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Suzuki M, Tsuchida T, Ibe A. Cold sensitivity among female clinical nurses in Japan: A nationwide study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 6:100208. [PMID: 38840896 PMCID: PMC11152699 DOI: 10.1016/j.ijnsa.2024.100208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/08/2024] [Accepted: 05/10/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan. Design A cross-sectional post survey research design. Settings The questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan. Participants 1,138 female nurses. Methods The survey captured participants' characteristics, work environment, health, and lifestyle. The factors investigated were perceived cold sensitivity, cold sensitivity according to the Hiesho Sensation Scale, and cold sensitivity during nursing care. The Diagnostic Inventory of Health and Life Habits (DIHAL.2) assessed health and lifestyle habits. Results Of the respondents, 44.3 % were aware of daily cold sensitivity and 21.4 % had a cold sensitivity disorder. The majority of respondents (63.1 %) felt cold in their hands when providing nursing care, and 28.1 % felt discomfort due to the coldness of their hands. Individuals diagnosed with cold sensitivity disorders exhibited poorer overall health compared to those without such disorders. However, there was no statistically significant difference in the overall health status between individuals who reported perceiving cold sensitivity and those who did not. The group with perceived cold sensitivity had significantly lower scores on exercise behavior, meal regularity, rest, sleep regularity, and sleep sufficiency. The proportion of female nurses working in Japanese hospitals who experienced cold sensitivity was similar to that of Japanese women with the same sensitivity. Most female nurses experienced cold in their hands while providing care. Nearly 30 % of the respondents experienced discomfort owing to cold hands. Conclusions The study underscores the widespread issue of cold sensitivity among female nurses in Japanese hospitals, emphasizing the critical need for targeted interventions to improve their comfort and optimize care provision.
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Affiliation(s)
- Miyuki Suzuki
- School of Nursing, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan
| | - Toshie Tsuchida
- School of Nursing, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan
| | - Aki Ibe
- Faculty of Nursing Science, Tsuruga Nursing University, 78-2-1 Kizaki, Tsuruga, Fukui, 914-0814, Japan
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Mun S, Yoo J, Lee S, Yim MH, Kim S, Kim D, Kim MJ, Lee Y, Park JH. Resting energy expenditure differs among individuals with different levels of perceived thermal sensitivity: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38293. [PMID: 38787987 PMCID: PMC11124673 DOI: 10.1097/md.0000000000038293] [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: 01/06/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Metabolic rate has been used in thermophysiological models for predicting the thermal response of humans. However, only a few studies have investigated the association between an individual's trait-like thermal sensitivity and resting energy expenditure (REE), which resulted in inconsistent results. This study aimed to explore the association between REE and perceived thermal sensitivity. The REE of healthy adults was measured using an indirect calorimeter, and perceived thermal intolerance and sensation in the body were evaluated using a self-administered questionnaire. In total, 1567 individuals were included in the analysis (women = 68.9%, age = 41.1 ± 13.2 years, body mass index = 23.3 ± 3.3 kg/m2, REE = 1532.1 ± 362.4 kcal/d). More women had high cold intolerance (31.8%) than men (12.7%), and more men had high heat intolerance (23.6%) than women (16.1%). In contrast, more women experienced both cold (53.8%) and heat (40.6%) sensations in the body than men (cold, 29.1%; heat, 27.9%). After adjusting for age, fat-free mass, and fat mass, lower cold intolerance, higher heat intolerance, and heat sensation were associated with increased REE only in men (cold intolerance, P for trend = .001; heat intolerance, P for trend = .037; heat sensation, P = .046), whereas cold sensation was associated with decreased REE only in women (P = .023). These findings suggest a link between the perceived thermal sensitivity and REE levels in healthy individuals.
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Affiliation(s)
- Sujeong Mun
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Junghun Yoo
- Department of Health Care Policy, Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Sanghun Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Mi Hong Yim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Soyoung Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Daehyeok Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Min-Ji Kim
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Youngseop Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jeong Hwan Park
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Chang CJ, Fan YH, Chiu YC, Cheng WM. Cold hypersensitivity in the hands and feet is associated with erectile dysfunction in young Taiwanese men. Sci Rep 2024; 14:10577. [PMID: 38719920 PMCID: PMC11078973 DOI: 10.1038/s41598-024-60260-x] [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: 01/22/2024] [Accepted: 04/20/2024] [Indexed: 05/12/2024] Open
Abstract
Cold hypersensitivity in the hands and feet (CHHF) is a protective or predisposing factor for many diseases; however, the relationship between CHHF and erectile dysfunction (ED) remains unclear. We aimed to investigate associations between CHHF and ED among young men of Southeast Asian origin. In this cross-sectional study, sexually active Taiwanese men aged 20-40 years were enrolled via an online questionnaire comprising general demographic information, comorbidities, subjective thermal sensations of their hands and feet in the past 6 months, and their erectile function using the International Index of Erectile Function-5 (IIEF-5). Participants who reported cold sensation of hands and feet were classified to have CHHF; those with IIEF-5 score ≤ 21 were considered to have ED. Total 54.2% and 27.9% of participants had ED and CHHF, respectively. Men with CHHF were significantly younger, had lower body mass index and IIEF-5 scores (p < 0.001), and a lower prevalence of diabetes mellitus (p = 0.033) along with higher prevalence of ED, psychiatric disorders, and insomnia (p < 0.001). After adjusting for predisposing factors of ED, CHHF (odds ratio 1.410, 95% confidence interval 1.159-1.714; p = 0.001) remained an independent predictor of ED. Thus, CHHF is independently associated with ED, affecting more than a quarter of young Taiwanese men. Autonomic dysregulation and subclinical endothelial dysfunction may be common pathophysiologies of CHHF and ED.
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Affiliation(s)
- Che-Jui Chang
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yu-Hua Fan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Chun Chiu
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan
| | - Wei-Ming Cheng
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan.
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Baek Y, Jung K, Kim H, Lee S. Partial sleep restriction-induced changes in stress, quality of life, and lipid metabolism in relation to cold hypersensitivity: A before-and-after intervention study. Medicine (Baltimore) 2022; 101:e31933. [PMID: 36401418 PMCID: PMC9678581 DOI: 10.1097/md.0000000000031933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Sleep disturbances are associated with cold hypersensitivity (CH) and characterized by excessive cold sensation in specific body parts and cold thermal discomfort. This study investigated the effects of short-term sleep restriction followed by a recovery phase on subjective health status, inflammation, and lipid metabolism in different types of CH. A total of 118 healthy adults aged 35 to 44 years without sleep disturbances were enrolled. Participants underwent 4-hour sleep restrictions per day for 3 days at a hospital and then returned to their daily lives for 4 days of rest. CH was assessed using a structured questionnaire with eight characteristic symptoms. A questionnaire and blood tests were administered baseline, after sleep restriction, and follow-up to assess cortisol, lipid profiles, and self-reported stress and quality of life (QOL). Participants were divided into CH (44.1%) and non-CH (55.9%) groups. The CH group showed increased stress, impaired QOL, and decreased low-density lipoprotein-cholesterol (LDL-C) levels compared to the non-CH group after sleep restriction. The variance for QOL (effect size = 0.07), subjective stress (effect size = 0.053), and LDL-C (effect size = 0.029) among time points depended on the group. Short-term sleep restriction was associated with deterioration of subjective health and reduced lipid metabolism; such changes were more evident in the CH group. Our findings suggest the need to consider an individual's CH status to assess the clinical risk associated with insufficient sleep.
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Affiliation(s)
- Younghwa Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyoungsik Jung
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hoseok Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- *Correspondence: Siwoo Lee, KM Data Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Republic of Korea (e-mail: )
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Park SM, Baek SJ, Ban HJ, Jin HJ, Cha S. Systematic Analysis of the Molecular Mechanisms of Cold and Hot Properties of Herbal Medicines. PLANTS (BASEL, SWITZERLAND) 2022; 11:plants11070997. [PMID: 35406976 PMCID: PMC9002596 DOI: 10.3390/plants11070997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 05/03/2023]
Abstract
Effective treatments for patients experiencing temperature-related symptoms are limited. The hot and cold effects of traditional herbal medicines have been utilized to treat and manage these symptoms, but their molecular mechanisms are not fully understood. Previous studies with arbitrarily selected herbs and ingredients may have produced biased results. Here, we aim to systematically elucidate the molecular mechanisms of the hot and cold properties of herbal medicines through an unbiased large-scale investigation of herbal ingredients, their target genes, and the transcriptome signatures induced by them. Using data regarding 243 herbs retrieved from two herbal medicine databases, we statistically identify (R)-Linalool, (-)-alpha-pinene, peruviol, (L)-alpha-terpineol, and cymol as five new hot-specific ingredients that share a common target, a norepinephrine transporter. However, no significant ingredients are cold-specific. We also statistically identify 14 hot- and 8 cold-specific new target genes. Pathway enrichment analysis of hot-specific target genes reveals the associated pathways including neurotransmitter reuptake, cold-induced thermogenesis, blood pressure regulation, adrenergic receptor signaling, and cation symporter activity. Cold-specific target genes are associated with the steroid pathway. Transcriptome analysis also shows that hot herbs are more strongly associated with coagulation and synaptic transmission than cold herbs. Our results, obtained from novel connections between herbal ingredients, target genes, and pathways, may contribute to the development of pharmacological treatment strategies for temperature-related pain using medicinal plants.
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Affiliation(s)
- Sang-Min Park
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea
| | - Su-Jin Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Hyo-Jeong Ban
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Hee-Jeong Jin
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Seongwon Cha
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
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Mun S, Park K, Lee S. Evaluation of thermal sensitivity is of potential clinical utility for the predictive, preventive, and personalized approach advancing metabolic syndrome management. EPMA J 2022; 13:125-135. [PMID: 35265229 PMCID: PMC8897525 DOI: 10.1007/s13167-022-00273-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/23/2022] [Indexed: 01/28/2023]
Abstract
A possible association between metabolic disorders and ambient temperature has been suggested, and cold exposure as a way of increasing energy expenditure has gained considerable interest for preventative/therapeutic measures toward metabolic disorders. Although thermal sensitivity, which has recently been studied in regard to its utility as a risk assessment/patient stratification for various diseases, might influence physiological responses to ambient temperature on an individual basis, more studies are needed. We aimed to investigate the association between self-identified thermal intolerance/sensation and metabolic syndrome (MetS) to verify the working hypothesis that individuals with altered thermal sensitivity may have a predisposition to MetS. We fitted generalized additive models for thermal intolerance/sensation using body mass index (BMI) and waist–hip ratio in women, and identified those with higher/lower thermal intolerance/sensation than those predicted by the models. Higher heat intolerance, higher heat sensation, and lower cold intolerance were associated with a higher prevalence of MetS. The risk of having MetS was increased in those who had two or three associated conditions compared with those with none of these conditions. In an analysis for MetS components, significant associations of thermal sensitivity were present with high glucose, triglyceride, and blood pressure levels. Overall, higher heat intolerance/sensation and lower cold intolerance were associated with increased prevalence of MetS even at a similar level of obesity. Our study indicates that evaluation of thermal sensitivity may help identify individuals at high risk for MetS, and lead to more advanced patient stratification and personalized treatment strategies for MetS, including cold-induced thermogenesis.
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Matsuura Y, Akamine K, Murakami A, Wada T, Atsumi H, Kane E, Yano M, Yasui T. Associations between Sensitivity to Cold, Menstruation-Related Symptoms and Handgrip Strength in Female University Students in Japan. Health (London) 2021. [DOI: 10.4236/health.2021.135040] [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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The Relationship between Cold Hypersensitivity in the Hands and Feet and Health-Related Quality of Life in Koreans: A Nationwide Population Survey. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:6217036. [PMID: 31118964 PMCID: PMC6500598 DOI: 10.1155/2019/6217036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/17/2019] [Indexed: 01/28/2023]
Abstract
Aim We investigated the distribution of cold hypersensitivity in the hands and feet (CHHF) and examined the association between CHHF and health-related quality of life (HRQOL) among Koreans. Methods Stratified multistage sampling was used for random selection of 2,201 adults. HRQOL was assessed using the Short-Form 12-Item Health Survey (SF-12). Cold hypersensitivity was measured using a new self-report questionnaire to score the extent of cold sensation in their hands, feet, and abdomen using a 7-point scale. The correlation between CHHF and HRQOL was analysed using multiple regression analysis. Results Cold hypersensitivity was present in the hands of 21.6%, the feet of 23.0%, and the abdomen in 22.5% of participants. Cold hypersensitivity in the hands and feet was observed in 17.9%, at least one body part (hands, feet, or abdomen) in 34.2%, and all three body regions in 12.3% of participants. The prevalence of cold hypersensitivity was significantly higher among women than among men, irrespective of the involved body part. Cold hypersensitivity scores in the hands and feet correlated negatively with body mass index, but not with age. The physical component summary (PCS) and mental component summary (MCS) of the SF-12 were both significantly lower in women with than in those without CHHF. Among men, only the PCS was significantly lower in the CHHF group. Multiple regression analysis, adjusted for sociodemographic variables, age, sex, and body mass index (BMI), confirmed that CHHF had negative effects on PCS and MCS. Conclusions CHHF is more common in women and in individuals with a lower BMI. CHHF has an independent negative effect on HRQOL.
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Bae KH, Go HY, Park KH, Ahn I, Yoon Y, Lee S. The association between cold hypersensitivity in the hands and feet and chronic disease: results of a multicentre study. Altern Ther Health Med 2018; 18:40. [PMID: 29385996 PMCID: PMC5793341 DOI: 10.1186/s12906-018-2082-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 01/08/2018] [Indexed: 02/06/2023]
Abstract
Background Cold hypersensitivity in the hands and feet (CHHF) is a common symptom in Korea and patients with CHHF complain of coldness in the hands and feet in an environment that is not considered cold by unaffected people. In traditional East Asian medicine, CHHF is believed to be accompanied by various diseases and symptoms, and is considered a symptom that needs active treatment. CHHF is used for pattern identification in the cold pattern, yang deficiency, and constitution. This study aimed to examine the differences in frequencies of chronic diseases with respect to the presence of CHHF. Methods Disease history, CHHF, body measurements, and blood test survey data from 6149 patients collected by 25 medical institutes in Korea were obtained from the Korean Medicine Data Center. The participants were divided into CHHF (n = 1909) and non-CHHF groups (n = 3017) according to the CHHF survey. The differences in frequencies of 18 diseases were analysed using chi-square tests, and the odds ratios (ORs) for each disease according to CHHF status were examined via logistic regression with adjustment for age, sex, and body mass index (BMI). Results Based on chi-square test results, the CHHF group showed a higher frequency of the following diseases: anaemia, hypotension, chronic gastritis, reflux oesophagitis, chronic rhinitis, dysmenorrhoea, and gastroduodenal ulcer. Diseases found in lower frequencies were as follows: hypertension, diabetes mellitus, impaired fasting glucose, dyslipidaemia, stroke, fatty liver, and angina pectoris. In addition, from the logistic regression with adjustment for age, sex, and BMI, the CHHF group showed a lower OR in diabetes mellitus and dyslipidaemia than the non-CHHF group, but a higher OR in degenerative arthritis, chronic gastritis, gastroduodenal ulcer, reflux oesophagitis, and chronic rhinitis. Conclusions This study showed that CHHF is associated with chronic disease. Further large-scale prospective studies are needed to validate these associations.
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The Association of Quantitative Facial Color Features with Cold Pattern in Traditional East Asian Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:9284856. [PMID: 29234442 PMCID: PMC5664382 DOI: 10.1155/2017/9284856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/13/2017] [Indexed: 11/17/2022]
Abstract
Introduction Facial diagnosis is a major component of the diagnostic method in traditional East Asian medicine. We investigated the association of quantitative facial color features with cold pattern using a fully automated facial color parameterization system. Methods The facial color parameters of 64 participants were obtained from digital photographs using an automatic color correction and color parameter calculation system. Cold pattern severity was evaluated using a questionnaire. Results The a⁎ values of the whole face, lower cheek, and chin were negatively associated with cold pattern score (CPS) (whole face: B = -1.048, P = 0.021; lower cheek: B = -0.494, P = 0.007; chin: B = -0.640, P = 0.031), while b⁎ value of the lower cheek was positively associated with CPS (B = 0.234, P = 0.019). The a⁎ values of the whole face were significantly correlated with specific cold pattern symptoms including cold abdomen (partial ρ = -0.354, P < 0.01) and cold sensation in the body (partial ρ = -0.255, P < 0.05). Conclusions a⁎ values of the whole face were negatively associated with CPS, indicating that individuals with increased levels of cold pattern had paler faces. These findings suggest that objective facial diagnosis has utility for pattern identification.
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Konieczka K, Erb C. Diseases potentially related to Flammer syndrome. EPMA J 2017; 8:327-332. [PMID: 29209435 PMCID: PMC5700007 DOI: 10.1007/s13167-017-0116-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/22/2017] [Indexed: 02/03/2023]
Abstract
Flammer syndrome (FS) is a prevalent and mostly benign condition. Subjects with FS seem to have a good life expectancy. Nevertheless, FS subjects are at increased risk for certain diseases, mainly when they are challenged by psychological stress or other stimuli such as coldness. FS is related to ocular diseases, such as normal-tension glaucoma, retinitis pigmentosa, central serous chorioretinopathy, optic nerve compartment syndrome, Leber’s hereditary optic neuropathy, arterial or venous occlusions in the retina, and choroid and optic nerve head, despite the absence of classical vascular risk factors. FS is also related to some non-ocular diseases, such as multiple sclerosis, breast cancer, and altitude sickness. The role of FS in other diseases such as tinnitus, sudden hearing loss, Ménière’s disease, anorexia nervosa, and thyroid dysfunction is currently under investigation. The exact relationship of FS to related diseases however still needs to be established. This may hopefully lead to more targeted diagnostics and personalized treatments.
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Affiliation(s)
- Katarzyna Konieczka
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Carl Erb
- Eye Clinic Wittenbergplatz, Berlin, Germany
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Barthelmes J, Nägele MP, Ludovici V, Ruschitzka F, Sudano I, Flammer AJ. Endothelial dysfunction in cardiovascular disease and Flammer syndrome-similarities and differences. EPMA J 2017; 8:99-109. [PMID: 28824736 DOI: 10.1007/s13167-017-0099-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/21/2017] [Indexed: 12/25/2022]
Abstract
The endothelium has increasingly been recognized as a smart barrier and a key regulator of blood flow in micro- and macrovascular beds. Endothelial dysfunction marks a stage of atherosclerosis and is an important prognostic marker for cardiovascular disease. Yet, some people who tend to be slim and physically active and with rather low blood pressure show a propensity to respond to certain stimuli such as emotional stress with endothelial-mediated vascular dysregulation (Flammer syndrome). This leads to characteristic vascular symptoms such as cold hands but also a risk for vascular-mediated diseases such as normal-tension glaucoma. It is the aim of this review to delineate the differences between Flammer syndrome and its "counterpart" endothelial dysfunction in the context of cardiovascular diseases.
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Affiliation(s)
- Jens Barthelmes
- University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Matthias P Nägele
- University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Valeria Ludovici
- University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Frank Ruschitzka
- University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Isabella Sudano
- University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Andreas J Flammer
- University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091 Zurich, Switzerland
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