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Darling AM, Young BE, Skow RJ, Dominguez CM, Saunders EFH, Fadel PJ, Greaney JL. Sympathetic and blood pressure reactivity in young adults with major depressive disorder. J Affect Disord 2024; 361:322-332. [PMID: 38897296 DOI: 10.1016/j.jad.2024.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/12/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Sympathetic and blood pressure (BP) hyper-reactivity to stress may contribute to increased cardiovascular disease (CVD) risk in adults with major depressive disorder (MDD); however, whether this is evident in young adults with MDD without comorbid disease remains unclear. We hypothesized that acute stress-induced increases in muscle sympathetic nerve activity (MSNA) and BP would be exaggerated in young adults with MDD compared to healthy non-depressed young adults (HA) and that, in adults with MDD, greater symptom severity would be positively related to MSNA and BP reactivity. METHODS In 28 HA (17 female) and 39 young adults with MDD of mild-to-moderate severity (unmedicated; 31 female), MSNA (microneurography) and beat-to-beat BP (finger photoplethysmography) were measured at rest and during the cold pressor test (CPT) and Stroop color word test (SCWT). RESULTS There were no group differences in resting MSNA (p = 0.24). Neither MSNA nor BP reactivity to either the CPT [MSNA: ∆24 ± 10 HA vs. ∆21 ± 11 bursts/min MDD, p = 0.67; mean arterial pressure (MAP): ∆22 ± 7 HA vs. ∆21 ± 10 mmHg MDD, p = 0.46)] or the SCWT (MSNA: ∆-4 ± 6 HA vs. ∆-5 ± 8 bursts/min MDD, p = 0.99; MAP: ∆7 ± 8 HA vs ∆9 ± 5 mmHg MDD; p = 0.82) were different between groups. In adults with MDD, symptom severity predicted MAP reactivity to the CPT (β = 0.78, SE = 0.26, p = 0.006), but not MSNA (p = 0.42). LIMITATIONS The mild-to-moderate symptom severity reflects only part of the MDD spectrum. CONCLUSIONS Neither sympathetic nor BP stress reactivity are exaggerated in young adults with MDD; however, greater symptom severity may amplify BP reactivity to stress, thereby increasing CVD risk.
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Affiliation(s)
- Ashley M Darling
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America
| | - Benjamin E Young
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America; Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Rachel J Skow
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America
| | - Cynthia M Dominguez
- Department of Bioengineering, The University of Texas at Arlington, United States of America
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, United States of America
| | - Paul J Fadel
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America
| | - Jody L Greaney
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America; Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, United States of America.
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Berbrier DE, Adler TE, Leone CA, Paidas MJ, Stachenfeld NS, Usselman CW. Blood pressure responses to handgrip exercise but not apnea or mental stress are enhanced in women with a recent history of preeclampsia. Am J Physiol Heart Circ Physiol 2024; 327:H140-H154. [PMID: 38700469 DOI: 10.1152/ajpheart.00020.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/05/2024]
Abstract
Preeclampsia is a risk factor for future cardiovascular diseases. However, the mechanisms underlying this association remain unclear, limiting effective prevention strategies. Blood pressure responses to acute stimuli may reveal cardiovascular dysfunction not apparent at rest, identifying individuals at elevated cardiovascular risk. Therefore, we compared blood pressure responsiveness with acute stimuli between previously preeclamptic (PPE) women (34 ± 5 yr old, 13 ± 6 mo postpartum) and women following healthy pregnancies (Ctrl; 29 ± 3 yr old, 15 ± 4 mo postpartum). Blood pressure (finger photoplethysmography calibrated to manual sphygmomanometry-derived values; PPE: n = 12, Ctrl: n = 12) was assessed during end-expiratory apnea, mental stress, and isometric handgrip exercise protocols. Integrated muscle sympathetic nerve activity (MSNA) was assessed in a subset of participants (peroneal nerve microneurography; PPE: n = 6, Ctrl: n = 8). Across all protocols, systolic blood pressure (SBP) was higher in PPE than Ctrl (main effects of group all P < 0.05). Peak changes in SBP were stressor specific: peak increases in SBP were not different between PPE and Ctrl during apnea (8 ± 6 vs. 6 ± 5 mmHg, P = 0.32) or mental stress (9 ± 5 vs. 4 ± 7 mmHg, P = 0.06). However, peak exercise-induced increases in SBP were greater in PPE than Ctrl (11 ± 5 vs. 7 ± 7 mmHg, P = 0.04). MSNA was higher in PPE than Ctrl across all protocols (main effects of group all P < 0.05), and increases in peak MSNA were greater in PPE than Ctrl during apnea (44 ± 6 vs. 27 ± 14 burst/100 hb, P = 0.04) and exercise (25 ± 8 vs. 13 ± 11 burst/100 hb, P = 0.01) but not different between groups during mental stress (2 ± 3 vs. 0 ± 5 burst/100 hb, P = 0.41). Exaggerated pressor and sympathetic responses to certain stimuli may contribute to the elevated long-term risk for cardiovascular disease in PPE.NEW & NOTEWORTHY Women with recent histories of preeclampsia demonstrated higher systolic blood pressures across sympathoexcitatory stressors relative to controls. Peak systolic blood pressure reactivity was exacerbated in previously preeclamptic women during small muscle-mass exercises, although not during apneic or mental stress stimuli. These findings underscore the importance of assessing blood pressure control during a variety of experimental conditions in previously preeclamptic women to elucidate mechanisms that may contribute to their elevated cardiovascular disease risk.
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Affiliation(s)
- Danielle E Berbrier
- 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
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut, United States
| | - Cheryl A Leone
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut, United States
| | - Michael J Paidas
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Nina S Stachenfeld
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut, United States
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Hissen SL, Takeda R, Badrov MB, Arias-Franklin S, Patel S, Nelson DB, Babb TG, Fu Q. Impact of maternal obesity on resting muscle sympathetic nerve activity during uncomplicated pregnancy: a longitudinal assessment. Am J Physiol Regul Integr Comp Physiol 2024; 326:R10-R18. [PMID: 37955129 PMCID: PMC11283889 DOI: 10.1152/ajpregu.00098.2023] [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: 04/26/2023] [Revised: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023]
Abstract
Maternal obesity increases the risk of adverse pregnancy outcomes. The mechanisms that contribute to this elevated risk are unclear but may be related to greater activity of the sympathetic nervous system, which is associated with hypertensive disorders of pregnancy. We hypothesized that resting muscle sympathetic nerve activity (MSNA) would be greater in women with obesity during pregnancy when compared with normal-weight women. Blood pressure, heart rate, and MSNA were recorded during 5 min of supine rest in 14 normal-weight women [body mass index (BMI) 22.1 ± 2.1 (SD) kg/m2] and 14 women with obesity (BMI 33.9 ± 3.5 kg/m2) during (early and late) pregnancy and postpartum. All women had uncomplicated pregnancies. Resting MSNA burst frequency was not different between groups during early (normal weight 17 ± 10 vs. obesity 22 ± 15 bursts/min, P = 0.35) but was significantly greater in the obesity group during late pregnancy (23 ± 13 vs. 35 ± 15 bursts/min, P = 0.031) and not different postpartum (10 ± 6 vs. 9 ± 7 bursts/min, P = 0.74). These findings were also apparent when comparing burst incidence and total activity. Although still within the normotensive range, systolic blood pressure was greater in the obesity group across all time points (P = 0.002). Diastolic blood pressure was lower during pregnancy compared with postpartum (P < 0.001) and not different between groups (P = 0.488). Heart rate increased throughout pregnancy in both groups (P < 0.001). Our findings suggest that maternal obesity is associated with greater increases in sympathetic activity even during uncomplicated pregnancy. Future research is needed to determine if this is linked with an increased risk of adverse outcomes or is required to maintain homeostasis in pregnancy.NEW & NOTEWORTHY The impact of maternal obesity on resting muscle sympathetic nerve activity was examined during (early and late) and after uncomplicated pregnancy. Resting muscle sympathetic nerve activity is not different during early pregnancy or postpartum but is significantly elevated in women with obesity during late pregnancy when compared with normal-weight women. Future research is needed to determine if this is linked with an increased risk of adverse outcomes or is required to maintain homeostasis in pregnancy.
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Affiliation(s)
- Sarah L Hissen
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Ryosuke Takeda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Mark B Badrov
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- University Health Network, Toronto, Ontario, Canada
| | - Sonia Arias-Franklin
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Shivani Patel
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - David B Nelson
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- The University of Texas Southwestern Medical Center, Dallas, Texas, United States
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Shiozawa K, Saito M, Lee JB, Kashima H, Endo MY, Ishida K, Millar PJ, Katayama K. Effects of sex and menstrual cycle phase on celiac artery blood flow during dynamic moderate-intensity leg exercise in young individuals. J Appl Physiol (1985) 2023; 135:956-967. [PMID: 37675470 DOI: 10.1152/japplphysiol.00472.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 09/08/2023] Open
Abstract
The purpose of this study was to clarify the effect of sex and menstrual cycle phase on celiac artery blood flow during dynamic exercise in healthy young humans. Eleven healthy young females (21 ± 2 yr, means ± SD) and 10 males (23 ± 3 yr) performed dynamic knee-extension and -flexion exercises at 30% of heart rate reserve for 4 min. The percent changes from baseline (Δ) for mean arterial blood pressure (MAP), mean blood flow (celMBF) in the celiac artery, and celiac vascular conductance (celVC) during exercise were calculated. Arterial blood pressure was measured using an automated sphygmomanometer, and celiac artery blood flow was recorded by Doppler ultrasonography. Female subjects performed the exercise test in the early follicular phase (EF) and in the midluteal phase (ML) of their menstrual cycle. The increase in MAP during exercise was not significantly (P > 0.05) different between sexes or between menstrual cycle phases (ΔMAP, EF in females: +16.6 ± 6.4%, ML in females: +20.2 ± 11.7%, and males: +19.9 ± 12.2%). The celMBF decreased during exercise in each group, but the response was not significantly (P > 0.05) different between sexes or between menstrual cycle phases (ΔcelMBF, EF in females: -24.6 ± 15.5%, ML in females: -25.2 ± 18.7%, and males: -29.2 ± 4.0%). The celVC decreased during dynamic exercise in each group, with no significant (P > 0.05) difference in the responses between sexes or between menstrual cycle phases (ΔcelVC, EF in females: -38.3 ± 15.0%, ML in females: -41.5 ± 19.1%, and males: -43.4 ± 7.2%). These results suggest that sex and menstrual cycle phase have minimal influence on hemodynamic responses in the splanchnic artery during dynamic moderate-intensity exercise in young healthy individuals.NEW & NOTEWORTHY During dynamic exercise, splanchnic organ blood flow is reduced from resting values. Whether sex and menstrual cycle phase influence splanchnic blood flow responses during exercise remains unknown. We show that the decrease in celiac artery blood flow during dynamic leg exercise does not differ between young females and males or between menstrual cycle phases. In young individuals, sex and menstrual cycle have minimal influence on splanchnic artery hemodynamic responses during dynamic moderate-intensity leg exercise.
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Affiliation(s)
- Kana Shiozawa
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Mitsuru Saito
- Applied Physiology Laboratory, Toyota Technological Institute, Nagoya, Japan
| | - Jordan B Lee
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Hideaki Kashima
- Department of Health Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Masako Yamaoka Endo
- Department of Health Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Koji Ishida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Keisho Katayama
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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D'Souza AW, Takeda R, Manabe K, Hissen SL, Washio T, Coombs GB, Sanchez B, Fu Q, Shoemaker JK. The interactive effects of age and sex on the neuro-cardiovascular responses during fatiguing rhythmic handgrip exercise. J Physiol 2023; 601:2877-2898. [PMID: 37083007 DOI: 10.1113/jp284517] [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: 02/08/2023] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
The impact of age on exercise pressor responses is equivocal, likely because of sex-specific neuro-cardiovascular changes with age. However, assessments of the interactive effects of age and sex on muscle sympathetic nerve activity (MSNA) responses to exercise are lacking. We tested the hypothesis that older females would exhibit exaggerated increases in blood pressure (BP) and MSNA discharge patterns during handgrip exercise compared with similarly aged males and young adults. Twenty-five young (25 (2) years; mean (SD)) males (YM; n = 12) and females (YF; n = 13) and 23 older (71 (5) years) males (OM; n = 11) and females (OF; n = 12) underwent assessments of BP, total peripheral resistance (TPR; Modelflow) and MSNA action potential (AP) discharge patterns (microneurography) during incremental rhythmic handgrip exercise and post-exercise circulatory occlusion (PECO). OM demonstrated larger ∆BP and ∆TPR from baseline than YM (both P < 0.001) despite smaller increases in ∆APs/burst (OM: 0.4 (3) vs. YM: 5 (3) spikes/burst, P < 0.001) and ∆AP clusters/burst (OM: 0.1 (1) vs. YM: 1.8 (1) clusters/burst, P < 0.001) during exercise. Testosterone was lower in OM than YM (P < 0.001) and was inversely related to ∆BP but positively related to ∆AP clusters/burst in males (both P = 0.03). Conversely, YF and OF demonstrated similar ∆BP and ∆AP discharge during exercise (range: P = 0.75-0.96). Age and sex did not impact haemodynamics or AP discharge during PECO (range: P = 0.08-0.94). Altogether, age-related changes in neuro-cardiovascular reactivity exist in males but not females during fatiguing exercise and seem to be related to testosterone. This sex-specific impact of age underscores the importance of considering biological sex when assessing age-related changes in neuro-cardiovascular control during exercise. KEY POINTS: Older males have the largest increase in blood pressure despite having the smallest increases in sympathetic vasomotor outflow during rhythmic handgrip exercise. Young males demonstrate greater increases in sympathetic action potential (AP) discharge compared with young females during rhythmic handgrip exercise. Older adults (regardless of sex) demonstrate smaller increases in muscle sympathetic nerve activity (MSNA) burst amplitude and total AP clusters compared with young adults during exercise, as well as smaller increases in integrated MSNA burst frequency, incidence and total MSNA activity during post-exercise circulatory occlusion (i.e. independent effect of age). Males, but not females (regardless of age), reflexively modify AP conduction velocity during exercise. Our results indicate that age and sex independently and interactively impact the neural and cardiovascular homeostatic adjustments to fatiguing small muscle mass exercise.
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Affiliation(s)
- Andrew W D'Souza
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Ryosuke Takeda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kazumasa Manabe
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah L Hissen
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Takuro Washio
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Geoff B Coombs
- Neurovascular research laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Belinda Sanchez
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - 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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Coovadia Y, Shoemaker JK, Usselman CW. The effects of sex and menstrual cycle phase on sympathetic action potential recruitment patterns during hypercapnic-hypoxic apnea. Auton Neurosci 2023; 247:103093. [PMID: 37121103 DOI: 10.1016/j.autneu.2023.103093] [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: 01/26/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 05/02/2023]
Abstract
Previously, we demonstrated that integrated muscle sympathetic nerve activity (MSNA) responses to acute chemoreflex stress were augmented during the early follicular (EF) phase of the menstrual cycle relative to both the midluteal (ML) phase and males. These differences were most pronounced in the amplitude component of MSNA, suggesting EF-driven increases in action potential (AP) recruitment in females. Therefore, we tested the hypothesis that neural recruitment, quantified as MSNA AP discharge patterns during acute chemoreflex stress, is potentiated during EF. We retrospectively analyzed MSNA data from 9 young males and 7 young females tested during the EF and ML phases at rest and during a voluntary end-inspiratory hypercapnic-hypoxic apnea. Sympathetic AP discharge patterns were analyzed using wavelet-based methodology. Apnea-driven increases in AP frequency and AP content per integrated burst were greater in EF relative to ML (APs/min: P = 0.02; APs/burst: P = 0.03) and to males (APs/min: P = 0.04; APs/burst: P = 0.02). The recruitment of new larger AP clusters was greater in EF than ML (P < 0.01) but not different from males (P = 0.50). Interestingly, we observed a positive association between the magnitude of change in the estrogen/progesterone ratio from EF to ML and the change in AP cluster recruitment, as both decreased from EF to ML (R2 = 0.82; P < 0.01). This suggests that the enhanced progesterone dominance over estrogen during ML may blunt the recruitment of new larger APs. Overall, these data indicate that both sex and the menstrual cycle impact AP recruitment patterns in a manner which may be mediated, at least in part, by gonadal hormones.
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Affiliation(s)
- Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Canada
| | - J Kevin Shoemaker
- Neurovascular Research Laboratory, School of Kinesiology, Canada; Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Canada; McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Quebec, Canada.
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Bigalke JA, Durocher JJ, Greenlund IM, Keller-Ross M, Carter JR. Blood pressure and muscle sympathetic nerve activity are associated with trait anxiety in humans. Am J Physiol Heart Circ Physiol 2023; 324:H494-H503. [PMID: 36800506 PMCID: PMC10259854 DOI: 10.1152/ajpheart.00026.2023] [Citation(s) in RCA: 1] [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: 01/18/2023] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
Chronic anxiety is prevalent and associated with an increased risk of cardiovascular disease. Prior studies that have reported a relationship between muscle sympathetic nerve activity (MSNA) and anxiety have focused on participants with anxiety disorders and/or metabolic syndrome. The present study leverages a large cohort of healthy adults devoid of cardiometabolic disorders to examine the hypothesis that trait anxiety severity is positively associated with resting MSNA and blood pressure. Resting blood pressure (BP) (sphygmomanometer and finger plethysmography), MSNA (microneurography), and heart rate (HR; electrocardiogram) were collected in 88 healthy participants (52 males, 36 females, 25 ± 1 yr, 25 ± 1 kg/m2). Multiple linear regression was performed to assess the independent relationship between trait anxiety, MSNA, resting BP, and HR while controlling for age and sex. Trait anxiety was significantly correlated with systolic arterial pressure (SAP; r = 0.251, P = 0.018), diastolic arterial pressure (DAP; r = 0.291, P = 0.006), mean arterial pressure (MAP; r = 0.328, P = 0.002), MSNA burst frequency (BF; r = 0.237, P = 0.026), and MSNA burst incidence (BI; r = 0.225, P = 0.035). When controlling for the effects of age and sex, trait anxiety was independently associated with SAP (β = 0.206, P = 0.028), DAP (β = 0.317, P = 0.002), MAP (β = 0.325, P = 0.001), MSNA BF (β = 0.227, P = 0.030), and MSNA BI (β = 0.214, P = 0.038). Trait anxiety is associated with increased blood pressure and MSNA, demonstrating an important relationship between anxiety and autonomic blood pressure regulation.NEW & NOTEWORTHY Anxiety is associated with development of cardiovascular disease. Although the sympathetic nervous system is a likely mediator of this relationship, populations with chronic anxiety have shown little, if any, alteration in resting levels of directly recorded muscle sympathetic nerve activity (MSNA). The present study is the first to reveal an independent relationship between trait anxiety, resting blood pressure, and MSNA in a large cohort of healthy males and females devoid of cardiometabolic comorbidities.
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Affiliation(s)
- Jeremy A Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States
- Department of Psychology, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - John J Durocher
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Department of Biological Sciences and Integrative Physiology and Health Sciences Center, Purdue University Northwest, Hammond, Indiana, United States
| | - Ian M Greenlund
- Department of Psychology, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Manda Keller-Ross
- Division of Physical Therapy and Rehabilitation Science, University of Minnesota, Minneapolis, Minnesota, United States
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
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D'Souza AW, Hissen SL, Okada Y, Jarvis SS, Washio T, Akins JD, Nelson DB, Fu Q. Differential regulation of sympathetic neural burst frequency and amplitude throughout normal pregnancy: a longitudinal study. Am J Physiol Regul Integr Comp Physiol 2023; 324:R249-R259. [PMID: 36534586 PMCID: PMC9902229 DOI: 10.1152/ajpregu.00239.2022] [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: 09/27/2022] [Revised: 11/29/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Sympathetic activation is a hallmark of pregnancy. However, longitudinal assessments of muscle sympathetic nerve activity (MSNA) in pregnancy are scarce and have primarily focused on burst occurrence (frequency) at rest, despite burst strength (amplitude) representing distinct characteristics of sympathetic outflow. Thus, we assessed MSNA burst amplitude distributions in healthy women to determine the impact of normal pregnancy on neural discharge patterns in response to orthostatic stress. Twenty-six women were studied longitudinally during pre-, early- (4-8 wk of gestation), and late (32-36 wk) pregnancy, as well as postpartum (6-10 wk after delivery). MSNA, blood pressure (BP), and heart rate (HR) were measured in the supine posture and during graded head-up tilt (30° and 60° HUT). Mean and median MSNA burst amplitudes were used to characterize burst amplitude distribution. In late pregnancy, women demonstrated smaller increases in HR (P < 0.001) during 60° HUT and larger increases in systolic BP (P = 0.043) throughout orthostasis, compared with prepregnancy. The increase in MSNA burst frequency during late- relative to prepregnancy (Late: Δ14[10] vs. Pre: Δ21[9] bursts/min; P = 0.001) was smaller during 60° HUT, whereas increases in burst incidence were smaller in late- relative to prepregnancy throughout orthostasis (P = 0.009). Nonetheless, median burst amplitude was smaller throughout orthostasis in late compared with prepregnancy (P = 0.038). Thus, while supine MSNA burst frequency was greater in late pregnancy, increases in burst frequency and strength during orthostasis were attenuated. These smaller, orthostatically induced MSNA increases may reflect natural adaptions of pregnancy serving to prevent sympathetic hyper-reactivity that is common in pathological states.
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Affiliation(s)
- Andrew W D'Souza
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah L Hissen
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yoshiyuki Okada
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Special Care Dentistry, Hiroshima University, Hiroshima, Japan
| | - Sara S Jarvis
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Takuro Washio
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - John D Akins
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - David B Nelson
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
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9
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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: 6.5] [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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10
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Korad S, Mündel T, Fan JL, Perry BG. Cerebral autoregulation across the menstrual cycle in eumenorrheic women. Physiol Rep 2022; 10:e15287. [PMID: 35524340 PMCID: PMC9076937 DOI: 10.14814/phy2.15287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022] Open
Abstract
There is emerging evidence that ovarian hormones play a significant role in the lower stroke incidence observed in pre‐menopausal women compared with men. However, the role of ovarian hormones in cerebrovascular regulation remains to be elucidated. We examined the blood pressure‐cerebral blood flow relationship (cerebral autoregulation) across the menstrual cycle in eumenorrheic women (n = 12; mean ± SD: age, 31 ± 7 years). Participants completed sit‐to‐stand and Valsalva maneuvers (VM, mouth pressure of 40 mmHg for 15 s) during the early follicular (EF), late follicular (LF), and mid‐luteal (ML) menstrual cycle phases, confirmed by serum measurement of progesterone and 17β‐estradiol. Middle cerebral artery blood velocity (MCAv), arterial blood pressure and partial pressure of end‐tidal carbon dioxide were measured. Cerebral autoregulation was assessed by transfer function analysis during spontaneous blood pressure oscillations, rate of regulation (RoR) during sit‐to‐stand maneuvers, and Tieck’s autoregulatory index during VM phases II and IV (AI‐II and AI‐IV, respectively). Resting mean MCAv (MCAvmean), blood pressure, and cerebral autoregulation were unchanged across the menstrual cycle (all p > 0.12). RoR tended to be different (EF, 0.25 ± 0.06; LF; 0.19 ± 0.04; ML, 0.18 ± 0.12 sec−1; p = 0.07) and demonstrated a negative relationship with 17β‐estradiol (R2 = 0.26, p = 0.02). No changes in AI‐II (EF, 1.95 ± 1.20; LF, 1.67 ± 0.77 and ML, 1.20 ± 0.55) or AI‐IV (EF, 1.35 ± 0.21; LF, 1.27 ± 0.26 and ML, 1.20 ± 0.2) were observed (p = 0.25 and 0.37, respectively). Although, a significant interaction effect (p = 0.02) was observed for the VM MCAvmean response. These data indicate that the menstrual cycle has limited impact on cerebrovascular autoregulation, but individual differences should be considered.
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Affiliation(s)
- Stephanie Korad
- School of Health Sciences, Massey University, Wellington, New Zealand.,School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Jui-Lin Fan
- Department of Physiology, Faculty of Medical and Health Sciences, Manaaki Manawa, The Centre for Heart Research, University of Auckland, Auckland, New Zealand
| | - Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
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11
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Wenner MM, Greaney JL, Matthews EL, McGinty S, Kaur J, Vongpatanasin W, Fadel PJ. Influence of Age and Estradiol on Sympathetic Nerve Activity Responses to Exercise in Women. Med Sci Sports Exerc 2022; 54:408-416. [PMID: 34711708 PMCID: PMC8847319 DOI: 10.1249/mss.0000000000002823] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Postmenopausal women (PMW) display exaggerated increases in blood pressure (BP) during exercise, yet the mechanism(s) involved remain unclear. Moreover, research on the impact of menopausal changes in estradiol on cardiovascular control during exercise are limited. Herein, we tested the hypothesis that sympathetic responses during exercise are augmented in PMWcompared with young women (YW), and estradiol administration attenuates these responses. METHODS Muscle sympathetic nerve activity (MSNA) and mean arterial pressure (MAP) were measured in 13 PMW (58 ± 1 yr) and 17 YW (22 ± 1 yr) during 2 min of isometric handgrip. Separately, MSNA and BP responses were measured during isometric handgrip in six PMW (53 ± 1 yr) before and after 1 month of transdermal estradiol (100 μg·d-1). A period of postexercise ischemia (PEI) to isolate muscle metaboreflex activation followed all handgrip bouts. RESULTS Resting MAP was similar between PMW and YW, whereas MSNA was greater in PMW (23 ± 3 vs 8 ± 1 bursts per minute; P < 0.05). During handgrip, the increases in MSNA (PMW Δ16 ± 2 vs YW Δ6 ± 1 bursts per minute; P < 0.05) and MAP (PMW Δ18 ± 2 vs YW Δ12 ± 2 mm Hg; P < 0.05) were greater in PMW and remained augmented during PEI. Estradiol administration decreased resting MAP but not MSNA in PMW. Moreover, MSNA (PMW (-E2) Δ27 ± 8 bursts per minute versus PMW (+E2) Δ12 ± 5 bursts per minute; P < 0.05) and MAP (Δ31 ± 8 mm Hg vs Δ20 ± 6 mm Hg; P < 0.05) responses during handgrip were attenuated in PMW after estradiol administration. Likewise, MAP responses during PEI were lower after estradiol. CONCLUSIONS These data suggest that PMW exhibit an exaggerated MSNA and BP response to isometric exercise, due in part to heightened metaboreflex activation. Furthermore, estradiol administration attenuated BP and MSNA responses to exercise in PMW.
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Affiliation(s)
- Megan M. Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Jody L. Greaney
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Evan L. Matthews
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ
| | - Shane McGinty
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Jasdeep Kaur
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | | | - Paul J. Fadel
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
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12
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Hwang CL, Okazaki K, Shibata S, Liu YL, Fu Q. Menstrual cycle effects on sympathetic neural burst amplitude distribution during orthostasis in young women. Clin Auton Res 2021; 31:767-773. [PMID: 34669075 PMCID: PMC11382632 DOI: 10.1007/s10286-021-00832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Fluctuations in ovarian hormones during the menstrual cycle impact muscle sympathetic nerve activity burst frequency and burst incidence at rest. The purpose of this study was to investigate menstrual cycle effects on sympathetic neural burst amplitude distribution during an orthostatic challenge in young women. METHODS This study included 11 healthy women (33 ± 10 years [mean ± standard deviation]). Muscle sympathetic nerve activity was measured in the supine position as baseline measurement and during 5 min of 60° upright tilting, during the early follicular phase (low estrogen and progesterone) and mid-luteal phase (high estrogen and progesterone) of the menstrual cycle. Relative burst amplitude distribution of muscle sympathetic nerve activity was characterized by the mean, median, skewness, and kurtosis. RESULTS From the supine to upright position, mean and median values of relative burst amplitude increased (both P < 0.05), regardless of phases of the menstrual cycle (P = 0.5 and P = 0.7, respectively). In comparison, during the early follicular phase, skewness and kurtosis remained unchanged (P = 0.6 and P = 0.3, respectively) and kurtosis decreased (1.25 ± 1.11 supine vs. - 0.03 ± 0.73 upright; P = 0.02); there was no change in skewness during the mid-luteal phase (P = 0.4). CONCLUSIONS In response to orthostasis, while the symmetry and tailedness/peakness of burst amplitude distribution do not change during the early follicular phase, the distribution during the mid-luteal phase becomes flatter with a lower but broader peak. The latter result suggests that the firing probability of large axon action potentials in response to orthostatic challenge is higher when estrogen and progesterone levels are elevated. The role of changes in sympathetic neural burst amplitude distribution in orthostatic tolerance remains to be determined.
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Affiliation(s)
- Chueh-Lung Hwang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Kazunobu Okazaki
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shigeki Shibata
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yu-Lun Liu
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA.
- The University of Texas Southwestern Medical Center, Dallas, TX, USA.
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13
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DeLorey DS. Sympathetic vasoconstriction in skeletal muscle: Modulatory effects of aging, exercise training, and sex. Appl Physiol Nutr Metab 2021; 46:1437-1447. [PMID: 34348066 DOI: 10.1139/apnm-2021-0399] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The sympathetic nervous system (SNS) is a critically important regulator of the cardiovascular system. The SNS controls cardiac output and its distribution, as well as peripheral vascular resistance and blood pressure at rest and during exercise. Aging is associated with increased blood pressure and decreased skeletal muscle blood flow at rest and in response to exercise. The mechanisms responsible for the blunted skeletal muscle blood flow response to dynamic exercise with aging have not been fully elucidated; however, increased muscle sympathetic nerve activity (MSNA), elevated vascular resistance and a decline in endothelium-dependent vasodilation are commonly reported in older adults. In contrast to aging, exercise training has been shown to reduce blood pressure and enhance skeletal muscle vascular function. Exercise training has been shown to enhance nitric oxide-dependent vascular function and may improve the vasodilatory capacity of the skeletal muscle vasculature; however, surprisingly little is known about the effect of exercise training on the neural control of circulation. The control of blood pressure and skeletal muscle blood flow also differs between males and females. Blood pressure and MSNA appear to be lower in young females compared to males. However, females experience a larger increase in MSNA with aging compared to males. The mechanism(s) for the altered SNS control of vascular function in females remain to be determined. Novelty: • This review will summarize our current understanding of the effects of aging, exercise training and sex on sympathetic vasoconstriction at rest and during exercise. • Areas where additional research is needed are also identified.
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Affiliation(s)
- Darren S DeLorey
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
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14
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Assadpour E, Ivry I, Wasef S, Adeyinka B, Murray KR, Edgell H. Oral contraceptives and menstrual cycle influence autonomic reflex function. Physiol Rep 2021; 8:e14550. [PMID: 32889781 PMCID: PMC7507440 DOI: 10.14814/phy2.14550] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/31/2022] Open
Abstract
Progesterone and its analogues are known to influence ventilation. Therefore, the purpose of this study was to investigate the role of endogenous and pharmaceutical female sex hormones in ventilatory control during the activation of the metaboreflex, mechanoreflex, and CO2 chemoreflex. Women aged 18–30 taking (n = 14) or not taking (n = 12) oral contraceptives (OC and NOC, respectively) were tested in the low hormone (LH) and high hormone (HH) conditions corresponding to the early follicular and mid‐luteal phases (NOC) or placebo and high‐dose pills (OC). Women underwent three randomized trials: (a) 3 min of passive leg movement (PLM), (b) 2 min of 40% maximal voluntary handgrip exercise followed by 2 min of post‐exercise circulatory occlusion (PECO), and (c) 5 min of breathing 5% CO2. We primarily measured hemodynamics and ventilation. During PLM, the OC group had a smaller pressor response (p = .012). During PECO, the OC group similarly exhibited a smaller pressor response (p = .043) and also exhibited a greater ventilatory response (p = .024). Lastly, in response to breathing 5% CO2, women in the HH phase had a greater ventilatory response (p = .022). We found that OC use attenuates the pressor response to both the metaboreflex and mechanoreflex while increasing the ventilatory response to metaboreflex activation. We also found evidence of an enhanced CO2 chemoreflex in the HH phase. We hypothesize that OC effects are from the chronic upregulation of pulmonary and vascular β‐adrenergic receptors. We further suggest that the increased cyclic progesterone in the HH phase enhances the chemoreflex.
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Affiliation(s)
- Elnaz Assadpour
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Ilana Ivry
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Sara Wasef
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Baithat Adeyinka
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Kevin R Murray
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Heather Edgell
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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15
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Greenlund IM, Bigalke JA, Tikkanen AL, Durocher JJ, Smoot CA, Carter JR. Evening Binge Alcohol Disrupts Cardiovagal Tone and Baroreflex Function During Polysomnographic Sleep. Sleep 2021; 44:6279273. [PMID: 34015116 DOI: 10.1093/sleep/zsab130] [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] [Received: 03/10/2021] [Revised: 04/23/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Binge alcohol consumption is associated with increased cardiovascular risk. The effects of evening binge alcohol consumption (i.e., 4-5 beverages within two hours) on the vagal components of HRV and cardiovagal baroreflex sensitivity (cvBRS) during sleep remain largely equivocal. The present study examined the effects of evening binge alcohol consumption on nocturnal cardiac vagal tone and baroreflex sensitivity during stage N2, slow wave (SWS), and rapid eye movement (REM) sleep. We hypothesized that evening binge drinking would reduce HRV and cvBRS in each sleep stage. METHODS Following a familiarization night within the laboratory, twenty-three participants were examined following a night of binge alcohol consumption and a fluid control (randomized, crossover design). A quality nocturnal beat-to-beat blood pressure signal was obtained in both conditions in 16 participants (7 men, 9 women; 25±1 years). RESULTS Binge drinking reduced both the high frequency (HF) and time-domain components (i.e., pNN50 and RMSSD) of HRV in stage N2 sleep, SWS, and REM. In addition, cvBRS up-up (vagal activation) was reduced following binge alcohol consumption in stage N2 (21±3 vs. 15±3 ms/mmHg, P=0.035) and REM (15[11-28] vs. 11[9-18] ms/mmHg, P=0.009). Binge alcohol consumption reduced cvBRS down-down (vagal withdrawal) in stage N2 (23±2 vs. 14±2 ms/mmHg, P<0.001), SWS (20[14-30] vs. 14[9-17] ms/mmHg, P=0.022), and REM (14[11-24] vs. 10[7-15] ms/mmHg, P=0.006). CONCLUSIONS Evening binge alcohol consumption disrupts cardiac vagal tone and baroreflex function during nearly all sleep stages. These findings provide mechanistic insight into the potential role of binge drinking and alcohol abuse on cardiovascular risk.
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Affiliation(s)
- Ian M Greenlund
- Department of Health & Human Development, Montana State University, Bozeman, Montana, United States.,Department of Psychology, Montana State University, Bozeman, Montana, United States.,Department of Kinesiology & Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - Jeremy A Bigalke
- Department of Health & Human Development, Montana State University, Bozeman, Montana, United States.,Department of Psychology, Montana State University, Bozeman, Montana, United States.,Department of Kinesiology & Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - Anne L Tikkanen
- Department of Health & Human Development, Montana State University, Bozeman, Montana, United States.,Department of Kinesiology & Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - John J Durocher
- Department of Kinesiology & Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States.,Department of Biological Sciences, Purdue University Northwest, Hammond, Indiana, United States
| | - Carl A Smoot
- Department of Health & Human Development, Montana State University, Bozeman, Montana, United States.,Department of Kinesiology & Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - Jason R Carter
- Department of Health & Human Development, Montana State University, Bozeman, Montana, United States.,Department of Psychology, Montana State University, Bozeman, Montana, United States.,Department of Kinesiology & Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
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16
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Giersch GEW, Charkoudian N, Pereira T, Edgell H, Freeberg KA, Craighead DH, Neill M, Allison EY, Zapcic AK, Smith KJ, Bock JM, Casey DP, Shenouda N, Ranadive SM, Tremblay JC, Williams AM, Simpson LL, Meah VL, Ruediger SL, Bailey TG, Pereira HM, Lei TH, Perry B, Mündel T, Freemas JA, Worley ML, Baranauskas MN, Carter SJ, Johnson BD, Schlader ZJ, Bates LC, Stoner L, Zieff G, Poles J, Adams N, Meyer ML, Hanson ED, Greenlund IM, Bigalke JA, Carter JR, Kerr ZY, Stanford K, Pomeroy A, Boggess K, de Souza HLR, Meireles A, Arriel RA, Leite LHR, Marocolo M, Chapman CL, Atencio JK, Kaiser BW, Comrada LN, Halliwill JR, Minson CT, Williams JS, Dunford EC, MacDonald MJ, Santisteban KJ, Larson EA, Reed E, Needham KW, Gibson BM, Gillen J, Barbosa TC, Cardoso LLY, Gliemann L, Tamariz-Ellemann A, Hellsten Y, DuBos LE, Babcock MC, Moreau KL, Wickham KA, Vagula M, Moir ME, Klassen SA, Rodrigues A. Commentaries on Point:Counterpoint: Investigators should/should not control for menstrual cycle phase when performing studies of vascular control. J Appl Physiol (1985) 2021; 129:1122-1135. [PMID: 33197376 DOI: 10.1152/japplphysiol.00809.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Gabrielle E W Giersch
- Thermal and Mountain Medicine Division, United States Army Research Institute for Environmental Medicine, Natick, Massachusetts,Oak Ridge Institute for Science and Education, Oak Ridge, Tennnessee
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute for Environmental Medicine, Natick, Massachusetts
| | - T Pereira
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada
| | - H Edgell
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada
| | - Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Matthew Neill
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Elric Y Allison
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Andrea K Zapcic
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kurt J Smith
- Integrative Physiology Lab, Department of Kinesiology and Nutrition, University of Chicago, Chicago, Illinois
| | - Joshua M Bock
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa,Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Ninette Shenouda
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland, College Park, Maryland
| | - Joshua C Tremblay
- Centre for Heart, Lung and Vascular Health, University of British Columbia–Okanagan, Kelowna, British Columbia, Canada
| | - Alexandra M Williams
- Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
| | - Lydia L Simpson
- Extremes Research Group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - Victoria L Meah
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Australia,School of Nursing, Midwifery and Social Work, The University of Queensland, Australia
| | - Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China,Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Blake Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Toby Mündel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Jessica A Freemas
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Morgan L Worley
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Marissa N Baranauskas
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Stephen J Carter
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Blair D Johnson
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Zachary J Schlader
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Lauren C Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jillian Poles
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nathan Adams
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ian M Greenlund
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Jeremy A Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Stanford
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alex Pomeroy
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kim Boggess
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hiago L R de Souza
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Anderson Meireles
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Rhai A Arriel
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Laura H R Leite
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Moacir Marocolo
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | - Jessica K Atencio
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brendan W Kaiser
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Lindan N Comrada
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - Jennifer S Williams
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Emily C Dunford
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Emma Reed
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Karen W Needham
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brandon M Gibson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Jenna Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Thales C Barbosa
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Licy L Yanes Cardoso
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | | | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Lyndsey E DuBos
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Matthew C Babcock
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kerrie L Moreau
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Veterans Affairs Eastern Colorado Geriatric Research, Educational and Clinical Center, Denver, Colorado
| | - Kate A Wickham
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | | | - M Erin Moir
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | | | - Alex Rodrigues
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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17
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Greenlund IM, Cunningham HA, Tikkanen AL, Bigalke JA, Smoot CA, Durocher JJ, Carter JR. Morning sympathetic activity after evening binge alcohol consumption. Am J Physiol Heart Circ Physiol 2021; 320:H305-H315. [PMID: 33185112 PMCID: PMC7864252 DOI: 10.1152/ajpheart.00743.2020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 01/14/2023]
Abstract
Binge alcohol consumption elicits acute and robust increases of muscle sympathetic nerve activity (MSNA), yet the impact of evening binge drinking on morning-after MSNA is unknown. The present study examined the effects of evening binge alcohol consumption on polysomnographic sleep and morning-after MSNA. We hypothesized that evening binge drinking (i.e. 4-5 drink equivalent in <2 h) would reduce sleep quality and increase morning-after blood pressure (BP) and MSNA. Following a familiarization night within the sleep laboratory, 22 participants (12 men, 10 women; 25 ± 1 yr) were examined after simulated binge drinking or fluid control (randomized, crossover design). Morning MSNA was successfully recorded across both conditions in 16 participants (8 men, 8 women) during a 10-min baseline and three Valsalva's maneuvers (VM). Binge drinking reduced rapid eye movement (REM) sleep (15 ± 1 vs. 20 ± 1%, P = 0.003), increased stage II sleep (54 ± 1 vs. 51 ± 1%, P = 0.002), and increased total urine output (2.9 ± 0.2 vs. 2.1 ± 0.1 liters, P < 0.001) but did not alter morning-after urine specific gravity. Binge drinking increased morning-after heart rate [65 (54-72) vs. 58 (51-67) beats/min, P = 0.013] but not resting BP or MSNA. Binge drinking elicited greater sympathoexcitation during VM (38 ± 3 vs. 43 ± 3 bursts/min, P = 0.036). Binge drinking augmented heart rate (P = 0.002), systolic BP (P = 0.022), and diastolic BP (P = 0.037) reactivity to VM phase IV and blunted cardiovagal baroreflex sensitivity during VM phases II (P = 0.028) and IV (P = 0.043). In conclusion, evening binge alcohol consumption disrupted REM sleep and morning-after autonomic function. These findings provide new mechanistic insight into the potential role of binge drinking on cardiovascular risk.NEW & NOTEWORTHY Chronic binge alcohol consumption is associated with future cardiovascular disease (CVD) risk in both men and women. In addition, binge alcohol consumption is known to disrupt normal sleep quality during the early morning hours, coinciding with the morning sympathetic surge. In the present study, an evening of binge alcohol consumption increased baseline morning heart rate and cardiovascular reactivity during the Valsalva maneuver (VM) strain. Specifically, muscle sympathetic nerve activity and phase IV hemodynamic responses increased during VM the morning after binge alcohol consumption. The autonomic dysfunction and increased cardiovascular reactivity during VM suggests a contributing mechanism to CVD risk present in individuals who binge drink.
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Affiliation(s)
- Ian M Greenlund
- Department of Psychology, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Hannah A Cunningham
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - Anne L Tikkanen
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Jeremy A Bigalke
- Department of Psychology, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Carl A Smoot
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - John J Durocher
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
- Department of Biological Sciences, Purdue University Northwest, Hammond, Indiana
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
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18
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Iwamoto E, Sakamoto R, Tsuchida W, Yamazaki K, Kamoda T, Neki T, Katayose M, Casey DP. Effects of menstrual cycle and menopause on internal carotid artery shear-mediated dilation in women. Am J Physiol Heart Circ Physiol 2020; 320:H679-H689. [PMID: 33306444 DOI: 10.1152/ajpheart.00810.2020] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study aimed to elucidate the effects of change in estrogen during the menstrual cycle and menopause on shear-mediated dilation of the internal carotid artery (ICA), a potential index of cerebrovascular endothelial function. Shear-mediated dilation of the ICA and serum estradiol were measured in 11 premenopausal (Pre-M, 21 ± 1 yr), 13 perimenopausal (Peri-M, 49 ± 2 yr), and 10 postmenopausal (Post-M, 65 ± 7 yr) women. Measurements were made twice within the Pre-M group at their early follicular (EF, lower estradiol) and late follicular (LF, higher estradiol) phases. Shear-mediated dilation was induced by 3 min of hypercapnia (target PETCO2 + 10 mmHg from individual baseline) and was calculated as the percent rise in peak diameter relative to baseline diameter. ICA diameter and blood velocity were simultaneously measured by Doppler ultrasound. In Pre-M, shear-mediated dilation was higher during the LF phase than during the EF phase (P < 0.01). Comparing all groups, shear-mediated dilation was reduced across the menopausal transition (P < 0.01), and Pre-M during the LF phase showed the highest value (8.9 ± 1.4%) compared with other groups (Pre-M in EF, 6.4 ± 1.1%; Peri-M, 5.5 ± 1.3%; Post-M, 5.2 ± 1.9%, P < 0.05 for all). Shear-mediated dilation was positively correlated with serum estradiol even after adjustment of age (P < 0.01, r = 0.55, age-adjusted; P = 0.02, r = 0.35). Collectively, these data indicate that controlling the menstrual cycle phase is necessary for the cross-sectional assessments of shear-mediated dilation of the ICA in premenopausal women. Moreover, current findings suggest that a decline in cerebrovascular endothelial function may be partly related to the reduced circulating estrogen levels in peri- and postmenopausal women.NEW & NOTEWORTHY The present study evaluated the effects of the menstrual cycle and menopause stages on the shear-mediated dilation of the ICA, a potential index of cerebrovascular endothelial function, in pre-, peri-, and postmenopausal women. Shear-mediated dilation of the ICA was increased from the low- to high-estradiol phases in naturally cycling premenopausal women and was reduced with advancing menopause stages. Furthermore, lower estradiol was associated with reduced shear-mediated dilation of the ICA, independent of age.
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Affiliation(s)
- Erika Iwamoto
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Rintaro Sakamoto
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Wakako Tsuchida
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Kagawa, Japan
| | - Kotomi Yamazaki
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Tatsuki Kamoda
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Toru Neki
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Iowa City, Iowa.,Abboud Cardiovascular Research Center, Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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19
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Greenlund IM, Smoot CA, Carter JR. Sex differences in blood pressure responsiveness to spontaneous K-complexes during stage II sleep. J Appl Physiol (1985) 2020; 130:491-497. [PMID: 33300855 DOI: 10.1152/japplphysiol.00825.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
K-complexes are a key marker of nonrapid eye movement sleep, specifically during stages II sleep. Recent evidence suggests the heart rate responses to a K-complexes may differ between men and women. The purpose of this study was to compare beat-to-beat blood pressure responses to K-complexes in men and women. We hypothesized that the pressor response following a spontaneous K-complex would be augmented in men compared with women. Ten men [age: 23 ± 2 yr, body mass index (BMI): 28 ± 4 kg/m2] and ten women (age: 23 ± 5 yr, BMI: 25 ± 4 kg/m2) were equipped with overnight finger plethysmography and standard 10-lead polysomnography. Hemodynamic responses to a spontaneous K-complex during stable stage II sleep were quantified for 10 consecutive cardiac cycles, and measurements included systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate. K-complex elicited greater pressor responses in men when blood pressures were expressed as SAP (cardiac cycle × sex: P = 0.007) and DAP (cardiac cycle × sex: P = 0.004). Heart rate trended to be different between men and women (cardiac cycle × sex: P = 0.078). These findings suggest a divergent pressor response between men and women following a spontaneous K-complex during normal stage II sleep. These findings could contribute to sex-specific differences in cardiovascular risk that exist between men and women.NEW & NOTEWORTHY K-complexes during stage II sleep have been shown to elicit acute increases in blood pressure and heart rate, but the role of sex (i.e., male vs. female) in this response is unclear. In the present study, we demonstrate that the pressor response following spontaneous K-complexes were augmented in men compared to age-matched women. The augmented blood pressure reactivity to spontaneous K-complexes during stage II sleep in men advance the field of cardiovascular sex differences, with implications for nocturnal blood pressure control.
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Affiliation(s)
- Ian M Greenlund
- Department of Health and Human Development, Montana State University, Bozeman, Montana.,Department of Psychology, Montana State University, Bozeman, Montana.,Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Carl A Smoot
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana.,Department of Psychology, Montana State University, Bozeman, Montana.,Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
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20
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Prasad B, Morgan BJ, Gupta A, Pegelow DF, Teodorescu M, Dopp JM, Dempsey JA. The need for specificity in quantifying neurocirculatory vs. respiratory effects of eucapnic hypoxia and transient hyperoxia. J Physiol 2020; 598:4803-4819. [PMID: 32770545 DOI: 10.1113/jp280515] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
KEY POINTS The carotid chemoreceptor mediates the ventilatory and muscle sympathetic nerve activity (MSNA) responses to hypoxia and contributes to tonic sympathetic and respiratory drives. It is often presumed that both excitatory and inhibitory tests of chemoreflex function show congruence in the end-organ responses. Ventilatory and neurocirculatory (MSNA, blood pressure and heart rate) responses to chemoreflex inhibition elicited by transient hyperoxia and to chemoreflex excitation produced by steady-state eucapnic hypoxia were measured in a cohort of 82 middle-aged individuals. Ventilatory and MSNA responsiveness to hyperoxia and hypoxia were not significantly correlated within individuals. It was concluded that ventilatory responses to hypoxia and hyperoxia do not predict MSNA responses and it is recommended that tests using the specific outcome of interest, i.e. MSNA or ventilation, are required. Transient hyperoxia is recommended as a sensitive and reliable means of quantifying tonic chemoreceptor-driven levels of sympathetic nervous system activity and respiratory drive. ABSTRACT Hypersensitivity of the carotid chemoreceptor leading to sympathetic nervous system activation and ventilatory instability has been implicated in the pathogenesis and consequences of several common clinical conditions. A variety of treatment approaches aimed at lessening chemoreceptor-driven sympathetic overactivity are now under investigation; thus, the ability to quantify this outcome variable with specificity and precision is crucial. Accordingly, we measured ventilatory and neurocirculatory responses to chemoreflex inhibition elicited by transient hyperoxia and chemoreflex excitation produced by exposure to graded, steady-state eucapnic hypoxia in middle-aged men and women (n = 82) with continuous positive airway pressure-treated obstructive sleep apnoea. Progressive, eucapnic hypoxia produced robust and highly variable increases in ventilation (+83 ± 59%) and muscle sympathetic nerve activity (MSNA) burst frequency (+55 ± 31%), whereas transient hyperoxia caused marked reductions in these variables (-35 ± 14% and -42 ± 16%, respectively). Coefficients of variation for ventilatory and MSNA burst frequency responses, indicating test-retest reproducibility, were respectively 9% and 24% for hyperoxia and 35% and 28% for hypoxia. Based on statistical measures of rank correlation or even comparisons across quartiles of corresponding ventilatory and MSNA responses, we found that the magnitudes of ventilatory inhibition with hyperoxia or excitation with eucapnic hypoxia were not correlated with corresponding MSNA responses within individuals. We conclude that, in conscious, behaving humans, ventilatory sensitivities to progressive, steady-state, eucapnic hypoxia and transient hyperoxia do not predict MSNA responsiveness. Our findings also support the use of transient hyperoxia as a reliable, sensitive, measure of the carotid chemoreceptor contribution to tonic sympathetic nervous system activity and respiratory drive.
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Affiliation(s)
- Bharati Prasad
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Barbara J Morgan
- John Rankin Laboratory of Pulmonary Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Ahana Gupta
- GPPA Medical Scholars Program, University of Illinois at Chicago, Chicago, IL, USA
| | - David F Pegelow
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Mihaela Teodorescu
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - John M Dopp
- Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Jerome A Dempsey
- John Rankin Laboratory of Pulmonary Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
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21
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Keir DA, Badrov MB, Tomlinson G, Notarius CF, Kimmerly DS, Millar PJ, Shoemaker JK, Floras JS. Influence of Sex and Age on Muscle Sympathetic Nerve Activity of Healthy Normotensive Adults. Hypertension 2020; 76:997-1005. [PMID: 32783757 DOI: 10.1161/hypertensionaha.120.15208] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
As with blood pressure, age-related changes in muscle sympathetic nerve activity (MSNA) may differ nonlinearly between sexes. Data acquired from 398 male (age: 39±17; range: 18-78 years [mean±SD]) and 260 female (age: 37±18; range: 18-81 years) normotensive healthy nonmedicated volunteers were analyzed using linear regression models with resting MSNA burst frequency as the outcome and the predictors sex, age, MSNA, blood pressure, and body mass index modelled with natural cubic splines. Age and body mass index contributed 41% and 11%, respectively, of MSNA variance in females and 23% and 1% in males. Overall, changes in MSNA with age were sigmoidal. At age 20, mean MSNA of males and females were similar, then diverged significantly, reaching in women a nadir at age 30. After 30, MSNA increased nonlinearly in both sexes. Both MSNA discharge and blood pressure were lower in females until age 50 (17±9 versus 25±10 bursts·min-1; P<1×10-19; 106±11/66±8 versus 116±7/68±9 mm Hg; P<0.01) but converged thereafter (38±11 versus 35±12 bursts·min-1; P=0.17; 119±15/71±13 versus 120±13/72±9 mm Hg; P>0.56). Compared with age 30, MSNA burst frequency at age 70 was 57% higher in males but 3-fold greater in females; corresponding increases in systolic blood pressure were 1 (95% CI, -4 to 5) and 12 (95% CI, 6-16) mm Hg. Except for concordance in females beyond age 40, there was no systematic change with age in any resting MSNA-blood pressure relationship. In normotensive adults, MSNA increases after age 30, with ascendance steeper in women.
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Affiliation(s)
- Daniel A Keir
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.)
| | - Mark B Badrov
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.).,School of Kinesiology, University of Western Ontario, London, ON, Canada (M.B.B., J.K.S.)
| | - George Tomlinson
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.)
| | - Catherine F Notarius
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.)
| | - Derek S Kimmerly
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.).,Division of Kinesiology, School of Health and Performance, Dalhousie University, Halifax, NS, Canada (D.S.K.)
| | - Philip J Millar
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.)
| | - J Kevin Shoemaker
- School of Kinesiology, University of Western Ontario, London, ON, Canada (M.B.B., J.K.S.).,Department of Human Health and Nutritional Science, University of Guelph, ON, Canada (P.J.M.)
| | - John S Floras
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto and the Toronto General Research Institute, University Health Network, Toronto, ON, Canada (D.A.K., M.B.B., G.T., C.F.N., D.S.K., P.J.M., J.S.F.)
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22
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Takeda R, Stickford AS, Best SA, Yoo JK, Fu Q. Salt intake impacts sympathetic neural control but not morning blood pressure surge in premenopausal women with a history of normal pregnancy. Am J Physiol Heart Circ Physiol 2020; 319:H571-H581. [PMID: 32734815 DOI: 10.1152/ajpheart.00197.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Salt intake may alter blood pressure (BP) regulation, but no study has investigated the impact of salt reduction versus salt loading on morning blood pressure surge (MBPS) and sympathetic neural control in premenopausal women with a history of normal pregnancy. Nine healthy women (42 ± 3 yr; mean ± SD) were given a low-salt diet (LS; 50 mEq sodium/day) and high-salt diet (HS; 250 mEq sodium/day) for 1 wk each (~2 mo apart with the order randomized), while water intake was ad libitum. Ambulatory BP at 24 h was measured, and the percent change in blood volume (BV) was calculated following LS and HS. MBPS was defined as the morning systolic BP (averaged for 2 h after wake-up) minus the lowest nocturnal systolic BP. Beat-by-beat BP, heart rate, and muscle sympathetic nerve activity (MSNA) were measured during supine rest. Signal averaging was used to characterize changes in beat-by-beat mean arterial pressure and total vascular conductance following spontaneous MSNA bursts to assess sympathetic vascular transduction. Ambulatory BP and MBPS (32 ± 7 vs. 26 ± 12 mmHg, P = 0.208) did not differ between LS and HS. From LS to HS, BV increased by 4.3 ± 3.7% (P = 0.008). MSNA (30 ± 20 vs. 18 ± 13 bursts/100 heartbeats, P = 0.005) was higher, whereas sympathetic vascular transduction was lower in LS than HS (both, P < 0.01). Changes in MSNA from LS to HS were correlated to percent changes in BV (r = -0.673; P = 0.047). Thus, salt intake affects sympathetic neural control but not MBPS in premenopausal women with a history of normal pregnancy. The underlying mechanisms remain unknown; however, alterations in sympathetic vascular transduction may, in part, contribute.NEW & NOTEWORTHY This is the first study to demonstrate that MBPS and ambulatory BP were not affected by salt intake despite a significant change in sympathetic outflow in healthy premenopausal women with a history of normal pregnancy. This may be due to compensatory adaptations in MSNA and sympathetic vascular transduction during salt reduction versus salt loading.
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Affiliation(s)
- Ryosuke Takeda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Abigail S Stickford
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stuart A Best
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jeung-Ki Yoo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas
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23
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Baker SE, Limberg JK, Scruggs ZM, Curry TB, Nicholson WT, Barnes JN, Joyner MJ. Greater Influence of Aerobic Fitness on Autonomic Support of Blood Pressure in Young Women Than in Older Women. Hypertension 2020; 75:1497-1504. [PMID: 32336237 DOI: 10.1161/hypertensionaha.119.14042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Aging increases autonomic support of blood pressure; however, the impact of aerobic fitness on autonomic support of blood pressure has not been addressed in women. As such, we hypothesized that aerobic fitness would be related to the change in blood pressure during ganglionic blockade such that women with greater aerobic fitness would have a blunted fall in blood pressure during ganglionic blockade due to increased vagal tone. Thirteen young premenopausal and 13 older postmenopausal women completed a screening visit where aerobic fitness (maximal oxygen consumption, VO2max) was measured. On a separate study day, participants were instrumented for assessment of muscle sympathetic nerve activity, heart rate (electrocardiography), and beat by beat blood pressure (arterial catheter and pressure transducer) and underwent pharmacological blockade of the autonomic ganglia using trimethaphan camyslate. Heart rate, blood pressure, and muscle sympathetic nerve activity were analyzed before and during ganglionic blockade. In young women, there was a significant relationship between aerobic fitness and the change in blood pressure during ganglionic blockade (r=0.761, P=0.003). In older women, there was no relationship between aerobic fitness and the change in blood pressure during ganglionic blockade (r=-0.106, P=0.73). Measures of heart rate variability were related to fitness in young women, but not older women (root mean square of successive differences between normal heartbeats, r=0.713, P=0.006 versus r=-0.172, P=0.575). Our data suggest that in young women, autonomic support of blood pressure is attenuated in those that are highly fit; however, this relationship is not significant in older women.
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Affiliation(s)
- Sarah E Baker
- From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN (S.E.B., Z.M.S., T.B.C., W.R.N., M.J.J.)
| | - Jacqueline K Limberg
- Department of Nutrition & Exercise Physiology, University of Missouri, Columbia (J.K.L.)
| | - Zachariah M Scruggs
- From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN (S.E.B., Z.M.S., T.B.C., W.R.N., M.J.J.)
| | - Timothy B Curry
- From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN (S.E.B., Z.M.S., T.B.C., W.R.N., M.J.J.)
| | - Wayne T Nicholson
- From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN (S.E.B., Z.M.S., T.B.C., W.R.N., M.J.J.)
| | - Jill N Barnes
- Department of Kinesiology, University of Wisconsin, Madison (J.N.B.)
| | - Michael J Joyner
- From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN (S.E.B., Z.M.S., T.B.C., W.R.N., M.J.J.)
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24
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Link BN, Eid C, Bublitz MH, Pengo MF, Salameh M, Ludwig KS, Millman RP, Dworkin L, Bourjeily G. Pulse transit time in pregnancy: a new way to diagnose and classify sleep disordered breathing? Sleep 2020; 42:5310043. [PMID: 30753641 DOI: 10.1093/sleep/zsz022] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/26/2018] [Indexed: 12/19/2022] Open
Abstract
STUDY OBJECTIVES There are significant discrepancies between the prevalence of snoring and that of objectively defined sleep disordered breathing among pregnant women, suggesting subtle airflow limitations that may not be captured by conventional scoring. This study examined the performance of pulse transit time, an indirect measure of arterial stiffness and sympathetic activation, in pregnancy. METHODS Pregnant women with obesity and snoring and a group of controls without symptoms of sleep disordered breathing were recruited in the first trimester. Women underwent a level III in-laboratory sleep monitoring study including an electrocardiogram and pulse oximetry, and pulse transit time was measured. Sleep disordered breathing was defined as an apnea-hypopnea index at least five events per hour of sleep. Statistical analysis was performed using Spearman correlation, Fisher's exact t-test, and univariate analysis. RESULTS Of the 222 women, 38 met criteria for sleep disordered breathing. Pulse transit time drops were very prevalent (95% of participants with snoring had > 5 drops per hour). Median apnea-hypopnea index was 0.7 (interquartile range [IQR]: 2.6) events per hour whereas median pulse transit time drop index was 20.70 (IQR: 35.90) events per hour. Pulse transit time index was significantly higher in snorers with apnea-hypopnea index less than five events per hours and participants with apnea-hypopnea index greater than five events per hour compared to controls. Examination of random epochs with pulse transit time drops showed that 95% of pulse transit time drops were associated with airflow limitation. CONCLUSIONS Pulse transit time ascertains frequent events of sympathetic activation in at-risk women with and without sleep disordered breathing beyond conventional apneas and hypopneas. Pulse transit time may be an important addition to the identification of clinically significant sleep disordered breathing in pregnant women, and may identify more sleep disordered breathing than apnea-hypopnea index.
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Affiliation(s)
| | - Celine Eid
- Department of Medicine, Brown University, Providence, RI
| | - Maggie H Bublitz
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - Martino F Pengo
- Sleep Disorder Center, Department of Cardiovascular, Neural, and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, University of Milan, Milan, Italy
| | - Myriam Salameh
- Department of Medicine, The Miriam Hospital, Women's Medicine Collaborative, Providence, RI
| | - Karin S Ludwig
- Department of Medicine, The Miriam Hospital, Women's Medicine Collaborative, Providence, RI
| | - Richard P Millman
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI.,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Rhode Island Hospital, Providence, RI
| | - Lance Dworkin
- Department of Medicine, University of Toledo, Toledo, OH
| | - Ghada Bourjeily
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI.,Department of Medicine, The Miriam Hospital, Women's Medicine Collaborative, Providence, RI.,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Rhode Island Hospital, Providence, RI
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25
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Abstract
Obesity increases sympathetic nerve activity (SNA) in men, but not women. Here, we review current evidence suggesting that sexually dimorphic sympathoexcitatory responses to leptin and insulin may contribute. More specifically, while insulin increases SNA similarly in lean males and females, this response is markedly amplified in obese males, but is abolished in obese females. In lean female rats, leptin increases a subset of sympathetic nerves only during the high estrogen proestrus reproductive phase; thus, in obese females, because reproductive cycling can become impaired, the sporadic nature of leptin-induced sympathoexcitaton could minimize its action, despite elevated leptin levels. In contrast, in males, obesity preserves or enhances the central sympathoexcitatory response to leptin, and current evidence favors leptin’s contribution to the well-established increases in SNA induced by obesity in men. Leptin and insulin increase SNA via receptor binding in the hypothalamic arcuate nucleus and a neuropathway that includes arcuate neuropeptide Y (NPY) and proopiomelanocortin (POMC) projections to the paraventricular nucleus. These metabolic hormones normally suppress sympathoinhibitory NPY neurons and activate sympathoexcitatory POMC neurons. However, obesity appears to alter the ongoing activity and responsiveness of arcuate NPY and POMC neurons in a sexually dimorphic way, such that SNA increases in males but not females. We propose hypotheses to explain these sex differences and suggest areas of future research.
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Affiliation(s)
- Zhigang Shi
- Department of Physiology and Pharmacology, L-334, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Jennifer Wong
- Department of Physiology and Pharmacology, L-334, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Virginia L Brooks
- Department of Physiology and Pharmacology, L-334, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
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26
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Usselman CW, Adler TE, Coovadia Y, Leone C, Paidas MJ, Stachenfeld NS. A recent history of preeclampsia is associated with elevated central pulse wave velocity and muscle sympathetic outflow. Am J Physiol Heart Circ Physiol 2020; 318:H581-H589. [DOI: 10.1152/ajpheart.00578.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We demonstrate that resting muscle sympathetic nerve activity is elevated in women with a recent history of preeclampsia relative to women who have recently had uncomplicated pregnancies and without a history of preeclampsia. Structural changes in the central arteries are associated with arterial stiffness following preeclampsia, independent of changes in the sympathetic nervous system. The structural changes are observed in these relatively young previously preeclamptic women, indicating elevated cardiovascular risk. Our data suggest that with aging (and the gradual loss of vascular protection for women, as established by others), this risk will become exaggerated compared with women who have had normal pregnancies.
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Affiliation(s)
- 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
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
| | - Tessa E. Adler
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut
| | - Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Cheryl Leone
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut
| | - Michael J. Paidas
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Nina S. Stachenfeld
- The John B. Pierce Laboratory, Yale School of Medicine, New Haven, Connecticut
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
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27
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Daugherty SL, Carter JR, Bourjeily G. Cardiovascular Disease in Women Across the Lifespan: The Importance of Sleep. J Womens Health (Larchmt) 2020; 29:452-460. [PMID: 32096682 PMCID: PMC7097694 DOI: 10.1089/jwh.2020.8331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular disease (CVD) and sleep disturbances are both common and associated with significant morbidity and mortality. Compared with men, women are more likely to report insufficient sleep. During the 2018 Research Conference on Sleep and the Health of Women sponsored by the National Heart, Lung, and Blood Institute, researchers in cardiology, integrative physiology and sleep medicine reviewed the current understanding of how sleep and sleep disturbances influence CVD in women across the lifespan. Women may be particularly vulnerable to the negative effects of sleep disturbances at important stages of their life, including during pregnancy and after menopause. The proposed pathways linking sleep disturbances and adverse cardiovascular outcomes in women are numerous and the complex interaction between them is not well understood. Future research focused on understanding the scope of sleep disorders in women, defining the underlying mechanisms, and testing interventions to improve sleep are critical for improving the cardiovascular health of all women.
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Affiliation(s)
- Stacie L. Daugherty
- Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado
- Adult and Children Center for Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado School of Medicine, Aurora, Colorado
- Colorado Cardiovascular Outcomes Research Group, Denver, Colorado
| | - Jason R. Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Ghada Bourjeily
- Divisions of Pulmonary, Critical Care and Sleep Medicine, and Obstetric Medicine, Department of Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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28
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Brooks VL, Fu Q, Shi Z, Heesch CM. Adaptations in autonomic nervous system regulation in normal and hypertensive pregnancy. HANDBOOK OF CLINICAL NEUROLOGY 2020; 171:57-84. [PMID: 32736759 DOI: 10.1016/b978-0-444-64239-4.00003-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is an increase in basal sympathetic nerve activity (SNA) during normal pregnancy; this counteracts profound primary vasodilation. However, pregnancy also impairs baroreflex control of heart rate and SNA, contributing to increased mortality secondary to peripartum hemorrhage. Pregnancy-induced hypertensive disorders evoke even greater elevations in SNA, which likely contribute to the hypertension. Information concerning mechanisms is limited. In normal pregnancy, increased angiotensin II acts centrally to support elevated SNA. Hypothalamic sites, including the subfornical organ, paraventricular nucleus, and arcuate nucleus, are likely (but unproven) targets. Moreover, no definitive mechanisms for exaggerated sympathoexcitation in hypertensive pregnancy have been identified. In addition, normal pregnancy increases gamma aminobutyric acid inhibition of the rostral ventrolateral medulla (RVLM), a key brainstem site that transmits excitatory inputs to spinal sympathetic preganglionic neurons. Accumulated evidence supports a major role for locally increased production and actions of the neurosteroid allopregnanolone as one mechanism. A consequence is suppression of baroreflex function, but increased basal SNA indicates that excitatory influences predominate in the RVLM. However, many questions remain regarding other sites and factors that support increased SNA during normal pregnancy and, more importantly, the mechanisms underlying excessive sympathoexcitation in life-threatening hypertensive pregnancy disorders such as preeclampsia.
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Affiliation(s)
- Virginia L Brooks
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR, United States.
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, United States; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Zhigang Shi
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR, United States
| | - Cheryl M Heesch
- Department of Biomedical Sciences and Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
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29
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Seligowski AV, Hurly J, Mellen E, Ressler KJ, Ramikie TS. Translational studies of estradiol and progesterone in fear and PTSD. Eur J Psychotraumatol 2020; 11:1723857. [PMID: 32158516 PMCID: PMC7048196 DOI: 10.1080/20008198.2020.1723857] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/23/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
Abstract
Translational models of fear have greatly informed our understanding of PTSD and its underlying fear circuitry. One of the most replicated findings in the field is the two-fold higher PTSD incidence in females compared to males. While sociocultural factors play a role, the most robust biological influencers to date are gonadal hormones, such as estradiol and progesterone, which fluctuate across the menstrual cycle. Among studies that account for these hormones, most do so in isolation or collect both and only report one. Variation in study findings suggests that the ratio between these two hormones (the P/E ratio) may be an important and missing variable to further understand gonadal hormone influences on fear. Here we review cross-species examinations of fear and PTSD, within the contexts of estradiol and progesterone as well as P/E ratios that were calculated based on extant literature. We then provide recommendations for best practices in assay methods and reporting to improve research on the P/E ratio in fear and PTSD. Ultimately, greater understanding of this important variable will advance efforts to characterize gonadal hormone influences on fear learning processes in humans and animals.
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Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Belmont, MA, USA
| | - Jordyn Hurly
- McLean Hospital, Belmont, MA, USA.,Northeastern University, Boston, MA, USA
| | | | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Belmont, MA, USA
| | - Teniel S Ramikie
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Belmont, MA, USA
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30
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Fu Q, Ogoh S. Sex differences in baroreflex function in health and disease. J Physiol Sci 2019; 69:851-859. [PMID: 31721084 PMCID: PMC10717578 DOI: 10.1007/s12576-019-00727-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/29/2019] [Indexed: 01/16/2023]
Abstract
This brief review summarizes the current knowledge on sex differences in baroreflex function, with a major focus on studies in humans. It has been demonstrated that healthy women have blunted cardiovagal baroreflx sensitivity during a rapid (i.e., within seconds) hypertensive stimulus, but baroreflex sensitivity is similar between the sexes during a hypotensive stimulus. Normal aging decreases cardiovagal baroreflex sensitivity and the rate of decline is similar in men and women. Cardiovagal baroreflex sensitivity is reduced in pathological conditions such as hypertension and type II diabetes, and the reduction is greater in female patients than male patients. There is no clear sex difference in sympathetic baroreflex sensitivity among young individuals, however, with women of more advanced age, sympathetic baroreflex sensitivity decreases, which appears to be associated with greater arterial stiffness compared with similarly aged men. The blunted sympathetic baroreflex sensitivity in older women may predispose them to an increased prevalence of hypertension and cardiovascular disease.
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Affiliation(s)
- Qi Fu
- Women's Heart Health Laboratory, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX, 75231, USA.
- The University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Tokyo, Japan
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31
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Carter JR. Microneurography and sympathetic nerve activity: a decade-by-decade journey across 50 years. J Neurophysiol 2019; 121:1183-1194. [PMID: 30673363 DOI: 10.1152/jn.00570.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The technique of microneurography has advanced the field of neuroscience for the past 50 years. While there have been a number of reviews on microneurography, this paper takes an objective approach to exploring the impact of microneurography studies. Briefly, Web of Science (Thomson Reuters) was used to identify the highest citation articles over the past 50 years, and key findings are presented in a decade-by-decade highlight. This includes the establishment of microneurography in the 1960s, the acceleration of the technique by Gunnar Wallin in the 1970s, the international collaborations of the 1980s and 1990s, and finally the highest impact studies from 2000 to present. This journey through 50 years of microneurographic research related to peripheral sympathetic nerve activity includes a historical context for several of the laboratory interventions commonly used today (e.g., cold pressor test, mental stress, lower body negative pressure, isometric handgrip, etc.) and how these interventions and experimental approaches have advanced our knowledge of cardiovascular, cardiometabolic, and other human diseases and conditions.
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Affiliation(s)
- Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University , Houghton, Michigan
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32
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Shorakae S, Lambert EA, Jona E, Ika Sari C, de Courten B, Dixon JB, Lambert GW, Teede HJ. Effect of Central Sympathoinhibition With Moxonidine on Sympathetic Nervous Activity in Polycystic Ovary Syndrome-A Randomized Controlled Trial. Front Physiol 2018; 9:1486. [PMID: 30410448 PMCID: PMC6210452 DOI: 10.3389/fphys.2018.01486] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/01/2018] [Indexed: 12/19/2022] Open
Abstract
Sympathetic nervous system (SNS) activity is increased in polycystic ovary syndrome (PCOS). Moxonidine is a centrally acting sympatholytic drug with known beneficial effects on hypertension, insulin sensitivity, dyslipidemia and inflammation. In this double-blind placebo controlled randomized clinical trial we examined the effect of moxonidine on modulating sympathetic activity and downstream metabolic abnormalities in 48 pre-menopausal women with PCOS (Rotterdam diagnostic criteria), recruited from the community (January 2013-August 2015). Participants received moxonidine (0.2 mg daily initially, up titrated to 0.4 mg daily in 2 weeks) (n = 23) or placebo (n = 25) for 12 weeks. Multiunit muscle sympathetic activity (by microneurography) and plasma noradrenaline levels were measured (primary outcomes). Fasting lipids, insulin resistance, serum androgens, and inflammatory markers were measured as secondary outcomes. Forty three women completed the trial (19 moxonidine, 24 placebo). Mean change in burst frequency (-3 ± 7 vs. -3 ± 8 per minute) and burst incidence (-3 ± 10 vs. -4 ± 12 per 100 heartbeat) did not differ significantly between moxonidine and placebo groups. Women on moxonidine had a significant reduction in hs-CRP compared to placebo group (-0.92 ± 2.3 vs. -0.04 ± 1.5) which did not persist post Bonferroni correction. There was a significant association between markers of insulin resistance at baseline and reduction in sympathetic activity with moxonidine. Moxonidine was not effective in modulating sympathetic activity in PCOS. Anti-inflammatory effects of moxonidine and a relationship between insulin resistance and sympathetic response to moxonidine are suggested which need to be further explored. Clinical Trial Registration Number: (NCT01504321).
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Affiliation(s)
- Soulmaz Shorakae
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
| | - Elisabeth A Lambert
- Faculty of Health, Arts and Design, Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Eveline Jona
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Carolina Ika Sari
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
| | - John B Dixon
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia.,Clinical Obesity Research Laboratories, Baker Heart & Diabetes Institute, Melbourne, VIC, Australia
| | - Gavin W Lambert
- Faculty of Health, Arts and Design, Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia.,Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
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33
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Koifman R, Dayan L, Ablin JN, Jacob G. Cardiovascular Autonomic Profile in Women With Premenstrual Syndrome. Front Physiol 2018; 9:1384. [PMID: 30327616 PMCID: PMC6174485 DOI: 10.3389/fphys.2018.01384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/11/2018] [Indexed: 11/28/2022] Open
Abstract
Introduction: The premenstrual syndrome (PMS) is a constellation of somatic and psychogenic symptoms that appear during late luteal (LL) phase of the menstrual cycle. Since many symptoms could be related to the autonomic nervous system, we hypothesized that the sympathetic nervous system is perturbed in PMS. Methods: The cardiovascular autonomic profile of nine women with PMS (30.4 ± 2.5 years) were compared to that of nine healthy controls (30 ± 2.5 years) during their early follicular (EF) and LL phases of the menstrual cycle. Plasma norepinephrine (NE) concentrations, power spectral analysis of heart rate and systolic blood pressure (BP), and baroreflex sensitivity (BRS) were assessed during recumbency and a head-up tilt (HUT). Cardiovascular responsiveness to α1- and β-adrenoreceptor agonists (phenylephrine and isoproterenol, respectively) were also assessed. Results: In the LL phase, the plasma NE concentrations in women with PMS during recumbency and a HUT were lower than those in women without PMS [180 ± 30 vs. 320 ± 50 pg/ml; p = 0.04 (recumbent), and 480 ± 70 vs. 940 ± 180 pg/ml: p = 0.02 (HUT)]. In the LL phase, the dose of phenylephrine required to increase systolic BP by 15 mmHg in women with PMS was significantly greater than that in women without PMS (202 ± 30 μg vs. 138 ± 20 μg; p = 0.02). Sympathetic and vagal cardiac control indices were comparable in the two groups in the menstrual phases. In women with PMS, the value of LFSBP in the LL phase was lower than that in the EF phase (0.98 ± 0.2 vs. 1.77 ± 0.4 mmHg2, p = 0.04). The increase in LFSBP in women with PMS in the LL phase during HUT was greater than that in the controls, 5.2 ± 0.9 vs. 3.1 ± 0.5 mmHg2, p = 0.045, and this increase was associated with a significant decrease in BRS. Conclusion: In women with PMS without psychogenic symptoms, the sympathetic control of their circulation is not dominant during the LL phase of their menstrual cycle.
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Affiliation(s)
- Rimma Koifman
- Department of Internal Medicine F, J. Recanati Autonomic Dysfunction Center, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Dayan
- Department of Internal Medicine F, J. Recanati Autonomic Dysfunction Center, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob N Ablin
- Department of Internal Medicine F, J. Recanati Autonomic Dysfunction Center, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Giris Jacob
- Department of Internal Medicine F, J. Recanati Autonomic Dysfunction Center, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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34
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Sex differences in the respiratory-sympathetic coupling in rats exposed to chronic intermittent hypoxia. Respir Physiol Neurobiol 2018; 256:109-118. [DOI: 10.1016/j.resp.2017.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/02/2017] [Accepted: 09/06/2017] [Indexed: 02/06/2023]
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35
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Morgan BJ, Teodorescu M, Pegelow DF, Jackson ER, Schneider DL, Plante DT, Gapinski JP, Hetzel SJ, Dopp JM. Effects of losartan and allopurinol on cardiorespiratory regulation in obstructive sleep apnoea. Exp Physiol 2018; 103:941-955. [PMID: 29750475 DOI: 10.1113/ep087006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/08/2018] [Indexed: 12/30/2022]
Abstract
NEW FINDINGS What is the central question of this study? In sleep apnoea, a putative link between intermittent hypoxia and hypertension is the generation of oxygen radicals by angiotensin II and xanthine oxidase within the chemoreflex arc and vasculature. We tested whether chemoreflex control of sympathetic outflow, hypoxic vasodilatation and blood pressure are altered by angiotensin blockade (losartan) and/or xanthine oxidase inhibition (allopurinol). What is the main finding and its importance? Both drugs lowered blood pressure without altering sympathetic outflow, reducing chemoreflex sensitivity or enhancing hypoxic vasodilatation. Losartan and allopurinol are effective therapies for achieving blood pressure control in sleep apnoea. ABSTRACT Chemoreflex sensitization produced by chronic intermittent hypoxia in rats is attenuated by angiotensin II type 1 receptor (AT1 R) blockade. Both AT1 R blockade and xanthine oxidase inhibition ameliorate chronic intermittent hypoxia-induced endothelial dysfunction. We hypothesized that treatment with losartan and allopurinol would reduce chemoreflex sensitivity and improve hypoxic vasodilatation in patients with obstructive sleep apnoea. Eighty-six hypertensive patients with apnoea-hypopnoea index ≥25 events h-1 and no other cardiovascular, pulmonary, renal or metabolic disease were randomly assigned to receive allopurinol, losartan or placebo for 6 weeks. Treatment with other medications and/or continuous positive airway pressure remained unchanged. Tests of chemoreflex sensitivity and hypoxic vasodilatation were performed during wakefulness before and after treatment. Ventilation (pneumotachography), muscle sympathetic nerve activity (microneurography), heart rate (electrocardiography), arterial oxygen saturation (pulse oximetry), blood pressure (sphygmomanometry), forearm blood flow (venous occlusion plethysmography) and cerebral flow velocity (transcranial Doppler ultrasound) were measured during eupnoeic breathing and graded reductions in inspired O2 tension. Losartan and allopurinol lowered arterial pressure measured during eupnoeic breathing and exposure to acute hypoxia. Neither drug altered the slopes of ventilatory, sympathetic or cardiovascular responses to acute hypoxia. We conclude that losartan and allopurinol are viable pharmacotherapeutic adjuncts for achieving blood pressure control in hypertensive obstructive sleep apnoea patients, even those who are adequately treated with continuous positive airway pressure.
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Affiliation(s)
- Barbara J Morgan
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Mihaela Teodorescu
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - David F Pegelow
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, USA
| | - Emily R Jackson
- Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Devin L Schneider
- Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - David T Plante
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - John M Dopp
- Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
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36
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Tabti E, Benmekki A, Bestaoui MH, Messad M, Ghembaza MA, Lounici A. [Hypertension associated with paraparesis of the lower limbs revealing an adrenal adenoma]. Ann Cardiol Angeiol (Paris) 2018; 67:226-229. [PMID: 29779837 DOI: 10.1016/j.ancard.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
Cushing's syndrome is a rare cause of high blood pressure. The originally adrenal cause is found in 15% of cases. We describe the case of a patient with hypertension associated with paraparesis of the lower limbs revealing a Cushing syndrome due to a left adrenal adenoma. A 23-year-old man consults for a paraparesis of the lower limbs. The highlighting of an arterial high blood pressure led to the realization of complementary examinations. Computed tomography of the abdomen shows a left adrenal mass. Chirurgical excision of the mass was performed and histological examination concluded with adrenal adenoma. After intervention, the patient normalized his blood pressure with 3 years of follow up. This case illustrates a form of endocrine hypertension of adrenal origin and the need for a careful clinical examination during the discovery of hypertension in the young subject in order to carry out adequate balance sheets to search for a curable cause of secondary hypertension.
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Affiliation(s)
- E Tabti
- Service de médecine interne, CHU Tidjani Damerdji, Tlemcen 13000, Algérie.
| | - A Benmekki
- Service de médecine interne, CHU Tidjani Damerdji, Tlemcen 13000, Algérie.
| | - M H Bestaoui
- Service de médecine interne, CHU Tidjani Damerdji, Tlemcen 13000, Algérie.
| | - M Messad
- Service de médecine interne, CHU Tidjani Damerdji, Tlemcen 13000, Algérie.
| | - M A Ghembaza
- Service de médecine interne, CHU Tidjani Damerdji, Tlemcen 13000, Algérie.
| | - A Lounici
- Service de médecine interne, CHU Tidjani Demerdji, Université Abou Bekr Belkaid, Tlemcen 13000, Algérie.
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37
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Reyes LM, Usselman CW, Davenport MH, Steinback CD. Sympathetic Nervous System Regulation in Human Normotensive and Hypertensive Pregnancies. Hypertension 2018. [DOI: 10.1161/hypertensionaha.117.10766] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Laura M. Reyes
- From the Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children’s Health Research Institute (L.M.R., C.W.U., M.H.D., C.D.S.) and Alberta Diabetes Institute (M.H.D.), University of Alberta, Edmonton, Canada
| | - Charlotte W. Usselman
- From the Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children’s Health Research Institute (L.M.R., C.W.U., M.H.D., C.D.S.) and Alberta Diabetes Institute (M.H.D.), University of Alberta, Edmonton, Canada
| | - Margie H. Davenport
- From the Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children’s Health Research Institute (L.M.R., C.W.U., M.H.D., C.D.S.) and Alberta Diabetes Institute (M.H.D.), University of Alberta, Edmonton, Canada
| | - Craig D. Steinback
- From the Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children’s Health Research Institute (L.M.R., C.W.U., M.H.D., C.D.S.) and Alberta Diabetes Institute (M.H.D.), University of Alberta, Edmonton, Canada
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Fonkoue IT, Schwartz CE, Wang M, Carter JR. Sympathetic neural reactivity to mental stress differs in black and non-Hispanic white adults. J Appl Physiol (1985) 2018; 124:201-207. [PMID: 28970198 DOI: 10.1152/japplphysiol.00134.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Black adults have a higher risk of hypertension compared with non-Hispanic white (NHW) adults, but physiological mechanisms underlying this predisposition remain unclear. This study compared muscle sympathetic nerve activity (MSNA) responses to mental stress in a group of young black and NHW participants. We hypothesized that the sympathoexcitation associated with mental stress would be greater in black adults compared with NHW participants. Thirty-five male adults (19 black, 23 ± 1 yr; 16 NHW, 22 ± 1 yr) were examined during 5-min supine baseline and 5 min of mental stress (via mental arithmetic). Baseline mean arterial pressure (80 ± 2 vs. 82 ± 1 mmHg), heart rate (61 ± 4 vs. 61 ± 2 beats/min), MSNA (13 ± 1 vs. 15 ± 2 bursts/min), and sympathetic baroreflex sensitivity (-1.1 ± 0.4 vs. -1.5 ± 0.3 bursts·100 heart beats-1·mmHg-1) were not significantly different between NHW and black adults ( P > 0.05), respectively. MSNA reactivity to mental stress was significantly higher in NHW compared with black adults (time × race, P = 0.006), with a particularly divergent responsiveness during the first minute of mental stress in NHW (Δ4 ± 1 burst/min) and black (Δ-2 ± 2 burst/min; P = 0.022) men. Blood pressure and heart rate reactivity to mental stress were similar between groups. In summary, black participants demonstrated a lower MSNA responsiveness to mental stress compared with NHW adults. These findings suggest that, despite a higher prevalence of hypertension, black subjects do not appear to have higher neural and cardiovascular responsiveness to mental stress compared with NHW. NEW & NOTEWORTHY Black men have a blunted muscle sympathetic nerve activity response to mental stress compared with non-Hispanic white (NHW) men, especially at the onset of mental stress when muscle sympathetic nerve activity decreased in blacks and increased in NHW men. Thus, despite a high prevalence of hypertension in blacks, normotensive NHW men display a greater peripheral sympathetic neural reactivity to mental stress than black men.
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Affiliation(s)
| | | | - Min Wang
- 1 Michigan Technological University
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Laffin LJ, Jafar MS, Bakris GL. Severe menses-associated hypertension successfully treated with gonadotropin-releasing hormone agonist. J Clin Hypertens (Greenwich) 2017. [DOI: 10.1111/jch.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Luke J. Laffin
- Department of Medicine; ASH Comprehensive Hypertension Center; University of Chicago Medicine; Chicago IL USA
- Section of Cardiology; University of Chicago Medicine; Chicago IL USA
| | - Munnam S. Jafar
- Department of Medicine; ASH Comprehensive Hypertension Center; University of Chicago Medicine; Chicago IL USA
| | - George L. Bakris
- Department of Medicine; ASH Comprehensive Hypertension Center; University of Chicago Medicine; Chicago IL USA
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Abidi S, Nili M, Serna S, Kim S, Hazlett C, Edgell H. Influence of sex, menstrual cycle, and oral contraceptives on cerebrovascular resistance and cardiorespiratory function during Valsalva or standing. J Appl Physiol (1985) 2017; 123:375-386. [PMID: 28522756 DOI: 10.1152/japplphysiol.00035.2017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 01/11/2023] Open
Abstract
Women experience orthostatic intolerance more than men, and they experience faintness more in the early follicular [i.e., low-hormone (LH)] than luteal [i.e., high-hormone (HH)] phase of the menstrual cycle. Men (n = 13, 25.8 ± 1.8 yr old) and women in the LH (days 2-5; placebo) and HH (days 18-24; high dose) phases of the menstrual cycle with (OC; n = 14, 22.0 ± 0.8 yr old) or without (NOC; n = 12, 21.8 ± 0.5 yr old) oral contraceptive (OC) use underwent the Valsalva maneuver and a supine-sit-stand protocol. Blood pressure, normalized stroke volume [stroke volume index (SVi)], cardiac output index, heart rate, end-tidal CO2, and middle cerebral artery (MCA) blood flow velocity were measured. When subjected to the Valsalva maneuver, all women had a greater increase in diastolic and mean MCA blood flow velocity than men (P ≤ 0.065), with no significant effect of menstrual cycle phase or OC use. When subjected to the supine-sit-stand protocol, men had lower MCA blood flow velocity (P < 0.038) than all women, and SVi was higher in men than in the NOC group in all postures (P < 0.011) and in the OC group in the LH phase of the menstrual cycle during standing (P = 0.010). Only men experienced higher resistance index (P < 0.001) and pulsatility index (P < 0.001) with standing. The OC group had lower end-tidal CO2 (P = 0.002) than the NOC group (P = 0.030) and men (P ≤ 0.067). SVi (P = 0.004) and cardiac output index (P = 0.008) were higher in the OC than NOC group. A tendency toward a lower mean MCA blood flow velocity (P = 0.058) and higher SVi (P = 0.059) and pulsatility index (P = 0.058) was noted in the HH than LH phase. Mean arterial pressure was higher in the OC than NOC group in the LH phase (P = 0.049) and lower in the HH than LH phase (P = 0.014). Our results indicate that cycling estrogens/progestins can influence ventilatory, cardiovascular, and/or cerebrovascular physiology.NEW & NOTEWORTHY We have found sex differences in the cerebrovascular response to the Valsalva maneuver and standing. Men have greater cerebral vasoconstriction (or women have greater cerebral vasodilation) during late phase II of the Valsalva maneuver, and the cerebrovascular resistance index increases in men, but not in women, during standing. Furthermore, our findings indicate that both the menstrual cycle phase and oral contraceptive use can influence cardiovascular function both at rest and during active standing.
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Affiliation(s)
- Syed Abidi
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada; and
| | - Misha Nili
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada; and
| | - Stephania Serna
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada; and
| | - Simon Kim
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada; and
| | - Christopher Hazlett
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada; and
| | - Heather Edgell
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada; and .,Muscle Health Research Centre, York University, Toronto, Ontario, Canada
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Li N, Wang Y, Yu L, Song M, Wang L, Ji C, Wang X, Wu S. Long-term effects of earthquake experience of young persons on cardiovascular disease risk factors. Arch Med Sci 2017; 13:75-81. [PMID: 28144258 PMCID: PMC5206373 DOI: 10.5114/aoms.2017.64716] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/14/2015] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The aim of the study was to study the long-term effect on cardiovascular disease risk factors of stress from direct experience of an earthquake as a young person. MATERIAL AND METHODS We selected workers born between July 1, 1958 and July 1, 1976 who were examined at Kailuan General Hospital between May and October of 2013. Data on cardiovascular events were taken during the workers' annual health examination conducted between 2006 and 2007. All subjects were divided into three groups according to their experience of the Tangshan earthquake of July 28, 1976, as follows: control group; exposed group 1 and exposed group 2. We compared cardiovascular disease risk factors between the three groups as well as by gender and age. RESULTS One thousand one hundred and ninety-six workers were included in the final statistical analysis. Among all subjects, resting heart rate (p = 0.003), total cholesterol (p < 0.001), and fasting blood glucose (p < 0.001) were significantly higher among those who experienced the earthquake compared with unexposed controls, but were unrelated to loss of relatives. No significant difference in triglyceride levels was observed between the three groups (p = 0.900). Further refinement showed that the effects were restricted to males 40 years of age or older at the time of analysis, but were due primarily to age at the time of earthquake exposure (p = 0.002, p < 0.001 and p = 0.002). CONCLUSIONS Earthquake experience in the early years of life has long-term effects on adult resting heart rate, total cholesterol, and fasting plasma glucose, especially among men.
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Affiliation(s)
- Na Li
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Yumei Wang
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Lulu Yu
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Mei Song
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Lan Wang
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Chunpeng Ji
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Xueyi Wang
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
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Park J, Kim MS, Nho H, Kim KA, Kim JK, Choi HM. The Effect of Cardiovascular Responses after Aerobic Exercise in Menstrual Cycle. Health (London) 2017. [DOI: 10.4236/health.2017.93030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Baker SE, Limberg JK, Ranadive SM, Joyner MJ. Neurovascular control of blood pressure is influenced by aging, sex, and sex hormones. Am J Physiol Regul Integr Comp Physiol 2016; 311:R1271-R1275. [PMID: 27856414 DOI: 10.1152/ajpregu.00288.2016] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/01/2016] [Accepted: 11/14/2016] [Indexed: 11/22/2022]
Abstract
In this review, we highlight that the relationship between muscle sympathetic nerve activity (MSNA) and mean arterial pressure is complex, differs by sex, and changes with age. In young men there is an inverse relationship between MSNA and cardiac output where high MSNA is compensated for by low cardiac output. This inverse relationship is not seen in older men. In young women sympathetic vasoconstriction is offset by β-adrenoreceptor mediated vasodilation, limiting the ability of young women to maintain blood pressure in response to orthostatic stress. However, β-mediated dilation in women is attenuated with age, leading to unopposed α-adrenergic vasoconstriction and a rise in the direct transduction of MSNA into increases in blood pressure. We propose that these changes with age and menopausal status are major contributing factors in the increased prevalence of hypertension in older women. In addition to aging, we highlight that changes in sex hormones in young women (across the menstrual cycle, with oral contraceptive use, or with pregnancy) influence MSNA and the transduction of MSNA into increases in blood pressure. It is likely that the β-adrenergic receptors and/or changes in baroreflex sensitivity play a large role in these sex differences and changes with alterations in sex hormones.
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Affiliation(s)
- Sarah E Baker
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
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Usselman CW, Nielson CA, Luchyshyn TA, Gimon TI, Coverdale NS, Van Uum SHM, Shoemaker JK. Hormone phase influences sympathetic responses to high levels of lower body negative pressure in young healthy women. Am J Physiol Regul Integr Comp Physiol 2016; 311:R957-R963. [PMID: 27733385 DOI: 10.1152/ajpregu.00190.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/28/2016] [Accepted: 10/11/2016] [Indexed: 01/03/2023]
Abstract
We tested the hypothesis that sympathetic responses to baroreceptor unloading may be affected by circulating sex hormones. During lower body negative pressure at -30, -60, and -80 mmHg, muscle sympathetic nerve activity (MSNA), heart rate, and blood pressure were recorded in women who were taking (n = 8) or not taking (n = 9) hormonal contraceptives. All women were tested twice, once during the low-hormone phase (i.e., the early follicular phase of the menstrual cycle and the placebo phase of hormonal contraceptive use), and again during the high-hormone phase (i.e., the midluteal phase of the menstrual cycle and active phase of contraceptive use). During baroreceptor unloading, the reductions in stroke volume and resultant increases in MSNA and total peripheral resistance were greater in high-hormone than low-hormone phases in both groups. When normalized to the fall in stroke volume, increases in MSNA were no longer different between hormone phases. While stroke volume and sympathetic responses were similar between women taking and not taking hormonal contraceptives, mean arterial pressure was maintained during baroreceptor unloading in women not taking hormonal contraceptives but not in women using hormonal contraceptives. These data suggest that differences in sympathetic activation between hormone phases, as elicited by lower body negative pressure, are the result of hormonally mediated changes in the hemodynamic consequences of negative pressure, rather than centrally driven alterations to sympathetic regulation.
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Affiliation(s)
- Charlotte W Usselman
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Chantelle A Nielson
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Torri A Luchyshyn
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Tamara I Gimon
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Nicole S Coverdale
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
| | - Stan H M Van Uum
- Department of Medicine, Western University, London, Ontario, Canada.,Lawson Health Research Institute, Western University, London, Ontario, Canada; and
| | - 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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Sympathetic neural and cardiovascular responses during static handgrip exercise in women with a history of hypertensive pregnancy. Clin Auton Res 2016; 26:395-405. [PMID: 27506589 DOI: 10.1007/s10286-016-0372-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 07/26/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE Women with a history of hypertensive pregnancy are at greater risk for future cardiovascular events; however, the mechanisms for this increased risk are unknown. Evidence suggests that an exercise stimulus unmasks latent hypertensive tendencies, identifying individuals at the greatest risk for developing cardiovascular disease. The current study examined the hypothesis that women with a hypertensive pregnancy history exhibit an augmented exercise pressor response. METHODS Normotensive women with a history of healthy pregnancy (CON; n = 9) and hypertensive pregnancy (HP+; n = 12) were studied during the mid-luteal phase of the menstrual cycle. Heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), and muscle sympathetic nerve activity (MSNA) were measured during a cold pressor test (CPT), and, following a sufficient period of recovery, during static handgrip to fatigue (SHG) and post-exercise circulatory arrest (PECA). RESULTS The BP, HR, and MSNA responses to the CPT were similar between groups. The SBP response to SHG and PECA was similar between groups, but DBP and HR were significantly greater in HP+ women (both p < 0.05). MSNA burst frequency, but not burst incidence or total activity, tended to be elevated in HP+ women during the stressor (peak Δ from baseline 31 ± 13 vs. 23 ± 13 bursts/min; p for group = 0.06). CONCLUSION Despite no clinical signs of cardiovascular disease or hypertension, women with a history of hypertensive pregnancy display an enhanced cardiovascular reactivity to an exercise stimulus compared to women with a healthy pregnancy history. This response may be indicative of impaired cardiovascular control that precedes the clinical manifestation of hypertension or cardiovascular events.
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Abstract
This brief review highlights new ideas about the role of the sympathetic nervous system in human blood pressure regulation. We emphasize how this role varies with age and sex and use our findings to raise questions about the sympathetic nervous system and hypertension in humans. We also focus on three additional areas, including (1) novel ideas about the carotid body and sympathoexcitation as it relates to hypertension, (2) clinical trials of renal denervation that attempted to treat hypertension by reducing ongoing sympathoexcitation, and (3) new ideas about resistant hypertension and cerebral blood flow. We further highlight that success of device-based therapy to modulate the sympathetic nervous system relies heavily on patient selection. Furthermore, data suggest that the majority of patients respond to anti-hypertensive therapy and the major cause of "resistant" hypertension is poor patient adherence. While the enthusiasm for device therapy or perhaps even "precision medicine" is high, it is likely that by far the most benefit to the most patients will occur via better screening, more aggressive therapy, and the development of strategies that improve patient adherence to medication regimens and lifestyle changes.
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Affiliation(s)
- Michael J Joyner
- Department of Anesthesiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, USA.
| | - Jacqueline K Limberg
- Department of Anesthesiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, USA
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The hypertension of Cushing's syndrome: controversies in the pathophysiology and focus on cardiovascular complications. J Hypertens 2016; 33:44-60. [PMID: 25415766 PMCID: PMC4342316 DOI: 10.1097/hjh.0000000000000415] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cushing's syndrome is associated with increased mortality, mainly due to cardiovascular complications, which are sustained by the common development of systemic arterial hypertension and metabolic syndrome, which partially persist after the disease remission. Cardiovascular diseases and hypertension associated with endogenous hypercortisolism reveal underexplored peculiarities. The use of exogenous corticosteroids also impacts on hypertension and cardiovascular system, especially after prolonged treatment. The mechanisms involved in the development of hypertension differ, whether glucocorticoid excess is acute or chronic, and the source endogenous or exogenous, introducing inconsistencies among published studies. The pleiotropic effects of glucocorticoids and the overlap of the several regulatory mechanisms controlling blood pressure suggest that a rigorous comparison of in-vivo and in-vitro studies is necessary to draw reliable conclusions. This review, developed during the first ‘Altogether to Beat Cushing's syndrome’ workshop held in Capri in 2012, evaluates the most important peculiarities of hypertension associated with CS, with a particular focus on its pathophysiology. A critical appraisal of most significant animal and human studies is compared with a systematic review of the few available clinical trials. A special attention is dedicated to the description of the clinical features and cardiovascular damage secondary to glucocorticoid excess. On the basis of the consensus reached during the workshop, a pathophysiology-oriented therapeutic algorithm has been developed and it could serve as a first attempt to rationalize the treatment of hypertension in Cushing's syndrome.
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Pinkham MI, Barrett CJ. Estradiol alters the chemosensitive cardiac afferent reflex in female rats by augmenting sympathoinhibition and attenuating sympathoexcitation. Clin Exp Pharmacol Physiol 2016; 42:622-31. [PMID: 25810130 DOI: 10.1111/1440-1681.12392] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/10/2015] [Accepted: 03/19/2015] [Indexed: 01/26/2023]
Abstract
The chemosensitive cardiac vagal and sympathetic afferent reflexes are implicated in driving pathophysiological changes in sympathetic nerve activity (SNA) in cardiovascular disease states. This study investigated the impact of sex and ovarian hormones on the chemosensitive cardiac afferent reflex. Experiments were performed in anaesthetized, sinoaortic baroreceptor denervated male, female and ovariectomized female (OVX) Wistar rats with either intact cardiac innervation or bilateral vagotomy. To investigate the chemosensitive cardiac afferent reflexes renal SNA, heart rate (HR) and arterial pressure (AP) were recorded before and following application of capsaicin onto the epicardial surface of the left ventricle. Compared to males, ovary-intact females displayed similar cardiac afferent reflex mediated changes in renal SNA albeit with a reduced maximum sympathetic reflex driven increase in renal SNA. In females, ovariectomy significantly attenuated the cardiac vagal afferent reflex mediated inhibition of renal SNA (renal SNA decreased 2 ± 17% in OVX versus -50 ± 4% in ovary-intact females, P < 0.05) and augmented cardiac sympathetic afferent reflex mediated sympathoexcitation (renal SNA increased 91 ± 11% in OVX vs 62 ± 9% in ovary-intact females, P < 0.05) so that overall increases in reflex driven sympathoexcitation were significantly enhanced. Chronic estradiol replacement, but not progesterone replacement, begun at time of ovariectomy restored cardiac afferent reflex responses to be similar as ovary-intact females. Vagal denervation eliminated all group differences. The current findings show ovariectomy in female rats, mimicking menopause in women, results in greater chemosensitive cardiac afferent reflex driven sympathoexcitation and does so, at least partly, via the loss of estradiols actions on the cardiac vagal afferent reflex pathway.
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Affiliation(s)
- Maximilian I Pinkham
- Circulatory Control Laboratory, Department of Physiology and Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Carolyn J Barrett
- Circulatory Control Laboratory, Department of Physiology and Bioengineering Institute, University of Auckland, Auckland, New Zealand
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Nielsen SE, Barber SJ, Chai A, Clewett DV, Mather M. Sympathetic arousal increases a negative memory bias in young women with low sex hormone levels. Psychoneuroendocrinology 2015; 62:96-106. [PMID: 26276087 PMCID: PMC4637251 DOI: 10.1016/j.psyneuen.2015.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 07/31/2015] [Accepted: 08/02/2015] [Indexed: 01/28/2023]
Abstract
Emotionally arousing events are typically better attended to and remembered than neutral ones. Current theories propose that arousal-induced increases in norepinephrine during encoding bias attention and memory in favor of affectively salient stimuli. Here, we tested this hypothesis by manipulating levels of physiological arousal prior to encoding and examining how it influenced memory for emotionally salient images, particularly those that are negative rather than positive in valence. We also tested whether sex steroid hormones interact with noradrenergic activity to influence these emotional memory biases in women. Healthy naturally cycling women and women on hormonal contraception completed one of the following physiological arousal manipulations prior to viewing a series of negative, positive and neutral images: (1) immediate handgrip arousal-isometric handgrip immediately prior to encoding, (2) residual handgrip arousal-isometric handgrip 15min prior to encoding, or (3) no handgrip. Sympathetic arousal was measured throughout the session via pupil diameter changes. Levels of 17β-estradiol and progesterone were measured via salivary samples. Memory performance was assessed approximately 10min after encoding using a surprise free recall test. The results indicated that handgrip successfully increased sympathetic arousal compared to the control task. Under immediate handgrip arousal, women showed enhanced memory for negative images over positive images; this pattern was not observed in women assigned to the residual and no-handgrip arousal conditions. Additionally, under immediate handgrip arousal, both high estradiol and progesterone levels attenuated the memory bias for negative over positive images. Follow-up hierarchical linear models revealed consistent effects when accounting for trial-by-trial variability in normative International Affective Picture System valence and arousal ratings. These findings suggest that heightened sympathetic arousal interacts with estradiol and progesterone levels during encoding to increase the mnemonic advantage of negative over positive emotional material.
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Affiliation(s)
- Shawn E Nielsen
- University of Southern California, Davis School of Gerontology, Los Angeles, CA 90089, USA.
| | - Sarah J Barber
- San Francisco State University, Psychology Department, San Francisco, CA 94132, USA
| | - Audrey Chai
- University of Southern California, Davis School of Gerontology, Los Angeles, CA 90089, USA
| | - David V Clewett
- University of Southern California, Neuroscience Graduate Program, Los Angeles, CA 90089, USA
| | - Mara Mather
- University of Southern California, Davis School of Gerontology, Los Angeles, CA 90089, USA; University of Southern California, Psychology Department, Los Angeles, CA 90089, USA; University of Southern California, Neuroscience Graduate Program, Los Angeles, CA 90089, USA
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Fonkoue IT, Carter JR. Sympathetic neural reactivity to mental stress in humans: test-retest reproducibility. Am J Physiol Regul Integr Comp Physiol 2015; 309:R1380-6. [PMID: 26400186 DOI: 10.1152/ajpregu.00344.2015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/16/2015] [Indexed: 02/03/2023]
Abstract
Mental stress consistently increases arterial blood pressure, but this reliable pressor response is often associated with highly variable muscle sympathetic nerve activity (MSNA) responsiveness between individuals. Although MSNA has been shown to be reproducible within individuals at rest and during the cold pressor test (CPT), intraindividual reproducibility of MSNA responsiveness to mental stress has not been adequately explored. The purpose of this study was to examine MSNA reactivity to mental stress across three experimental sessions. Sixteen men and women (age 21 ± 1 yr) performed two experimental sessions within a single laboratory visit and a third experimental session 1 mo later. Each experimental session consisted of a mental stress trial via mental arithmetic and a CPT trial. Blood pressure, heart rate (HR), and MSNA were measured, and the consistencies of these variables were determined using intraclass correlation (Cronbach's α coefficient). MSNA, mean arterial pressure (MAP), and HR were highly reproducible across the baselines preceding mental stress (Cronbach's α ≥ 0.816, P ≤ 0.001) and CPT (Cronbach's α ≥ 0.782, P ≤ 0.001). Across the three mental stress trials, changes in MSNA (Cronbach's α = 0.875; P = 0.001), MAP (Cronbach's α = 0.749; P < 0.001), and HR (Cronbach's α = 0.919; P < 0.001) were reproducible. During CPT, changes in MSNA (Cronbach's α = 0.805; P = 0.008), MAP (Cronbach's α = 0.878; P < 0.001), and HR (Cronbach's α = 0.927; P < 0.001) remained consistent across the three sessions. In conclusion, our findings demonstrate that MSNA reactivity to mental stress is consistent within a single laboratory visit and across laboratory sessions conducted on separate days.
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Affiliation(s)
- Ida T Fonkoue
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
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