinically applicable methods to identify this difference are still missing. An organ largely sensitive to SNS is the spleen whose response to exercise can be easily evaluated, being included in the field of view of myocardial perfusion imaging (MPI). Here, we aimed to verify whether gender interferes with the spleen perfusion and its response to exercise. Methods: For this purpose, we evaluated 286 original scans of consecutive patients submitted to MPI in the course of 2019. Our standard procedure implies a single-day stress-rest sequence with a gap of ≥2 h between the administrations of 180 and 500 MBq of 99mTc-Sestamibi, respectively. Imaging is performed 30 min after radiotracer administration, with scan duration set at 25 and 35 s per view, respectively. Non-gated scans were reconstructed with the filtered back-projection method. A volume of interest was drawn on the spleen and heart to estimate the dose-normalized average counting rate that was expressed in normalized counts per seconds (NCPS). Results: In all subjects submitted to exercise MPI (n = 228), NCPS were higher during stress than at rest (3.52 ± 2.03 vs. 2.78 ± 2.07, respectively; p < 0.01). This effect was not detected in the 58 patients submitted to dipyridamole-stress. The response to exercise selectively involved the spleen, since NCPS in heart were unchanged irrespective of the used stressor. This same response was dependent upon gender, indeed spleen NCPS during stress were significantly higher in the 75 women than in the 153 men (3.86 ± 1.8 vs. 3.23 ± 1.6, respectively, p < 0.01). Again, this variance was not reproduced by heart. Finally, spleen NCPS were lower in the 173 patients with myocardial reversible perfusion defects (summed difference score ≥3) than in the remaining 55, despite similar values of rate pressure product at tracer injection. Conclusion: Thus, exercise interference on spleen perfusion can be detected during MPI. This effect is dependent upon gender and ischemia confirming the high sensitivity of this organ to SNS activation.
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Affiliation(s)
- Francesco Lanfranchi
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Francesca D'Amico
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Stefano Raffa
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | - Alberto Miceli
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Chiola
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sara Maggio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Vanessa Cossu
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Gianmario Sambuceti
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cecilia Marini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Milan, Italy
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Liu X, Kumar A, O'Neil J, Wong J, Saadoon O, Kadire S, Mitscher GA, Li X, Chen PS, Emery MS, Everett TH. Skin sympathetic nerve activity as a biomarker of fitness. Heart Rhythm 2021; 18:2169-2176. [PMID: 34481982 PMCID: PMC8629931 DOI: 10.1016/j.hrthm.2021.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/13/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Exercise stress testing is frequently used to expose cardiac arrhythmias. Aerobic exercise conditioning has been used as a nonpharmacologic antiarrhythmic intervention. OBJECTIVE The purpose of this study was to test the hypothesis that noninvasively recorded skin sympathetic nerve activity (SKNA) is increased during exercise and that SKNA response varies according to fitness levels. METHODS Oxygen consumption (VO2) and SKNA were recorded in 39 patients undergoing an incremental exercise test. Patients were grouped by 5 levels of fitness based on age, sex, and VO2max. RESULTS With exercise, all patients had a significant increase in average SKNA (aSKNA) (1.58 ± 1.12 μV to 4.50 ± 3.06 μV, P = .000) and heart rate (HR) (87.40 ± 20.42 bpm to 154.13 ± 16.82 bpm, P = .000). A mixed linear model of aSKNA was used with fixed effects of fitness, exercise time, and recovery time, and random effects of subject level intercept and slopes for exercise time and recovery times. The poor fitness group had significantly higher aSKNA than the other groups (P = .0273). For all subjects studied, aSKNA increased by 5% per minute with progression of exercise and decreased by 15% per minute with progression of recovery. The fitness variable encodes information on both comorbidities and body mass index (BMI). Once fitness level is known, comorbidities and BMI are not significantly associated with aSKNA. In all groups, aSKNA positively correlated with HR (R2 = 0.47 ± 0.23) and VO2 (R2 = 0.68 ± 0.25). CONCLUSION Fitness level determines the magnitude and time course of SKNA increase during exercise. SKNA may be a useful fitness biomarker in exercise stress testing.
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Affiliation(s)
- Xiao Liu
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Awaneesh Kumar
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana
| | - Joseph O'Neil
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana
| | - Johnson Wong
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana
| | - Osama Saadoon
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana
| | - Siri Kadire
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana
| | - Gloria A Mitscher
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana
| | - Xiaochun Li
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Michael S Emery
- Tomsich Family Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana.
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Molbo L, Hansen RK, Østergaard LR, Frøkjær JB, Larsen RG. Sex differences in microvascular function across lower leg muscles in humans. Microvasc Res 2021; 139:104278. [PMID: 34774583 DOI: 10.1016/j.mvr.2021.104278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 12/18/2022]
Abstract
Studies have reported sex-based differences in conduit artery function, however little is known about possible sex-based differences in microvascular function, and possible influence of muscle group. Blood-oxygen-level-dependent (BOLD) MR images acquired during ischemia-reperfusion assess the reactive hyperemic response in the microvasculature of skeletal muscle. We tested the hypothesis that women have greater microvascular reactivity, reflected by faster time-to-peak (TTP) and time-to-half-peak (TTHP) of the BOLD response, across all lower leg muscles. In healthy, young men (n = 18) and women (n = 12), BOLD images of both lower legs were acquired continuously during 30 s of rest, 5 min of cuff occlusion and 2 min of reperfusion, in a 3 T MR scanner. Segmentation of tibialis anterior (TA), soleus (SO), gastrocnemius medial (GM), and the peroneal group (PG) were performed using image registration, and TTP and TTHP of the BOLD response were determined for each muscle. Overall, women had faster TTP (p = 0.001) and TTHP (p = 0.01) than men. Specifically, women had shorter TTP and TTHP in TA (27.5-28.4%), PG (33.9-41.6%), SO (14.7-19.7%) and GM (15.4-18.8%). Overall, TTP and TTHP were shorter in TA compared with PG (25.1-31.1%; p ≤ 0.007), SO (14.3-16%; p ≤ 0.03) and GM (15.6-26%; p ≤ 0.01). Intra class correlations analyses showed large variation in absolute agreement (range: 0.10-0.81) of BOLD parameters between legs (within distinct muscles). Faster TTP and TTHP across all lower leg muscles, in women, provide novel evidence of sex-based differences in microvascular function of young adults matched for age, body mass index, and physical activity level.
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Affiliation(s)
- Lars Molbo
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Rasmus Kopp Hansen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Jens Brøndum Frøkjær
- Department of Radiology, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ryan Godsk Larsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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20
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Lumbikananda S, Sriwantana T, Rattanawonsakul K, Parakaw T, Phruksaniyom C, Rattanasuwan K, Vivithanaporn P, Thonabulsombat C, Sibmooh N, Srihirun S. Nitrite in paraffin-stimulated saliva correlates with blood nitrite. Nitric Oxide 2021; 116:1-6. [PMID: 34371196 DOI: 10.1016/j.niox.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/15/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
Nitrite anion (NO2-) is a circulating nitric oxide (NO) metabolite considered an endothelial function marker. Nitrite can be produced from nitrate (NO3-) secreted from plasma into saliva. The nitrate reductase of oral bacteria converts salivary nitrate to nitrite, which is swallowed and absorbed into circulation. In this study, we aimed to examine the relevance between these species' salivary and blood levels. We collected three whole saliva samples (unstimulated, paraffin-stimulated, and post-chlorhexidine mouthwash stimulated saliva) and blood from 75 healthy volunteers. We measured the nitrite and nitrate by the chemiluminescence method. The nitrite levels in stimulated saliva and post-mouthwash stimulated saliva exhibited weak correlations with blood nitrite. There was no correlation between nitrite in unstimulated saliva with blood nitrite. The baseline platelet activity, determined as P-selectin expression, negatively correlated with nitrite in plasma and post-mouthwash stimulated saliva. The salivary nitrate in all saliva samples showed correlations with its plasma levels. We conclude that nitrite in stimulated saliva correlates with blood nitrite.
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Affiliation(s)
- Supanat Lumbikananda
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Thanaporn Sriwantana
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Krit Rattanawonsakul
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Tipparat Parakaw
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Kanyawat Rattanasuwan
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pornpun Vivithanaporn
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | | | - Nathawut Sibmooh
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Sirada Srihirun
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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21
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Obesity-associated cardiovascular risk in women: hypertension and heart failure. Clin Sci (Lond) 2021; 135:1523-1544. [PMID: 34160010 DOI: 10.1042/cs20210384] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/14/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
The pathogenesis of obesity-associated cardiovascular diseases begins long prior to the presentation of a cardiovascular event. In both men and women, cardiovascular events, and their associated hospitalizations and mortality, are often clinically predisposed by the presentation of a chronic cardiovascular risk factor. Obesity increases the risk of cardiovascular diseases in both sexes, however, the clinical prevalence of obesity, as well as its contribution to crucial cardiovascular risk factors is dependent on sex. The mechanisms via which obesity leads to cardiovascular risk is also discrepant in women between their premenopausal, pregnancy and postmenopausal phases of life. Emerging data indicate that at all reproductive statuses and ages, the presentation of a cardiovascular event in obese women is strongly associated with hypertension and its subsequent chronic risk factor, heart failure with preserved ejection fraction (HFpEF). In addition, emerging evidence indicates that obesity increases the risk of both hypertension and heart failure in pregnancy. This review will summarize clinical and experimental data on the female-specific prevalence and mechanisms of hypertension and heart failure in women across reproductive stages and highlight the particular risks in pregnancy as well as emerging data in a high-risk ethnicity in women of African ancestry (AA).
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22
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Hockin BCD, Tang EZ, Lloyd MG, Claydon VE. Forearm vascular resistance responses to the Valsalva maneuver in healthy young and older adults. Clin Auton Res 2021; 31:737-753. [PMID: 34014418 DOI: 10.1007/s10286-021-00810-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Effective end-organ peripheral vascular resistance responses are critical to blood pressure control while upright, and prevention of syncope (fainting). The Valsalva maneuver (VM) induces blood pressure decreases that evoke baroreflex-mediated vasoconstriction. We characterized beat-to-beat forearm vascular resistance (FVR) responses to the VM in healthy adults, evaluated the impact of age and sex on these responses, and investigated their association with orthostatic tolerance (OT; susceptibility to syncope). We hypothesized that individuals with smaller FVR responses would be more susceptible to syncope. METHODS Healthy young (N = 36; 19 women; age 25.4 ± 4.6 years) and older (N = 21; 12 women; age 62.4 ± 9.6 years) adults performed a supine 40 mmHg, 20 s VM. Graded 60° head-up-tilt with combined lower body negative pressure continued to presyncope was used to determine OT. Non-invasive beat-to-beat blood pressure and heart rate (finger plethysmography) were recorded continuously. FVR was calculated as mean arterial pressure (MAP) divided by brachial blood flow velocity (Doppler ultrasound) relative to baseline. RESULTS The VM produces a distinctive FVR pattern that peaks (+137.1 ± 11.6%) in phase 2B (17.5 ± 0.3 s) as the baroreflex responds to low-pressure perturbations. This response increased with age overall (p < 0.001) and within male (p = 0.030) and female subgroups (p < 0.001). Maximum FVR during the VM was significantly correlated with maximal tilt FVR (r = 0.364; p = 0.0153) and with OT when expressed relative to the MAP decrease in phase 2A (Max FVR (%)/MAP2A-1; r = 0.337; p = 0.0206). CONCLUSION This is the first characterization of FVR responses to the VM. The VM elicits large baroreflex-mediated increases in FVR; small FVR responses to the VM may indicate susceptibility to syncope.
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Affiliation(s)
- Brooke C D Hockin
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.,International Collaboration On Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Eileen Z Tang
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.,International Collaboration On Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Matthew G Lloyd
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.,International Collaboration On Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Victoria E Claydon
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada. .,International Collaboration On Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
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23
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Bauer P, Kraushaar L, Dörr O, Nef H, Hamm CW, Most A. Sex differences in workload-indexed blood pressure response and vascular function among professional athletes and their utility for clinical exercise testing. Eur J Appl Physiol 2021; 121:1859-1869. [PMID: 33709207 PMCID: PMC8192366 DOI: 10.1007/s00421-021-04656-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/05/2021] [Indexed: 12/28/2022]
Abstract
Purpose Sex differences in blood pressure (BP) regulation at rest have been attributed to differences in vascular function. Further, arterial stiffness predicts an exaggerated blood pressure response to exercise (BPR) in healthy young adults. However, the relationship of vascular function to the workload-indexed BPR and potential sex differences in athletes are unknown. Methods We examined 47 male (21.6 ± 1.7 years) and 25 female (21.1 ± 2 years) athletes in this single-center pilot study. We assessed vascular function at rest, including systolic blood pressure (SBP). Further, we determined the SBP/W slope, the SBP/MET slope, and the SBP/W ratio at peak exercise during cycling ergometry. Results Male athletes had a lower central diastolic blood pressure (57 ± 9.5 vs. 67 ± 9.5 mmHg, p < 0.001) but a higher central pulse pressure (37 ± 6.5 vs. 29 ± 4.7 mmHg, p < 0.001), maximum SBP (202 ± 20 vs. 177 ± 15 mmHg, p < 0.001), and ΔSBP (78 ± 19 vs. 58 ± 14 mmHg, p < 0.001) than females. Total vascular resistance (1293 ± 318 vs. 1218 ± 341 dyn*s/cm5, p = 0.369), pulse wave velocity (6.2 ± 0.85 vs. 5.9 ± 0.58 m/s, p = 0.079), BP at rest (125 ± 10/76 ± 7 vs. 120 ± 11/73.5 ± 8 mmHg, p > 0.05), and the SBP/MET slope (5.7 ± 1.8 vs. 5.1 ± 1.6 mmHg/MET, p = 0.158) were not different. The SBP/W slope (0.34 ± 0.12 vs. 0.53 ± 0.19 mmHg/W) and the peak SBP/W ratio (0.61 ± 0.12 vs. 0.95 ± 0.17 mmHg/W) were markedly lower in males than in females (p < 0.001). Conclusion Male athletes displayed a lower SBP/W slope and peak SBP/W ratio than females, whereas the SBP/MET slope was not different between the sexes. Vascular functional parameters were not able to predict the workload-indexed BPR in males and females.
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Affiliation(s)
- Pascal Bauer
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany.
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
- Department of Cardiology, Kerckhoff Clinic GmbH, Bad Nauheim, Germany
| | - Astrid Most
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
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24
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Jamal MT, Li Q, Li Q, Liang W, Wang L, Wei J, Liang Q, Hu N, Li L. Association of thyroid hormones with blood pressure and arterial stiffness in the general population: The Dali study. J Clin Hypertens (Greenwich) 2021; 23:363-372. [PMID: 33369115 PMCID: PMC8029764 DOI: 10.1111/jch.14154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022]
Abstract
Thyroid dysfunction plays a role in blood pressure (BP) regulation. However, the associations between thyroid function and BP and arterial stiffness in the general Chinese population without thyroid disease are unknown. This population-based cross-sectional study aimed to investigate the association between thyroid function and peripheral and central BP and arterial stiffness in Chinese individuals. After excluding those who had thyroid diseases or incomplete clinical measurements, this study included 691 participants. Of the participants, 444 (64.2%) were women and 215 (31.1%) had hypertension. After adjustment for covariates, serum FT3 was significantly associated with a higher pulse rate in both sexes. In men, each 2.72-fold increase in serum FT4 levels was associated with higher peripheral systolic BP (+10.82 mmHg, p = .005) and pulse pressure (+5.71 mmHg, p = .03). Each 2.72-fold increase in serum FT4 levels was associated with higher central systolic BP (+8.03 mmHg, p = .03) and pulse pressure (+3.89 mmHg, p = .05). In women, serum FT4 was only associated with a higher central pulse pressure (+2.96 mmHg, p = .04). After adjustment for covariates, serum FT4 was significantly associated with a faster cfPWV exclusively in men. Our study showed that serum FT4 is associated with higher peripheral and central BP and faster cfPWV in men, whereas serum FT3 is positively associated with a higher pulse rate in both sexes, indicating that the effects of thyroid function on BP and arterial stiffness are more significant in men than in women.
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Affiliation(s)
- Md Tasneem Jamal
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Qing‐Lu Li
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Qi‐Yan Li
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Wan‐Ying Liang
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Li‐Hong Wang
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Jian‐Hang Wei
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Quan Liang
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Nai‐Qing Hu
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
| | - Li‐Hua Li
- Department of GerontologyThe First Affiliated Hospital of Dali UniversityDaliChina
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25
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Abstract
BACKGROUND Hypertension and obesity often coexist. There are sex differences in the mechanisms of obesity-related hypertension but the reasons for these differences are still not fully understood. OBJECTIVE The aim of this study was to investigate sex differences in the development of hypertension associated with obesity. METHODS A total of 866 men and 1022 women were selected for the study. Anthropometric measurements, including arterial pressure measurements, were performed. The plasma lipid levels were measured using an enzymatic method with commercially available kits. RESULTS In both overweight and obesity, hypertensive women had more atherogenic lipid profiles and higher values of lipid accumulation product (LAP) than normotensive women. In overweight and obese men, no significant differences in lipid levels or LAP were noted between the normotensive and hypertensive groups. CONCLUSION The pathogenesis of obesity-related hypertension in women differs from that in men and tends to be associated with metabolic disorders.
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Affiliation(s)
- Anastasiya M Kaneva
- Institute of Physiology of Коmi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, Syktyvkar, Russia
| | - Evgeny R Bojko
- Institute of Physiology of Коmi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, Syktyvkar, Russia
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26
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Ambulatory blood pressure variability and combined exercise training: comparison between hypertensive and normotensive postmenopausal women. Blood Press Monit 2020; 25:338-345. [PMID: 32815922 DOI: 10.1097/mbp.0000000000000480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of the study was to verify the effects of moderate combined aerobic and resistance exercises training in ambulatory blood pressure (ABPM) and its variability in hypertensive and normotensive postmenopausal women. METHODS Twenty-six participants were divided into two groups: hypertensive (HT = 13) and normotensive (NT = 13). They performed 30 sessions of combined exercises (aerobic and resistance exercises at same session) over 10 weeks. We evaluated: resting BP and 24-h ABPM with systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and heart rate (HR). To evaluate blood pressure variability (BPV), the following were considered: 24-h SD (SD24), the mean diurnal and nocturnal deviations (SDdn), average real variability (ARV24). RESULTS The two-way analysis of variance showed no difference in ABPM nor BPV responses after training between groups. Both HT and NT groups had similar BP reductions in 24-h DBP (P < 0.01; ΔNT = -3.1 ± 1.1, ΔHT = -1.8 ± 1.2 mmHg), 24-h area under the curve of DBP (P = 0.01; ΔNT = -73±105, ΔHT = -44 ± 115 mmHg), and wake DBP (P < 0.01; ΔNT = -3.4 ± 1.2, ΔHT = -1.8 ± 1.3 mmHg), without differences in BPV responses. Moreover, HT women had higher overall SBP SDdn (P = 0.01), SBP ARV (P = 0.02), and MBP ARV (P < 0.01) than NT women. CONCLUSION Ten-week combined exercise training resulted in similar BP reductions in hypertensive and normotensive postmenopausal women, but not in BPV responses.
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27
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Coovadia Y, Adler TE, Steinback CD, Fraser GM, Usselman CW. Sex differences in dynamic blood pressure regulation: beat-by-beat responses to muscle sympathetic nerve activity. Am J Physiol Heart Circ Physiol 2020; 319:H531-H538. [PMID: 32734818 DOI: 10.1152/ajpheart.00245.2020] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
It has been suggested that sex differences in acute blood pressure fluctuations occur during the periods of time between bursts of muscle sympathetic nerve activity. Therefore, we tested the hypothesis that men experience more dynamic changes in mean arterial pressure (Finometer MIDI) than women during acute sympathoinhibition (i.e., slow breathing) in which bursts of sympathetic activity occur more infrequently than at rest. We tested healthy women (n = 9) and men (n = 9) of similar age (22 ± 2 vs. 23 ± 3 yr, P = 0.6). Custom software was used to calculate beat-by-beat changes in blood pressure following sympathetic burst and nonburst sequences (recorded using microneurography) during 10 min of supine rest and a 15-min bout of slow breathing. During slow breathing following nonburst sequences, women demonstrated smaller overall reductions in mean arterial pressure compared with men over the subsequent 15 cardiac cycles (P < 0.01). In addition, following a burst of sympathetic activity, women experienced greater overall increases in mean arterial pressure compared with men over the following 15 cardiac cycles (P < 0.01). Despite these differences, the peak and nadir changes in arterial pressure following burst and nonburst sequences were not different between the sexes (P = 0.45 and P = 0.48, burst and nonburst sequences, respectively). As such, these data suggest that women respond to a burst of sympathetic activity with more sustained increases in blood pressure than men, coupled with improved maintenance of blood pressure during acute periods of sympathetic quiescence. In other words, these findings suggest that men rely more on frequent bursts of sympathetic activity to acutely regulate arterial pressure than women.NEW & NOTEWORTHY We demonstrate that during acute sympathoinhibition, women demonstrate more sustained increases in blood pressure following sympathetic bursts of activity than men. Likewise, during prolonged sympathetic quiescence, blood pressure is less labile in women than men. This suggests that lower overall blood pressure in young women may not be mediated by smaller beat-by-beat changes in blood pressure in response to sympathetic outflow but may instead be mediated by a lower frequency of sympathetic bursts.
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Affiliation(s)
- Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Tessa E Adler
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Craig D Steinback
- Neurovascular Health Laboratory, Program for Pregnancy and Postpartum Health, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.,Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Graham M Fraser
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Quebec, Canada
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28
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Liu F, Liu Y, Sun X, Yin Z, Li H, Deng K, Zhao Y, Wang B, Ren Y, Liu X, Zhang D, Chen X, Cheng C, Liu L, Liu D, Chen G, Hong S, Wang C, Zhang M, Hu D. Race- and sex-specific association between alcohol consumption and hypertension in 22 cohort studies: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2020; 30:1249-1259. [PMID: 32446870 DOI: 10.1016/j.numecd.2020.03.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/08/2020] [Accepted: 03/18/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS The alcohol-hypertension relation has been well documented, but whether women have protective effect or race and type of beverage consumed affect the association remain unclear. To quantify the relation between total or beverage-specific alcohol consumption and incident hypertension by considering the effect of sex and race. METHODS AND RESULTS Articles were identified in PubMed and Embase databases with no restriction on publication date. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random effects models. Restricted cubic splines were used to model the dose-response association. This study involved 22 articles (31 studies) and included 414,477 participants. The hypertension risk was different among liquor, wine, and beer at 5.1-10 g/d of ethanol consumption (P-across subgroups = 0.002). The hypertension risk differed between men (RR: 1.14, 95% CI: 1.07, 1.20) and women (RR: 0.98, 95% CI: 0.89, 1.06) at 10 g/d (P-across subgroups = 0.005). We found a linear alcohol-hypertension association among white (P-linearity = 0.017), black people (P-linearity = 0.035), and Asians (P-linearity<0.001). With 10 g/d increment of consumption, the RRs for hypertension were 1.06 (95% CI: 1.04, 1.08), 1.14 (95% CI: 1.01, 1.28), and 1.06 (95% CI: 1.01, 1.10) for Asians, black, and white people, respectively. CONCLUSION Sex modifies the alcohol-hypertension association at low level of alcohol consumption and we did not find evidence of a protective effect of alcohol consumption among women. Black people may have higher hypertension risk than Asians and white people at the same ethanol consumption.
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Affiliation(s)
- Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Zhaoxia Yin
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xuejiao Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xu Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Cheng Cheng
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Leilei Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dechen Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Guozhen Chen
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Shihao Hong
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
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Oliveira-Dantas FF, Brasileiro-Santos MDS, Thomas SG, Silva AS, Silva DC, Browne RAV, Farias-Junior LF, Costa EC, Santos ADC. Short-Term Resistance Training Improves Cardiac Autonomic Modulation and Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial. J Strength Cond Res 2020; 34:37-45. [PMID: 31877119 DOI: 10.1519/jsc.0000000000003182] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Oliveira-Dantas, FF, Brasileiro-Santos, MdS, Thomas, SG, Silva, AS, Silva, DC, Browne, RAV, Farias-Junior, LF, Costa, EC, and Santos, AdC. Short-term resistance training improves cardiac autonomic modulation and blood pressure in hypertensive older women: a randomized controlled trial. J Strength Cond Res 34(1): 37-45, 2020-This randomized controlled trial investigated the efficacy of short-term resistance training (RT) on cardiac autonomic modulation and peripheral hemodynamic parameters in hypertensive older women. Twenty-five hypertensive older women who were insufficiently active (64.7 ± 4.7 years) participated in this study. Subjects were randomly allocated to a 10-week RT program (2 d·wk in the first 5 weeks; 3 d·wk in the last 5 weeks) or a nonexercise control group. Linear reverse periodization was used for the RT program. Cardiac autonomic modulation, mean blood pressure (MBP), peripheral vascular resistance (PVR), and resting heart rate (RHR) were measured before and after 10 weeks. The RT group reduced cardiac sympathetic modulation (0V%; B = -6.6; 95% confidence interval [CI]: -12.9 to -0.2; p = 0.045; Cohen's d = 0.88) and showed a trend for increased parasympathetic modulation (2V%; B = 12.5; 95% CI: 0-25; p = 0.050; Cohen's d = 0.87) compared with the control group. The RT group reduced MBP (B = -8.5 mm Hg; 95% CI: -13.6 to -3.4; p = 0.001; Cohen's d = 1.27), PVR (B = -14.1 units; 95% CI: -19.9 to -8.4; p < 0.001; Cohen's d = 1.86), and RHR (B = -8.8 b·min; 95% CI: -14.3 to -3.3; p = 0.002; Cohen's d = 1.20) compared with the control group. In the RT group, the changes in 2V% patterns and low-frequency components showed a correlation with changes in MBP (r = -0.60; p = 0.032) and RHR (r = 0.75; p = 0.0003). In conclusion, 10 weeks of RT improved cardiac autonomic modulation and reduced MBP and PVR in hypertensive older women. These results reinforce the importance of RT for this population.
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Affiliation(s)
- Filipe F Oliveira-Dantas
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil.,Research Laboratory for Physical Training Applied to Health, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | - Maria do Socorro Brasileiro-Santos
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil.,Research Laboratory for Physical Training Applied to Health, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | - Scott G Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada; and
| | - Alexandre S Silva
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil
| | - Douglas C Silva
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil
| | - Rodrigo A V Browne
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Luiz F Farias-Junior
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Eduardo C Costa
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Amilton da Cruz Santos
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil.,Research Laboratory for Physical Training Applied to Health, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
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Blanken AE, Nation DA. Does Gender Influence the Relationship Between High Blood Pressure and Dementia? Highlighting Areas for Further Investigation. J Alzheimers Dis 2020; 78:23-48. [PMID: 32955459 PMCID: PMC8011824 DOI: 10.3233/jad-200245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Gender differences have been noted in studies linking blood pressure to all-cause dementia, and the two most common forms of dementia: Alzheimer's disease (AD) and vascular dementia (VaD). However, how gender modifies the relationship between blood pressure and dementia remains unclear. OBJECTIVE To review evidence for a gender modifying effect on the link between blood pressure and all-cause dementia. METHODS A systematic review was conducted according to PRISMA guidelines. Sixteen out of 256 reviewed articles met inclusion criteria. RESULTS For women, higher midlife systolic blood pressure (SBP) and hypertension were both associated with greater risk of all-cause dementia, AD, and VaD, in six out of seven studies. Two of these studies reported higher midlife SBP/hypertension were associated with greater risk for all-cause dementia in women, but not men. One study reported higher midlife SBP associated with greater AD risk in women, but not men. However, another study reported that midlife hypertension associated with AD risk in men, but not women. No clear gender differences were reported in the relationship between late-life high blood pressure/hypertension with all-cause dementia or AD. CONCLUSION Studies rarely, and inconsistently, analyzed or reported gender effects. Therefore, interpretation of available evidence regarding the role of gender in blood pressure associated dementia was difficult. Several studies indicated higher midlife SBP was associated with greater risk of all-cause dementia for women, compared to men. Future studies should evaluate women-specific aging processes that occur in midlife when considering the association between blood pressure and dementia risk.
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Affiliation(s)
- Anna E. Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Daniel A. Nation
- Department of Psychological Science, University of California Irvine, Irvine, CA, USA
- Institute for Memory Disorders and Neurological Impairments, University of California Irvine, Irvine, CA, USA
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Maguire DG, Ruddock MW, Milanak ME, Moore T, Cobice D, Armour C. Sleep, a Governor of Morbidity in PTSD: A Systematic Review of Biological Markers in PTSD-Related Sleep Disturbances. Nat Sci Sleep 2020; 12:545-562. [PMID: 32801980 PMCID: PMC7402856 DOI: 10.2147/nss.s260734] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/06/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sleep disturbances (SD) are the most impactful and commonly reported symptoms in post-traumatic stress disorder (PTSD). Yet, they are often resistant to primary PTSD therapies. Research has identified two distinct SDs highly prevalent in PTSD; insomnia and nightmares. Those who report SDs prior to a traumatic event are at greater risk for developing PTSD; highlighting that sleep potentially plays a role in PTSD's pathology. To further understand the pathobiological mechanisms that lead to the development of PTSD, it is first imperative to understand the interplay which exists between sleep and PTSD on a biological level. The aim of this systematic review is to determine if biological or physiological markers are related to SD in PTSD. METHODS A systematic literature search was conducted on the electronic databases; Medline, Embase, AMED and PsycINFO, using Medical Subject Headings and associated keywords. RESULTS Sixteen studies were included in the final analyses. Physiological makers of autonomic function, and biochemical markers of HPA-axis activity; inflammatory processes; and trophic factor regulation were related to the severity of SDs in PTSD. CONCLUSION These findings add to the growing literature base supporting a central focus on sleep in research aiming to define the pathophysiological processes which result in PTSD, as well as emphasising the importance of specifically targeting sleep as part of a successful PTSD intervention strategy. Resolving SDs will not only reduce PTSD symptom severity and improve quality of life but will also reduce all-cause mortality, hospital admissions and lifetime healthcare costs for those with PTSD. Limitations of the current literature are discussed, and key recommendations future research must adhere to are made within.
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Affiliation(s)
- Daniel G Maguire
- Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, Northern Ireland
| | - Mark W Ruddock
- Randox Laboratories Ltd, Clinical Studies, Crumlin, County Antrim BT29 4QY, Northern Ireland
| | - Melissa E Milanak
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Tara Moore
- Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, Northern Ireland
| | - Diego Cobice
- Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, Northern Ireland
| | - Cherie Armour
- School of Psychology, David Keir Building, Queen's University Belfast, Belfast BT9 5BN, Northern Ireland
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Feasibility and effectiveness of thoracic spine mobilization on sympathetic/parasympathetic balance in a healthy population - a randomized controlled double-blinded pilot study. Arch Physiother 2019; 9:15. [PMID: 31867125 PMCID: PMC6900844 DOI: 10.1186/s40945-019-0067-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/01/2019] [Indexed: 02/05/2023] Open
Abstract
Background Physiotherapists often use thoracic spine mobilization (TSM) to reduce pain in patients with back disorders via a reduction of sympathetic activity. There is a "trade-off" in the activity of the sympathetic and parasympathetic nervous system activity. A sympathetic/parasympathetic balance (SPB) is needed to guarantee body homeostasis. However, body homeostasis is seldom considered as an aim of the treatment from the perspective of most physiotherapists. Strong empirical evidence for the effects of TSM on the SPB is still lacking.Some studies showed that spinal manipulation may yield beneficial effects on SPB. Therefore, it could be hypothesized that TSM is feasible and could influence SPB reactions. The primary aim was to describe the participants' adherence to the intervention and to the measurement protocol, to identify unexpected adverse events (UAE) after TSM, to evaluate the best method to measure SPB parameters (heart rate variability (HRV), blood pressure (BP), heart rate (HR), skin perfusion and erythema) and to estimate the investigation procedure. The secondary aim was to assess the effects of TSM on SPB parameters in a small sample of healthy participants. Methods This crossover pilot study investigated TSM using posterior-anterior mobilization (PAM) and anterior-posterior mobilization (APM) on segments T6 to T12 in twelve healthy participants during two consecutive days. To evaluate feasibility, the following outcomes were assessed: adherence, UAE, data collection and data analysis. To evaluate the effect of TSM on SPB, HRV, BP, HR, skin perfusion and erythema were measured. Results The adherence was 100%. No UAE were reported. PAM showed larger effect sizes compared to APM in many secondary variables. Conclusions Although 100% maximal adherence was reached and no UAE were observed, data recording in future studies should be done during a second time interval while the data transfer from device to the computer software should occur immediately after completion of each participant's measurement. The results of this pilot study suggest that PAM can reduce HRV HF and HRV ratio LF/HF and increase HR. Trial registration ClinicalTrail.gov (NCT02832141).
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Smith JR, Koepp KE, Berg JD, Akinsanya JG, Olson TP. Influence of Sex, Menstrual Cycle, and Menopause Status on the Exercise Pressor Reflex. Med Sci Sports Exerc 2019; 51:874-881. [PMID: 30986812 DOI: 10.1249/mss.0000000000001877] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In this review, we highlight the underlying mechanisms responsible for the sex differences in the exercise pressor reflex (EPR), and, importantly, the impact of sex hormones and menopausal status. The EPR is attenuated in premenopausal women compared with age-matched men. Specifically, activation of the metaboreflex (a component of the EPR) results in attenuated increases in blood pressure and sympathetic vasomotor outflow compared with age-matched men. In addition, premenopausal women exhibit less transduction of sympathetic outflow to the peripheral vasculature than men. In stark contrast, postmenopausal women exhibit an augmented EPR arising from exaggerated metaboreflex-induced autonomic and cardiovascular reflexes. We propose that metaboreflex-induced autonomic and cardiovascular changes associated with menopause majorly contribute to the elevated blood pressure response during dynamic exercise in postmenopausal women. In addition, we discuss the potential mechanisms by which sex hormones in premenopausal women may impact the EPR as well as metaboreflex.
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Affiliation(s)
- Joshua R Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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Gatineau E, Gong MC, Yiannikouris F. Soluble Prorenin Receptor Increases Blood Pressure in High Fat-Fed Male Mice. Hypertension 2019; 74:1014-1020. [PMID: 31378099 PMCID: PMC6739191 DOI: 10.1161/hypertensionaha.119.12906] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/25/2019] [Indexed: 01/13/2023]
Abstract
Obesity-related hypertension is a major public health concern. We recently demonstrated that plasma levels of the soluble form of the prorenin receptor (sPRR) were elevated in obesity-associated hypertension. Therefore, in the present study, we investigated the contribution of sPRR to blood pressure (BP) elevation in the context of obesity. High fat-fed C57BL/6 male mice were infused with vehicle or sPRR (30 µg/kg per day) via subcutaneously implanted osmotic minipump for 4 weeks. BP parameters were recorded using radiotelemetry devices. Male mice infused with sPRR exhibited higher systolic BP and mean arterial pressure and lower spontaneous baroreflex sensitivity than mice infused with vehicle. To define mechanisms involved in systolic BP elevation, mice were injected with an AT1R (Ang II [angiotensin II] type 1 receptor) antagonist (losartan), a muscarinic receptor antagonist (atropine), a β-adrenergic antagonist (propranolol), and a ganglionic blocker (chlorisondamine). Losartan did not blunt sPRR-induced elevation in systolic BP. Chlorisondamine treatment exacerbated the decrease in mean arterial pressure in male mice infused with sPRR. These results demonstrated that sPRR induced autonomic nervous dysfunction. Interestingly, plasma leptin levels were increased in high fat-fed C57BL/6 male mice infused with sPRR. Overall, our results indicated that sPRR increased systolic BP through an impairment of the baroreflex sensitivity and an increase in the sympathetic tone potentially mediated by leptin in high fat-fed C57BL/6 male mice.
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Affiliation(s)
- Eva Gatineau
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY
| | - Ming C. Gong
- Department of Physiology, University of Kentucky, Lexington, KY
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Gunning MN, Meun C, van Rijn BB, Maas AHEM, Benschop L, Franx A, Boersma E, Budde RPJ, Appelman Y, Lambalk CB, Eijkemans MJC, Velthuis BK, Laven JSE, Fauser BCJM. Coronary artery calcification in middle-aged women with premature ovarian insufficiency. Clin Endocrinol (Oxf) 2019; 91:314-322. [PMID: 31049984 DOI: 10.1111/cen.14003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/25/2019] [Accepted: 05/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Women with premature ovarian insufficiency (POI) enter menopause before age 40. Early menopause was associated with increased risk for coronary artery disease (CAD), death from cardiovascular disease and all-cause mortality. We compared the prevalence of CAD between middle-aged women on average 10 years following the initial POI diagnosis, with a population-based cohort. DESIGN Cross-sectional case-control study. PARTICIPANTS Women from two Dutch University Medical Centers above 45 years of age previously diagnosed with POI (n = 98) were selected and compared with age- and race-matched controls from the Multi-Ethnic Study of Atherosclerosis (MESA). MEASUREMENTS The primary outcome was detectable coronary artery calcium (CAC) determined by coronary computed tomography (CCT). RESULTS Women with POI had significantly higher blood pressure, cholesterol and glucose, despite lower BMI compared to controls. Similar proportions of detectable CAC (CAC score >0 Agatston Units) were observed in women with POI and controls (POI n = 16 (16%), controls n = 52 (18%), P = 0.40 and Padj = 0.93). In women with POI separately, we were not able to identify associations between CVD risk factors and CAC. The following CVD risk factors in controls were positively associated with CAC: age, diabetes mellitus, hypertension and LDL cholesterol. HRT use was negatively associated with CAC in controls. CONCLUSIONS The presence of CAC did not differ significantly in women with POI around 50 years of age, compared to an age- and race-matched control group. We observe no increased calcified coronary disease in POI patients, despite the presence of unfavourable cardiovascular risk factors in these women.
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Affiliation(s)
- Marlise N Gunning
- Department of Reproductive Medicine & Gynecology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Cindy Meun
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bas B van Rijn
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
- Wilhelmina Children's Hospital Birth Centre, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Angela H E M Maas
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Laura Benschop
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Arie Franx
- Wilhelmina Children's Hospital Birth Centre, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ricardo P J Budde
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Cornelis B Lambalk
- Department of Obstetrics and Gynecology, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Marinus J C Eijkemans
- Department of Reproductive Medicine & Gynecology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
- Julius Centre for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bart C J M Fauser
- Department of Reproductive Medicine & Gynecology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
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Song JJ, Ma Z, Wang J, Chen LX, Zhong JC. Gender Differences in Hypertension. J Cardiovasc Transl Res 2019; 13:47-54. [PMID: 31044374 DOI: 10.1007/s12265-019-09888-z] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 04/09/2019] [Indexed: 12/26/2022]
Abstract
Hypertension is the leading risk factor for global mortality and morbidity and remains the major preventable cause of cardiovascular diseases. Gender differences in risk factors and awareness, treatment, and control of hypertension have been well established in humans. There are significant differences in epidemiology and clinical characteristic of hypertension between men and women. Moreover, gender differences are linked with several specific types of hypertension, including postmenopausal hypertension, white coat hypertension, masked hypertension, and hypertensive disorders of pregnancy. Gender differences have been implicated in the prevalence and determinants of hypertension and prehypertension whereas the control rate is similar between men and women taking antihypertensive medication. Importantly, distinct roles of the angiotensin-converting enzyme 2/Apelin signaling, sex hormone, endothelin-1, and sympathetic nervous activity contribute to sex differences in blood pressure control. This review summarizes gender differences in clinical features and determinants of hypertension and the underlying mechanisms responsible for hypertension.
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Affiliation(s)
- Juan-Juan Song
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Zheng Ma
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Juan Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Lin-Xi Chen
- Institute of Pharmacy and Pharmacology, University of South China, Hengyang, 421001, China
| | - Jiu-Chang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
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Stanhewicz AE, Wenner MM, Stachenfeld NS. Sex differences in endothelial function important to vascular health and overall cardiovascular disease risk across the lifespan. Am J Physiol Heart Circ Physiol 2018; 315:H1569-H1588. [PMID: 30216121 PMCID: PMC6734083 DOI: 10.1152/ajpheart.00396.2018] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 02/07/2023]
Abstract
Diseases of the cardiovascular system are the leading cause of morbidity and mortality in men and women in developed countries, and cardiovascular disease (CVD) is becoming more prevalent in developing countries. The prevalence of atherosclerotic CVD in men is greater than in women until menopause, when the prevalence of CVD increases in women until it exceeds that of men. Endothelial function is a barometer of vascular health and a predictor of atherosclerosis that may provide insights into sex differences in CVD as well as how and why the CVD risk drastically changes with menopause. Studies of sex differences in endothelial function are conflicting, with some studies showing earlier decrements in endothelial function in men compared with women, whereas others show similar age-related declines between the sexes. Because the increase in CVD risk coincides with menopause, it is generally thought that female hormones, estrogens in particular, are cardioprotective. Moreover, it is often proposed that androgens are detrimental. In truth, the relationships are more complex. This review first addresses female and male sex hormones and their receptors and how these interact with the cardiovascular system, particularly the endothelium, in healthy young women and men. Second, we address sex differences in sex steroid receptor-independent mechanisms controlling endothelial function, focusing on vascular endothelin and the renin-angiotensin systems, in healthy young women and men. Finally, we discuss sex differences in age-associated endothelial dysfunction, focusing on the role of attenuated circulating sex hormones in these effects.
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Affiliation(s)
- Anna E Stanhewicz
- Department of Kinesiology, Pennsylvania State University , University Park, Pennsylvania
| | - Megan M Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Nina S Stachenfeld
- The John B. Pierce Laboratory, New Haven, Connecticut
- Department of Obstetrics, Gynecology and Reproductive Sciences and Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut
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Dietz LJ, Pham SV, Melhem N, Porta G, Brent DA. Blood pressure recovery to social stress in parentally bereaved and non-bereaved youths. J Psychosom Res 2018; 113:58-65. [PMID: 30190049 PMCID: PMC6157912 DOI: 10.1016/j.jpsychores.2018.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 07/13/2018] [Accepted: 07/26/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine differences in blood pressure response and recovery in a sample of bereaved and non-bereaved youths during an acute stress task conducted 5 years after time of parental death. METHODS One-hundred and ninety-two (n = 192) bereaved and non-bereaved offspring (ages 11-29) participated in an adaptation of the Trier Social Stress Task (TSST) 5-years after the time of parental death. Blood pressure measurements were collected before, during, and after the laboratory stress protocol. Mixed models for repeated measures were used to analyze the effects of bereavement status and course of psychiatric disorder in the 5-year period after parental death in both offspring and caregivers on blood pressure response; linear regression was used to examine these associations with blood pressure recovery. RESULTS Although there were no differences across groups in diastolic (DBP) or systolic blood pressure (SBP) response to stress, bereaved offspring demonstrated less SBP recovery to the TSST as compared to non-bereaved offspring. A significant interaction between bereavement status and race, and a marginally significant interaction between bereavement status and sex indicated poor SBP recovery for parentally bereaved racial/ethnic minority offspring as compared to parentally bereaved Caucasian offspring, and for parentally bereaved males compared to parentally bereaved females. CONCLUSIONS Parentally bereaved youths demonstrate blood pressure response to social stress tasks similar to that of non-bereaved youths, but parentally bereaved ethnic/racial minority youths and parentally bereaved males evidence a less complete recovery from the effects of stress. The health consequences of poor blood pressure recovery in bereaved youths are discussed.
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Affiliation(s)
- Laura J Dietz
- University of Pittsburgh at Johnstown, Johnstown, PA, United States.
| | | | - Nadine Melhem
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Giovanna Porta
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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Age- and sex-dependent changes in sympathetic activity of the left ventricular apex assessed by 18F-DOPA PET imaging. PLoS One 2018; 13:e0202302. [PMID: 30106984 PMCID: PMC6091960 DOI: 10.1371/journal.pone.0202302] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/31/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sexual dimorphism in cardiac sympathetic outflow has recently gained attention in the context of Takotsubo cardiomyopathy. Previous studies suggest that there are sex- and age-dependent differences in peripheral autonomic control, however, data on cardiac-specific sympathetic activation in aged women and men are lacking. METHODS AND RESULTS Regional quantitative analysis of cardiac fluorine-18 (18F)- Dihydroxyphenylalanine (DOPA) uptake was retrospectively performed in 133 patients (69 females, mean age 52.4±17.7 years) referred for assessment of neuroendocrine tumours (NET) by Positron-Emission-Tomography. Cardiac 18F-DOPA uptake was significantly higher in women as compared to men (1.33±0.21 vs. 1.18±0.24, p<0.001). This sex-difference was most pronounced in the apical region of the left ventricle (LV, 1.30±0.24 in women vs. 1.13±0.25 in men, p<0.001) and in individuals >55 years of age (1.39±0.25 in women vs. 1.09±0.24 in men, p<0.001). Women showed a prominent increase in myocardial 18F-DOPA uptake with age with the strongest increase seen in the LV apical region (r = 0.34, p = 0.004). Accordingly, sex and age were selected as significant predictors of LV apical 18F-DOPA uptake in a stepwise linear regression model. No age-dependent changes of cardiac 18F-DOPA uptake were observed in men or in the right ventricular region. CONCLUSION Our study suggests that aging is related to sex-specific changes in regional cardiac sympathetic activity. Future studies will have to assess whether the increase in LV apical 18F-DOPA uptake with age in women is of pathogenic relevance for the higher susceptibility of postmenopausal women to conditions associated with increased sympathetic activity.
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The regulation of aldosterone secretion by leptin: implications in obesity-related cardiovascular disease. Curr Opin Nephrol Hypertens 2018; 27:63-69. [PMID: 29135585 DOI: 10.1097/mnh.0000000000000384] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Although it has been known for some time that increases in body mass enhance aldosterone secretion, particularly in women, the origin of this elevation in aldosterone production is not well defined. Adipocyte-derived factors have emerged as potential candidates to increase aldosterone production in obesity. RECENT FINDINGS Emerging evidence suggests the presence of a mechanistic link in which the adipocyte-derived hormone leptin stimulates aldosterone production in obesity, thereby creating a positive feedback loop for obesity-associated cardiovascular disease. In addition, recent reports give credence to the concept that this leptin-aldosterone stimulation pathway in obesity is an underlying mechanism for sex-discrepancies in obesity-associated cardiovascular disease. SUMMARY Leptin appears as a new direct regulator of adrenal aldosterone production and leptin-mediated aldosterone production is a novel candidate mechanism underlying obesity-associated hypertension, particularly in females.
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Characterizing and Comparing Acute Responses of Blood Pressure, Heart Rate, and Forearm Blood Flow to 2 Handgrip Protocols. J Cardiopulm Rehabil Prev 2018; 38:400-405. [PMID: 29952807 DOI: 10.1097/hcr.0000000000000344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Growing evidence supports handgrip exercise training for reducing resting blood pressure (BP), with inconsistent exercise protocols reported throughout the literature. To verify safety of such protocols, real-time cardiovascular responses must be assessed. Consequently, this research sought to evaluate the acute impact of dissimilar handgrip protocols on the cardiovascular responses of BP, heart rate (HR), and forearm blood flow. METHODS Using a randomized intraindividual crossover design, 20 post-menopausal women completed 2 distinct handgrip protocols compared with a nonexercise control: 4 × 2-min sustained grips at 30% moderate intensity with 1-min rest between sets (ZONA), and 32 × 5-sec intermittent grips at maximal intensity with 5-sec rest between sets (MINT). Cardiovascular responses were measured throughout exercise and post-exercise recovery. RESULTS Compared to ZONA, the MINT protocol required less time and less exercise effort, yet caused greater average BP perturbations (systolic, MINT: 16.9 ± 12.9 mm Hg, ZONA: 7.9 ± 11.6 mm Hg; diastolic, MINT: 8.7 ± 7.2 mm Hg, ZONA: 4.5 ± 4.9 mm Hg) (P < .05), with peak BP changes far below published safety guidelines. Average HR responses were similarly elevated between protocols (MINT: 5.4 ± 4.9 beats/min, ZONA: 3.4 ± 3.6 beats/min). Post-exercise recovery of BP and HR occurred swiftly following MINT while remaining elevated following ZONA. CONCLUSIONS Handgrip exercise protocols with distinct design features (ie, grip intensity, grip strategy, and exercise duration) cause dissimilar acute cardiovascular responses. Careful and controlled attention should be directed toward determining how such acute dissimilarities influence corresponding training outcomes. Given the confirmed safety of acute BP perturbations, future researchers can have confidence in prescribing even the high-intensity MINT protocol for at-home, unsupervised activity.
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Coates AM, INCOGNITO ANTHONYV, SEED JEREMYD, DOHERTY CONNORJ, MILLAR PHILIPJ, BURR JAMIEF. Three Weeks of Overload Training Increases Resting Muscle Sympathetic Activity. Med Sci Sports Exerc 2018; 50:928-937. [DOI: 10.1249/mss.0000000000001514] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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44
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Altered nocturnal blood pressure profiles in women with insomnia disorder in the menopausal transition. Menopause 2018; 24:278-287. [PMID: 27749736 DOI: 10.1097/gme.0000000000000754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Insomnia disorder is a risk factor for cardiovascular (CV) pathology. It is unknown whether insomnia that develops in the context of the menopausal transition (MT) impacts the CV system. We assessed nocturnal blood pressure (BP) and heart rate (HR) profiles in women with insomnia disorder in the MT. METHODS Twelve women meeting DSM-IV criteria for insomnia in the MT (age, mean ± SD: 50.5 ± 3.6 y) and 11 controls (age, mean ± SD: 49.0 ± 3.0 y) had polysomnographic recordings on one or two nights during which beat-to-beat BP and HR were assessed and analyzed hourly from lights-out across the first 6 hours of the night and according to sleep stage. Physiological hot flashes were identified from fluctuations in sternal skin conductance. RESULTS Women with insomnia and controls had similar distributions of sleep stages and awakenings/arousals across hours of the night, although insomnia participants tended to have more wakefulness overall. More women in the insomnia group (7 of 12) than in the control group (2 of 11) had at least one physiological hot flash at night (P < 0.05). Both groups showed a drop in BP in the first part of the night; however, systolic and diastolic BP patterns diverged later, remaining low in controls but increasing in insomnia participants 4 to 6 hours after lights-out (P < 0.05). Both groups showed a similar pattern of decline in HR across the night. CONCLUSIONS Our findings suggest altered regulatory control of BP during sleep in the MT insomnia. The causes and long-term consequences of this altered nocturnal BP profile remain to be determined.
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45
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Hart EC. Human hypertension, sympathetic activity and the selfish brain. Exp Physiol 2018; 101:1451-1462. [PMID: 27519960 DOI: 10.1113/ep085775] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/10/2016] [Indexed: 12/19/2022]
Abstract
NEW FINDINGS What is the topic of this review? This review article revisits an historical hypothesis that cerebral hypoperfusion, caused by elevated cerebral vascular resistances, causes the onset of high sympathetic nerve activity and hypertension in humans. What advances does it highlight? The review article highlights new evidence indicating that congenital cerebrovascular abnormalities, namely vertebral artery hypoplasia and an incomplete posterior circle of Willis, may play a role in the onset of hypertension. Despite the harmful consequences of high blood pressure (hypertension; e.g. stroke, renal failure, dementia and even death), the underlying physiological mechanisms that cause the onset of hypertension are poorly understood. The most established finding is that hypertension occurs alongside activation of the sympathetic nervous system, yet exactly what triggers this in humans is ambiguous. This review discusses evidence for elevated sympathetic nerve activity, particularly in human hypertension, and revisits an historical theory regarding the aetiology underlying human hypertension that was proposed by Seymour Kety and John Dickinson in the 1940s-1950s. My research group hypothesizes that elevated sympathetic nerve activity and hypertension develop as a fundamental mechanism to maintain adequate cerebral blood flow, which is now termed Cushing's mechanism or the selfish brain hypothesis. Moreover, it goes against the traditional belief that high cerebrovascular resistance is a consequence of hypertension; we propose that this elevated resistance drives hypertension. This review discusses historical and new evidence in animals and humans supporting this hypothesis. In particular, unique human data indicating a higher prevalence of congenital cerebral vascular abnormalities in hypertension are considered.
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Affiliation(s)
- Emma C Hart
- School of Physiology, Pharmacology and Neuroscience, Clinical Research and Imaging Centre, University of Bristol, Bristol, UK
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46
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Faulkner JL, Belin de Chantemèle EJ. Sex Differences in Mechanisms of Hypertension Associated With Obesity. Hypertension 2017; 71:15-21. [PMID: 29133358 DOI: 10.1161/hypertensionaha.117.09980] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jessica L Faulkner
- From the Vascular Biology Center, Medical College of Georgia at Augusta University, GA
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Lin J, Wang H, Yan F, Tang K, Zhu H, Weng Z, Wang K. Effects of occupational exposure to noise and dust on blood pressure in Chinese industrial workers. Clin Exp Hypertens 2017; 40:257-261. [PMID: 29087739 DOI: 10.1080/10641963.2017.1368534] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Along with the rapid development of economy and urbanization, noise and air pollution are becoming major occupational health hazards in the process of industrial production. In this study, we collected data from 7293 industrial workers in China. The association between occupational exposure of noise and dust and blood pressure was investigated. Controlling for demographic variables, including sex, age, and length of service, a stepwise regression model with backward elimination was constructed. The results showed that both noise and dust decreased the level of systolic blood pressure (p < 0.001). This finding prompted the manufacturing industry to reduce noise and dust hazards and protect the occupational health of workers. Prospective studies in different populations are still required to verify the net contribution of noise and dust to the decrease in blood pressure.
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Affiliation(s)
- Jingfeng Lin
- a Department of Food Science and Engineering, Institute of Occupational Health and Poison Control , Fuzhou , China
| | - Hufei Wang
- b Department of Food Science and Engineering, College of Biological Science and Engineering , Fuzhou University , Fuzhou , China
| | - Fen Yan
- b Department of Food Science and Engineering, College of Biological Science and Engineering , Fuzhou University , Fuzhou , China
| | - Kefu Tang
- c Prenatal Diagnosis Center , Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Huang Zhu
- e Department of Medicine, Division of Regenerative Medicine , University of California-San Diego , San Diego , California
| | - Zuquan Weng
- b Department of Food Science and Engineering, College of Biological Science and Engineering , Fuzhou University , Fuzhou , China
| | - Kejian Wang
- d Lin He's Academician Workstation of New Medicine and Clinical Translation at The Third Affiliated Hospital , Guangzhou Medical University , Guangzhou , China
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Trinity JD, Layec G, Hart CR, Richardson RS. Sex-specific impact of aging on the blood pressure response to exercise. Am J Physiol Heart Circ Physiol 2017; 314:H95-H104. [PMID: 29030342 DOI: 10.1152/ajpheart.00505.2017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An exaggerated blood pressure (BP) response to exercise has been linked to cardiovascular disease, but little is known about the impact of age and sex on this response. Therefore, this study examined the hemodynamic and skeletal muscle metabolic response to dynamic plantar flexion exercise, at 40% of maximum plantar flexion work rate, in 40 physical activity-matched young (23 ± 1 yr, n = 20) and old (73 ± 2 yr, n = 20), equally distributed, male and female subjects. Central hemodynamics and BP (finometer), popliteal artery blood flow (Doppler ultrasound), and skeletal muscle metabolism (31P-magnetic resonance spectroscopy) were measured during 5 min of plantar flexion exercise. Popliteal artery blood flow and high-energy phosphate responses to exercise were not affected by age or sex, whereas aging, independent of sex, attenuated stroke volume and cardiac output responses. Systolic BP and mean arterial pressure responses were exaggerated in old women (Δ42 ± 4 and Δ28 ± 3 mmHg, respectively), with all other groups exhibiting similar increases in systolic BP (old men: Δ27 ± 8 mmHg, young men: Δ27 ± 3 mmHg, and young women: Δ22 ± 3 mmHg) and mean arterial pressure (old men: Δ15 ± 4 mmHg, young men: Δ19 ± 2 mmHg, and young women: Δ17 ± 2 mmHg). Interestingly, the exercise-induced change in systemic vascular resistance in old women (∆0.8 ± 1.0 mmHg·l-1·min-1) was augmented compared with young women and young and old men (∆-2.8 ± 0.5, ∆-1.6 ± 0.6, and ∆-3.18 ± 1.4 mmHg·l-1·min-1, respectively, P < 0.05). Thus, in combination, advancing age and female sex results in an exaggerated BP response to exercise, likely the result of a failure to reduce systemic vascular resistance. NEW & NOTEWORTHY An exaggerated blood pressure response to exercise has been linked to cardiovascular disease; however, little is known about how age and sex impact this response in healthy individuals. During dynamic exercise, older women exhibited an exaggerated blood pressure response driven by an inability to lower systemic vascular resistance.
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Affiliation(s)
- Joel D Trinity
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Gwenael Layec
- Department of Internal Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Corey R Hart
- Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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Kitada K, Nishiyama A. Sodium intake affects sex difference in aldosterone concentration. Am J Physiol Renal Physiol 2017; 313:F957-F958. [DOI: 10.1152/ajprenal.00353.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kento Kitada
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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50
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Barnes JN. Sex-specific factors regulating pressure and flow. Exp Physiol 2017; 102:1385-1392. [PMID: 28799254 DOI: 10.1113/ep086531] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/10/2017] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the topic of this review? There are sex- and sex-hormone-specific differences in autonomic control of blood pressure, central haemodynamics and cerebral blood flow. What advances does it highlight? Sex differences in autonomic control of blood pressure may underlie other sex-specific characteristics associated with cerebral blood flow, which can, in turn, affect tissue function. Over the last decade, there have been many published reports on sex differences in blood pressure regulation between young men and young women. The autonomic nervous system is a primary contributor to both acute and long-term blood pressure regulation. Sex differences in blood pressure regulation are likely to have effects that extend beyond mean arterial pressure and that can affect blood flow and tissue function. This short review includes recent literature from our laboratory focusing on autonomic control of the circulation, specifically age- and sex-hormone-related differences in central haemodynamics and cerebral blood flow, and discusses potential clinical implications.
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Affiliation(s)
- Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, 53706, USA
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