Assessment of autonomic nervous system dysfunction and cardiovascular disease risk in young adults with intellectual disability

2020 ◽  
Author(s):  
Clara Christine Zwack ◽  
Rachael McDonald ◽  
Ainura Tursunalieva ◽  
Amali Cooray ◽  
Gavin W Lambert ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Nervous System ◽  
Young Adults ◽  
Intellectual Disability ◽  
Autonomic Nervous System ◽  
Systolic Blood Pressure ◽  
Autonomic Dysfunction ◽  
Blood Pressure Variability ◽  
Systolic Blood Pressure Variability

People with intellectual disability (ID) experience cardiometabolic related morbidity and mortality. However, it has been suggested that this population present and live with underestimated cardiovascular risk factors at a younger age, hence affecting their overall health, quality of life and contributing to early mortality. We assessed autonomic nervous system function in subjects with ID (n=39), aged 18-45 years, through measures of sudomotor function, heart rate and systolic blood pressure variability, and cardiac baroreflex function. Traditional clinical cardiovascular measurements and a biochemical analysis were also undertaken. We found that young adults with ID presented with sudomotor dysfunction, and impaired cardiac baroreflex sensitivity and systolic blood pressure variability, when compared to age-matched control subjects (n=38). Reduced hand and feet electrochemical skin conductance and asymmetry were significantly associated with having a moderate-profound ID. Autonomic dysfunction in those with ID persisted after controlling for age, sex and other metabolic parameters. Subjects in the ID group also showed significantly increased blood pressure, body mass index, waist/hip circumference ratio, and increased plasma haemoglobin A1c and high sensitivity C reactive protein. We conclude that autonomic dysfunction is present in young adults with ID and is more marked in those with more severe disability. These finding have important implications in developing preventative strategies to reduce the risk of cardiovascular disease in people with ID.

scholarly journals Age-specific associations of blood pressure variability with cardiovascular disease and mortality: 10-year Diabetes cohort study

2020 ◽  
Author(s):  
Eric Yuk Fai WAN ◽  
Esther Yee Tak Yu ◽  
Weng Yee Chin ◽  
Jessica K. Barrett ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Systolic Blood Pressure ◽  
Mortality Risk ◽  
Blood Pressure Variability ◽  
Hazard Ratio ◽  
Diabetic Patients ◽  
Age Group ◽  
Systolic Blood Pressure Variability

Abstract Background: This study evaluated the age-specific association of systolic blood pressure variability with cardiovascular disease and mortality in Type-2 diabetic patients. The detrimental effects of increased systolic blood pressure variability on cardiovascular disease and mortality risk in diabetic patients remains unclear. Methods: A retrospective cohort study investigated 155,982 diabetic patients aged from 45 to 84 years old without prior history of cardiovascular disease at baseline from 2008 to 2010). systolic blood pressure variability was estimated using systolic blood pressure standard deviation from mixed effects model to reduce regression dilution bias. Age-specific associations (45-54; 55-64; 65-74; 75-84 years) between systolic blood pressure variability, cardiovascular disease and mortality risk were assessed by Cox regression adjusted for patient characteristics with subgroups stratified by subject baseline characteristics. Results: After a median follow-up of 9.7 years (16.4 million person-years), 49,816 events (including 34,039 events with and 29,211 mortalities) were identified. Elevated and independent systolic blood pressure variability was positively and log-linearly associated with higher risk on cardiovascular disease and mortality among all age groups, without evidence of a specific threshold. The cardiovascular disease and mortality risk per 5mmHg increase in systolic blood pressure variability within 45-54 years age group is over three times higher than the 70-79 years age group [Hazard Ratio: 1.66 (1.49, 1.85) vs. Hazard Ratio: 1.19 (1.15, 1.23)]. The significant associations remained consistent among all subgroups. Patients with younger age, lower systolic blood pressure and comorbidity with more types of anti-hypertensive prescription drug users had higher hazard ratios. Conclusions: The findings suggest that systolic blood pressure variability was strongly associated with cardiovascular disease and mortality risk without evidence of a specific threshold in diabetic population. In addition to optimize blood pressure control, the systolic blood pressure variability particularly for younger patients should be monitored and evaluated in routine practice.

Long term habitual vigorous physical activity is associated with lower visit-to-visit systolic blood pressure variability

2020 ◽  
Author(s):  
Xiaoyong Xu ◽  
Xianghong Meng ◽  
Shin-ichi Oka
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Vigorous Physical Activity ◽  
Systolic Blood Pressure Variability ◽  
Average Real Variability ◽  
Post Hoc

Abstract Objective Our work aimed to investigate the association between vigorous physical activity and visit-to-visit systolic blood pressure variability (BPV). Methods We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (<120 mmHg) or standard (<140 mmHg) SBP targets. We assessed whether patients with hypertension who habitually engage in vigorous physical activity would have lower visit-to-visit systolic BPV compared with those who do not engage in vigorous physical activity. Visit-to-visit systolic BPV was calculated by standard deviation (SD), average real variability (ARV), and standard deviation independent of the mean (SDIM) using measurements taken during the 1-, 2-, 3-, 6-, 9- and 12-month study visits. A medical history questionnaire assessed vigorous physical activity, which was divided into three categories according to the frequency of vigorous physical activity. Results A total of 7571 participants were eligible for analysis (34.8% female, mean age 67.9±9.3 years). During a follow-up of 1-year, vigorous physical activity could significantly reduce SD, ARV, and SDIM across increasing frequency of vigorous physical activity. There were negative linear trends between frequency of vigorous physical activity and visit-to-visit systolic BPV. Conclusions Long-term engagement in vigorous physical activity was associated with lower visit-to-visit systolic BPV.

scholarly journals Post-Exertional Malaise May Be Related to Central Blood Pressure, Sympathetic Activity and Mental Fatigue in Chronic Fatigue Syndrome Patients

2021 ◽  
Vol 10 (11) ◽  
pp. 2327
Author(s):  
Sławomir Kujawski ◽  
Joanna Słomko ◽  
Lynette Hodges ◽  
Derek F. H. Pheby ◽  
Modra Murovska ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Systolic Blood Pressure ◽  
Sympathetic Activity ◽  
Chronic Fatigue ◽  
Mental Fatigue ◽  
Fatigue Syndrome ◽  
Central Systolic Blood Pressure

Post-exertional malaise (PEM) is regarded as the hallmark symptom in chronic fatigue syndrome (CFS). The aim of the current study is to explore differences in CFS patients with and without PEM in indicators of aortic stiffness, autonomic nervous system function, and severity of fatigue. One-hundred and one patients met the Fukuda criteria. A Chronic Fatigue Questionnaire (CFQ) and Fatigue Impact Scale (FIS) were used to assess the level of mental and physical fatigue. Aortic systolic blood pressure (sBPaortic) and the autonomic nervous system were measured with the arteriograph and Task Force Monitor, respectively. Eighty-two patients suffered prolonged PEM according to the Fukuda criteria, while 19 did not. Patients with PEM had higher FIS scores (p = 0.02), lower central systolic blood pressure (p = 0.02) and higher mental fatigue (p = 0.03). For a one-point increase in the mental fatigue component of the CFQ scale, the risk of PEM increases by 34%. For an sBPaortic increase of 1 mmHg, the risk of PEM decreases by 5%. For a one unit increase in sympathovagal balance, the risk of PEM increases by 330%. Higher mental fatigue and sympathetic activity in rest are related to an increased risk of PEM, while higher central systolic blood pressure is related to a reduced risk of PEM. However, none of the between group differences were significant after FDR correction, and therefore conclusions should be treated with caution and replicated in further studies.

scholarly journals Correction: Prognostic impact of systolic blood pressure variability in people with diabetes

PLoS ONE ◽  
2019 ◽  
Vol 14 (10) ◽  
pp. e0224538
Author(s):  
Katy J. L. Bell ◽  
Lamiae Azizi ◽  
Peter M. Nilsson ◽  
Andrew Hayen ◽  
Les Irwig ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Prognostic Impact ◽  
Systolic Blood Pressure Variability

Feedback effects of circulating norepinephrine on sympathetic outflow in healthy subjects

2005 ◽  
Vol 288 (2) ◽  
pp. H710-H715 ◽  
Author(s):  
Mikko P. Tulppo ◽  
Heikki V. Huikuri ◽  
Elli Tutungi ◽  
Derek S. Kimmerly ◽  
Adrian W. Gelb ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Sympathetic Activity ◽  
Healthy Subjects ◽  
Blood Pressure Variability ◽  
Feedback Inhibition ◽  
Adrenergic Blockade ◽  
Sympathetic Outflow ◽  
Systolic Blood Pressure Variability ◽  
Normalized Units

The amplitude of low-frequency (LF) oscillations of heart rate (HR) usually reflects the magnitude of sympathetic activity, but during some conditions, e.g., physical exercise, high sympathetic activity results in a paradoxical decrease of LF oscillations of HR. We tested the hypothesis that this phenomenon may result from a feedback inhibition of sympathetic outflow caused by circulating norepinephrine (NE). A physiological dose of NE (100 ng·kg−1·min−1) was infused into eight healthy subjects, and infusion was continued after α-adrenergic blockade [with phentolamine (Phe)]. Muscle sympathetic nervous activity (MSNA) from the peroneal nerve, LF (0.04–0.15 Hz) and high frequency (HF; 0.15–0.40 Hz) spectral components of HR variability, and systolic blood pressure variability were analyzed at baseline, during NE infusion, and during NE infusion after Phe administration. The NE infusion increased the mean blood pressure and decreased the average HR ( P < 0.01 for both). MSNA (10 ± 2 vs. 2 ± 1 bursts/min, P < 0.01), LF oscillations of HR (43 ± 13 vs. 35 ± 13 normalized units, P < 0.05), and systolic blood pressure (3.1 ± 2.3 vs. 2.0 ± 1.1 mmHg2, P < 0.05) decreased significantly during the NE infusion. During the NE infusion after PHE, average HR and mean blood pressure returned to baseline levels. However, MSNA (4 ± 2 bursts/min), LF power of HR (33 ± 9 normalized units), and systolic blood pressure variability (1.7 ± 1.1 mmHg2) remained significantly ( P < 0.05 for all) below baseline values. Baroreflex gain did not change significantly during the interventions. Elevated levels of circulating NE cause a feedback inhibition on sympathetic outflow in healthy subjects. These inhibitory effects do not seem to be mediated by pressor effects on the baroreflex loop but perhaps by a presynaptic autoregulatory feedback mechanism or some other mechanism that is not prevented by a nonselective α-adrenergic blockade.

Sign in / Sign up

Export Citation Format

Share Document