Association of blood pressure and antihypertensive drugs with diurnal alpha-amylase activity

Evaluation of Salivary Mucin, Amylase, Protein Profile, and Periodontal Parameters among Hypertensive and Diabetic Patients

Systemic and localized oral disease instigates alterations in salivary composition and content. The objective of the study was to evaluate the levels of salivary amylase, mucin, total protein levels, and periodontal inflammatory parameters in Type 2 Diabetes mellitus (T2DM), hypertensive (HTN) patients, and healthy controls. The study sample was divided into three groups: healthy, T2DM, and HTN. Salivary samples were collected from the included participants and salivary flow rate (SFR) and pH were measured. The salivary levels of amylase, mucin, and total protein concentration were analyzed using an enzyme-linked immunosorbent assay. The effect of anti-hypertensive and hypoglycemic drugs on the salivary flow rate, salivary pH, mucin, amylase, and total protein concentrations was evaluated. The results were analyzed with Chi-squared and analysis of variance to compare the means and standard deviations of variables among the study groups. SFR was significantly (p < 0.01) lower among diabetics (0.78 ± 0.45 mL/min) in comparison to healthy (1.52 ± 0.62 mL/min) and hypertensive (1.07 ± 0.7 mL/min) subjects. PISA values were significantly higher in T2DM (1029 ± 234.6 mm2) and HTN (799.4 ± 155.05 mm2) subjects when compared to controls, indicating a high inflammatory burden of oral cavity caused by these conditions, and showed statistically significant difference between the groups (p-value < 0.001). Mucin levels were significantly higher (p-value < 0.05) in hypertensive patients (4.6 ± 1.17 units) compared to diabetics (3.59 ± 1.03 unit/mL) and healthy (2.26 ± 1.09 units/mL) subjects. Amylase levels were significantly higher among healthy subjects (1.76 ± 0.75 mg/mL) compared to both hypertensive (1.33 ± 1.0 mg/mL) and diabetic (0.88 ± 0.57 mg/mL) patients. Total protein concentration was significantly raised (p-value < 0.001) in diabetics (37.67 ± 3.12 mg/mL) compared to healthy (29.3 ± 3.22 mg/mL) subjects. Significant differences in BOP, CAL, and PPD was observed (p-value < 0.001). Use of antihypertensive and hypoglycemic drugs showed a significant influence on salivary flow rate, protein, mucin, and amylase levels. T2DM and HTN induced irregularities in salivary flow rate, pH, amylase, and mucin levels and showed an increased incidence of moderate to severe periodontitis in patients. UWS levels of SFR, mucin, amylase, and total protein can be used as diagnostic and therapeutic biomarkers in patients with T2DM and HTN with oral disease.

Hyperreactivity of Salivary Alpha-Amylase to Acute Psychosocial Stress and Norepinephrine Infusion in Essential Hypertension

It is unknown whether the observed general physiological hyperreactivity to acute psychosocial stress in essential hypertension also extends to salivary alpha-amylase (sAA), a surrogate sympathetic nervous system marker. Here, we investigated sAA reactivity to acute psychosocial stress in essential hypertensive males (HT) as compared to normotensive controls (NT). To shed light on underlying mechanisms, we moreover tested for sAA reactivity following a standardized norepinephrine (NE) infusion. We hypothesized that both acute psychosocial stress and an NE infusion of similar duration would lead to greater sAA reactivity in HT than in NT. In the stress study, we examined sAA reactivity to 15 min of acute psychosocial stress induced by the Trier Social Stress Test (TSST) in 19 HT and 23 NT up to 40 min after stress. In the infusion study, 20 HT and 22 NT received a standardized NE infusion (5 μg/mL/min) over 15 min mimicking NE release in reaction to acute psychosocial stress. HT exhibited greater sAA reactivity to the TSST as compared to NT (p = 0.049, η_p² = 0.08, f = 0.29). In reaction to the standardized NE infusion, HT showed higher sAA reactivity as compared to NT (p = 0.033, η_p² = 1.00, f = 0.33). Our findings suggest stress-induced sAA hyperreactivity in essential hypertension that seems to be at least in part mediated by a higher reactivity to a standardized amount of NE in HT. With respect to clinical implications, sAA stress reactivity may serve as a noninvasive marker indicative of early cardiovascular risk.

Effect of Yoga on Blood Pressure in Prehypertension: A Systematic Review and Meta-Analysis

Introduction

Prehypertension is a precursor for developing hypertension and is a risk factor for cardiovascular diseases. Yoga therapy may have a role in lowering the blood pressures in prehypertension and hypertension. This systematic review aims to synthesize the available literature for the same. Methodology. Databases such as PubMed, Embase, Scopus, and Web of Science were searched for randomised control trials only in the time duration of 2010–2021. The main outcome of interest was systolic and diastolic blood pressures. Articles were screened based on the inclusion criteria, and 8 articles were recruited for the review. Meta-analysis was done for suitable articles. RevMan 5.4 by Cochrane was used for meta-analysis and forest plot construction. Risk of bias was determined using the Downs and Black checklist by three independent authors.

Results

The meta-analysis of the articles favoured yoga intervention over the control intervention. Yoga therapy had significantly reduced the systolic pressure (−0.62 standard mean difference, at IV fixed 95% CI: −0.83, −0.41) and diastolic pressure (−0.81 standard mean difference, at IV random 95% CI: −1.39, −0.22). Secondary outcome measures studied were heart rate, weight, BMI, waist circumference, and lipid profile. The main protocol of yoga therapy included postures, breathing exercises, and different meditation techniques. A significant reduction in secondary outcomes was observed, except for HDL values in lipid profile which showed a gradual increase in yoga group in comparison with alternative therapy.

Conclusion

Yoga therapy has shown to be significant in the reduction of systolic and diastolic pressure in prehypertensive population. Supporting evidence lacks in providing a proper structured dosage of yoga asanas and breathing techniques. Considering the existing literature and evidence, Yoga therapy can be used and recommended in prehypertensive population and can be beneficial in reducing the chances of developing hypertension or cardiovascular diseases.

Association of salivary alpha-amylase and salivary flow rate with working memory functioning in healthy children

The aim of this study was to examine the association between auditory and visual working memory (WM) performance and salivary alpha-amylase (sAA) and salivary flow rate (SFR) in a sample of 63 children (38 boys). WM was assessed by means of WISC-V subtests: four auditory subtests (Digit Span and Letter-Number Sequencing) and one visual subtest (Picture Span). SAA activity, output, and SFR were measured at baseline (10 min prior to testing), one minute prior to testing, one minute after the end of the auditory WM subtests and one minute after the end of the visual WM subtest. Our statistical analyses showed an association among SAA activity, output and SFR levels and the number of recalled digits in the last attempt score in Letter-Number Sequencing subtest. Specifically, our results showed that working performance in this task was associated with a concurrent decrease in SFR (r(63) = -0.423, p < .05). This salivary measure was the best predictor of this specific index of working memory performance (β = -0.423, p < .05). These results show that the changes in SFR, which represents changes in parasympathetic tone, could be employed in future studies as a noninvasive marker of working memory performance in child studies.

Low subjective social status in the police is linked to health-relevant changes in diurnal salivary alpha-amylase activity in Swiss police officers

The objective of this study was to assess basal autonomic nervous system (ANS) activity as a pathway linking subjective social status to health in a high-demand work environment. It was hypothesized that officers with a lower status experienced more chronic stress (higher basal ANS activity) and that chronic stress was related to more health problems. Fifty-six male and female Swiss police officers self-reported on subjective social status (country, community, friends, police) and their health (depression, post-traumatic stress, physical symptoms) and collected 12 saliva samples over two days for basal α-amylase activation (sAA) assessment. Multilevel regression analyses revealed that subjective social status in the police and physical symptoms explained a significant part of the variance in diurnal sAA activity patterns. The current findings support the idea that more narrowly defined subjective social status may be more closely linked to biological stress mechanisms. Additionally, sAA activity was specifically related to physical, but not mental health problems. These results suggest that subjective social status referencing one's work environment may be a promising early indicator of health-relevant changes in stress-related physiological systems.

Salivary alpha amylase levels in youths with anxiety disorders

It is suggested that salivary alpha-amylase (sAA) may be a marker of sympathoadrenal medullary system activity. Thus, it can be a possible relationship sAA and anxiety disorders. The aim of this study is to investigate sAA in children and adolescents with anxiety disorders and healthy controls. Thirty drug-free youths, aged 8-16 years, who were diagnosed as any anxiety disorders and 36 healthy controls with similar socio-demographic characteristics were included in this study. The sAA was found to be significantly increased in anxiety group compared to control group. However, there was no correlation between sAA and any anxiety scores of the scales. Present study suggested that anxiety disorders in youths may be associated with increased autonomic activity.

Effects of Hatha yoga on blood pressure, salivary α-amylase, and cortisol function among normotensive and prehypertensive youth

OBJECTIVE

Evidence is accumulating, predominantly among clinical trials in adults, that yoga improves blood pressure (BP) control, with downregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS) projected as underlying mechanisms. This pilot study assessed whether Hatha yoga has the potential to reduce BP among youth and whether dampening of the SNS and/or HPA activity is a likely pathway of change.

DESIGN

Thirty-one seventh graders were randomly assigned to a Hatha yoga program (HYP) or attention control (AC) music or art class. Baseline and 3-month evaluations included resting BP; overnight urine samples; and saliva collected at bedtime, upon awakening, and at 30 and 60 minutes after awakening for α-amylase and cortisol assays.

RESULTS

Twenty-eight (14 in the HYP group and 14 in the AC group) students were assessed both before and after the intervention. BP changes from pre- to post-intervention were -3.0/-2.0 mmHg for the HYP group and -0.07/-0.79 mmHg for the AC group (p=0.30 and 0.57, respectively). Changes in systolic BP (SBP)/diastolic BP (DBP) for the prehypertensive (75th-94th percentiles for SBP) subgroup analyses were -10.75/-8.25 mmHg for the HYP group (n=4) versus 1.8/1.0 mmHg for the AC group (n=5) (p for SBP=0.02; p for DBP=0.09). Although no statistically significant group differences were observed with changes in SNS or HPA awakening curves (area under curve for α-amylase and cortisol, respectively), a small to moderate effect size was seen favoring a reduction of α-amylase activation for the HYP group (Cohen d=0.34; prehypertensive d=0.20).

CONCLUSIONS

A school-based Hatha yoga program demonstrated potential to decrease resting BP, particularly among prehypertensive youth. Reduced SNS drive may be an underlying neurohormonal pathway beneficially affected by the program. A large-scale efficacy/effectiveness randomized clinical trial is warranted.

Is salivary alpha-amylase an indicator of autonomic nervous system dysregulations in mental disorders?--a review of preliminary findings and the interactions with cortisol

During recent years, a growing interest emerged in using salivary alpha-amylase (sAA) as a non-invasive, surrogate marker for sympathetic activity. Numerous studies applying stress protocols have demonstrated that sAA is highly sensitive to stress-related changes (in healthy subjects). Additionally, it was suggested that sAA might moreover serve as an index for pathological dysregulation of the autonomic nervous system (ANS) in patients showing psychopathology. Since then, a small but growing literature investigated sAA in patients with mental disorders. This review aims to give an overview of preliminary findings in this field of research. The results of n=15 studies are described in detail and implications for further research are discussed. Although the number of studies and the samples examined were rather small, changes in sAA, reflecting adrenergic dysregulation, could be demonstrated in psychopathology, especially in anxiety-related disorders. This field of research is still in its early stages. However, the studies included in this review revealed first evidence that the employment of sAA, as an indicator of ANS dysregulation in mental disorders, is promising.