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Towards a More Individually Tailored Exercise Prescription for Promoting Cardiovascular Health. J Cardiovasc Dev Dis 2022; 9:jcdd9110401. [DOI: 10.3390/jcdd9110401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
The beneficial effects of exercise training (ET) in promoting cardiovascular health have been well established [...]
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Völz S, Lundblad LC, Andersson B, Multing J, Rundqvist B, Elam M. Unaltered neurocardiovascular reactions to mental stress after renal sympathetic denervation. Clin Exp Hypertens 2019; 42:160-166. [PMID: 30870039 DOI: 10.1080/10641963.2019.1590387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The impact of renal denervation (RDN) on muscle sympathetic nerve activity (MSNA) at rest remains controversial. Mental stress (MS) induces transient changes in sympathetic nerve activity, heart rate (HR) and blood pressure (BP). It is not known whether RDN modifies these changes.Purpose: The main objective was to assess the effect of RDN on MSNA and BP alterations during MS.Methods: In 14 patients (11 included in analysis) with resistant hypertension multi-unit MSNA, BP (Finometer ®) and HR were assessed at rest and during forced arithmetics at baseline and 6 months after RDN.Results: Systolic office BP decreased significantly 6 months after RDN (185 ± 29 vs.175 ± 33 mmHG; p = 0.04). No significant changes in MSNA at rest (68 ± 5 vs 73 ± 5 bursts/100hb; p = 0.43) were noted and no significant stress-induced change in group averaged sympathetic activity was found pre- (101 ± 24%; p = 0.9) or post-intervention (108 ± 26%; p = 0.37). Stress was associated with significant increases in mean arterial BP (p < 0.01) and HR (p < 0.01) at baseline, reactions which remained unaltered after intervention. We did not note any correlation between sympathetic nerve activity and BP changes after RDN.Conclusion: Thus, in our group of resistant hypertensives we find no support for the hypothesis that the BP-lowering effect of RDN depends on altered neurovascular responses to stress.
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Affiliation(s)
- Sebastian Völz
- Department of Cardiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Linda C Lundblad
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Bert Andersson
- Department of Cardiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Jonas Multing
- Department of Cardiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Bengt Rundqvist
- Department of Cardiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Mikael Elam
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Ahmaniemi T, Rajala S, Lindholm H, Taipalus T, Muller K. Variations of Heart Rate, Pulse Arrival Time and Blood Pressure in a Versatile Laboratory Protocol. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:2772-2775. [PMID: 30440976 DOI: 10.1109/embc.2018.8512876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many studies dealing with blood pressure modeling are evaluated based on a single type of provocation. This paper investigates widely used provocations such as controlled breathing, mental arithmetic and Stroop tests, Valsalva maneuver, cold pressor and muscle tension and combines them in a versatile laboratory protocol. The protocol was tested in an experiment where pulse arrival time (PAT) and heart rate (HR) were measured with chest ECG and finger PPG sensors and blood pressure (BP) with continuous fingercuff monitor. The experiment results show that mental tasks provoked HR, BP and PAT very little while cold pressor and muscle tension had strong impact in all parameters. Valsalva maneuver had strongest impact in HR and PAT but the effect was transient like. We also predicted systolic BP based on the PAT values. We selected nine points in the protocol to calculate linear prediction model for each subject and then fitted data points to the models. If only the calibration points are taken into account, the correlation between the predicted and measured systolic BP was 0.91. When all the data points are fed into model, correlation was 0.75.
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Schneider AC, Hughes WE, Ueda K, Bock JM, Casey DP. Reduced blood pressure responsiveness to skeletal muscle metaboreflex activation in older adults following inorganic nitrate supplementation. Nitric Oxide 2018; 78:81-88. [DOI: 10.1016/j.niox.2018.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/24/2018] [Accepted: 05/31/2018] [Indexed: 01/25/2023]
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Brown EG, Creaven AM. Performance feedback, self-esteem, and cardiovascular adaptation to recurring stressors. ANXIETY STRESS AND COPING 2016; 30:290-303. [DOI: 10.1080/10615806.2016.1269324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Eoin G. Brown
- Study of Anxiety, Stress and Health Laboratory, Department of Psychology, University of Limerick, Limerick, Ireland
- Centre for Social Issues Research, University of Limerick, Limerick, Ireland
| | - Ann-Marie Creaven
- Study of Anxiety, Stress and Health Laboratory, Department of Psychology, University of Limerick, Limerick, Ireland
- Centre for Social Issues Research, University of Limerick, Limerick, Ireland
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Lazzarino AI, Hamer M, Gaze D, Collinson P, Rumley A, Lowe G, Steptoe A. The association between fibrinogen reactivity to mental stress and high-sensitivity cardiac troponin T in healthy adults. Psychoneuroendocrinology 2015; 59:37-48. [PMID: 26010862 PMCID: PMC4512259 DOI: 10.1016/j.psyneuen.2015.05.002] [Citation(s) in RCA: 10] [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: 01/28/2015] [Revised: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Plasma fibrinogen is considered as a positive mediator between mental stress and cardiovascular disease because it is an acute-phase protein released in response to mental stress and a coagulation factor. However those three factors have never been studied together within a single integrated framework, using cardiac troponin T as a marker of cardiovascular risk. METHODS 491 disease-free men and women aged 53-76 were tested for fibrinogen levels before, immediately after, and following recovery from standardized mental stress tasks. We measured plasma cardiac troponin T using a high-sensitivity assay (HS-CTnT) and coronary calcification using electron-beam dual-source computed tomography. RESULTS The average fibrinogen concentration increased by 5.1% (s.d.=7.3) in response to stress and then tended to return to baseline values. People with higher baseline fibrinogen values had smaller increases (blunted responses) following the stress task (P=0.001), and people with higher stress responses showed better recovery (P<0.001). In unadjusted analyses, higher baseline fibrinogen was associated with higher chances of having detectable HS-CTnT (P=0.072) but, conversely, higher fibrinogen response was associated with lower chances of having detectable HS-CTnT (P=0.007). The adjustment for clinical, inflammatory, and haemostatic factors, as well as for coronary calcification eliminated the effect of baseline fibrinogen, whereas the negative association between fibrinogen response and HS-CTnT remained robust: the odds of detectable HS-CTnT halved for each 10% increase in fibrinogen concentration due to stress (OR=0.49, P=0.007, 95% CI=0.30-0.82). CONCLUSIONS Greater fibrinogen responses to mental stress are associated with lower likelihood of detectable high-sensitivity troponin T plasma concentration. A more dynamic fibrinogen response appears to be advantageous for cardiovascular health.
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Affiliation(s)
- Antonio Ivan Lazzarino
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
| | - David Gaze
- Chemical Pathology, Clinical Blood Sciences, St George's Healthcare NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom
| | - Paul Collinson
- Chemical Pathology, Clinical Blood Sciences, St George's Healthcare NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom
| | - Ann Rumley
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, United Kingdom
| | - Gordon Lowe
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, United Kingdom
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
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Mitchell HR, Levy BR, Keene DE, Monin JK. Reactivity to a Spouse's Interpersonal Suffering in Late Life Marriage: A Mixed-Methods Approach. J Aging Health 2015; 27:939-61. [PMID: 25659746 PMCID: PMC4520739 DOI: 10.1177/0898264315569456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine how older adult spouses react to their partners' interpersonal suffering. METHOD Spouses of individuals with musculoskeletal pain were recorded describing their partners' suffering while their blood pressure (BP) was monitored. After the account, spouses described their distress. Speeches were transcribed and analyzed with Linguistic Inquiry and Word Count software and coded for interpersonal content. Multivariate regression analyses were conducted with interpersonal content variables predicting BP and distress. Exploratory qualitative analysis was conducted using ATLAS.ti to explore mechanisms behind quantitative results. RESULTS Describing partners' suffering as interpersonal and using social (family) words were associated with higher systolic BP reactivity. Husbands were more likely to describe partners' suffering as interpersonal. Qualitative results suggested shared stressors and bereavement-related distress as potential mechanisms for heightened reactivity to interpersonal suffering. DISCUSSION Spouses' interpersonal suffering may negatively affect both men and women's cardiovascular health, and older husbands may be particularly affected.
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Affiliation(s)
| | - Becca R Levy
- Yale School of Public Health, New Haven, CT, USA
| | | | - Joan K Monin
- Yale School of Public Health, New Haven, CT, USA
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Burgdorf C, Rinn C, Stemmler G. Effects of personality on the opioidergic modulation of the emotion warmth-liking. J Comp Neurol 2015; 524:1712-26. [DOI: 10.1002/cne.23847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 01/28/2023]
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Santana López S, Perdomo Hernández MDC, Montero Díaz R. [Cardiovascular hyperreactivity to physical stress predicts high blood pressure in working populations: 4 years follow-up]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2014; 26:268-273. [PMID: 24703199 DOI: 10.1016/j.arteri.2014.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 02/07/2014] [Accepted: 02/07/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION High blood pressure (HBP) is a disease, and as well as a risk factor for other diseases, such as atherosclerosis. Cardiovascular hyperreactivity (CVHR) is a predictor for this disease. The aim of this study was to demonstrate if CVHR to physical stress predicts HBP in working populations. METHODS A four year (2008-2012) cohort study was conducted on two population groups: CVHR (48), and normal cardiovascular reactivity (40) after applying the Sustained Weight test. A survival analysis was used to predict HBP, and the χ(2) test and hazard ratio, with a confidence interval of 95%, were used for the statistical analysis. CONCLUSIONS The CVHR is a predictor of HBP, determined by the Sustained Weight test. The working populations can be stratified according to cardiovascular reactivity in order to introduce preventive health actions on the modifiable cardiovascular risk factors of future hypertensives in the workplace.
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Affiliation(s)
- Sandra Santana López
- Medicina Interna, Instituto Nacional de Salud de los Trabajadores Asistencia Médica, La Habana, Cuba.
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Ribeiro DMD, Colunas MFM, Marques FAF, Fernandes JM, Cunha JPS. A real time, wearable ECG and continous blood pressure monitoring system for first responders. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2011:6894-8. [PMID: 22255923 DOI: 10.1109/iembs.2011.6091736] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The study of stress and fatigue among First Responders is a major step in mitigating this public health problem. Blood pressure, heart rate variability and fatigue related arrhythmia are three of the main "windows" to study stress and fatigue. In this paper we present a wearable medical device, capable of acquiring an electrocardiogram and estimating blood pressure in real time, through a pulse wave transit time approach. The system is based on an existent certified wearable medical device called "Vital Jacket" and is aimed to become a tool to allow cardiologists in studying stress and fatigue among first response professionals.
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Affiliation(s)
- David M D Ribeiro
- Institute of Electronics and TelematicsEngineering of Aveiro, Aveiro, University of Aveiro, Portugal.
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Mizuno J, Kato S, Sato T, Sawamura S. Pre-anesthesia systolic blood pressure increases with age regardless of sex. J Anesth 2012; 26:496-502. [PMID: 22699367 DOI: 10.1007/s00540-012-1379-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 03/16/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Pre-anesthesia hypertension (PAH) is the temporary elevation of blood pressure (BP), compared with normal ambulatory recorded BP or self-measured BP at home, in patients waiting for operation in the operating room (OR) before anesthesia induction. In general, the incidence of sustained hypertension (SH) increases progressively with age and the increase is greater in males than in females. In this study, we investigated the influence of age and sex on PAH. METHODS Sampling data on consecutive patients who were more than 20 years old and who had undergone surgery under general, intrathecal, or epidural anesthesia were retrospectively collected from hospital records and anesthesia records. Patients with SH, which was defined as a past history of hypertension and taking oral antihypertensive medications, were excluded from the analyses, and the data of 231 patients, 102 males and 129 females, were used for the analyses. RESULTS The proportions of male and female patients with a systolic BP (sBP) of more than 140 mmHg in the OR before anesthesia induction were 55.9 and 42.6%, respectively. The proportions of male and female patients with a diastolic BP (dBP) of more than 90 mmHg were 34.3 and 23.3%, respectively. There was no difference in the proportions of male and female patients with PAH. The differences in sBP between measurements in the hospital room (HR) before the operation and those in the OR (ΔsBP) in males and females were 22.9 ± 25.6 and 19.0 ± 24.0 mmHg, respectively. The differences in dBP between measurements in the HR and those in the OR (ΔdBP) in males and females were 12.7 ± 16.5 and 8.4 ± 17.9 mmHg, respectively. There were no differences in ΔsBP and ΔdBP between males and females. The sBP in the OR and the ΔsBP increased significantly with age in both males and females. CONCLUSION Age is an important clinical factor related to PAH. Pre-anesthesia sBP and the change in pre-anesthesia sBP increase progressively with age regardless of sex. These findings suggest that the higher BP seen in the elderly in the OR before anesthesia induction, as reported previously, might be explained in part by a greater impact of PAH in older people.
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Affiliation(s)
- Ju Mizuno
- Department of Anesthesiology and the Intensive Care Unit, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
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Neves FJ, Carvalho ACG, Rocha NG, Silva BM, Sales ARK, de Castro RRT, Rocha JD, Thomaz TG, Nóbrega ACL. Hemodynamic mechanisms of the attenuated blood pressure response to mental stress after a single bout of maximal dynamic exercise in healthy subjects. Braz J Med Biol Res 2012; 45:610-6. [PMID: 22584644 PMCID: PMC3854267 DOI: 10.1590/s0100-879x2012007500083] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 05/03/2012] [Indexed: 11/28/2022] Open
Abstract
To determine the hemodynamic mechanisms responsible for the attenuated blood pressure response to mental stress after exercise, 26 healthy sedentary individuals (age 29 ± 8 years) underwent the Stroop color-word test before and 60 min after a bout of maximal dynamic exercise on a treadmill. A subgroup (N = 11) underwent a time-control experiment without exercise. Blood pressure was continuously and noninvasively recorded by infrared finger photoplethysmography. Stroke volume was derived from pressure signals, and cardiac output and peripheral vascular resistance were calculated. Perceived mental stress scores were comparable between mental stress tests both in the exercise (P = 0.96) and control (P = 0.24) experiments. After exercise, the systolic blood pressure response to mental stress was attenuated (pre: 10 ± 13 vs post: 6 ± 7 mmHg; P < 0.01) along with lower values of systolic blood pressure (pre: 129 ± 3 vs post: 125 ± 3 mmHg; P < 0.05), stroke volume (pre: 89.4 ± 3.5 vs post: 76.8 ± 3.8 mL; P < 0.05), and cardiac output (pre: 7.00 ± 0.30 vs post: 6.51 ± 0.36 L/min; P < 0.05). Except for heart rate, the hemodynamic responses and the mean values during the two mental stress tests in the control experiment were similar (P > 0.05). In conclusion, a single bout of maximal dynamic exercise attenuates the blood pressure response to mental stress in healthy subjects, along with lower stroke volume and cardiac output, denoting an acute modulatory action of exercise on the central hemodynamic response to mental stress.
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Affiliation(s)
- F J Neves
- Programa de Pós-Graduação em Ciências Cardiovasculares, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil
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Faulk KE, Bartholomew JB. The moderating effect of physical activity on cardiovascular reactivity following single fat feedings. Psychophysiology 2011; 49:145-9. [PMID: 22092271 DOI: 10.1111/j.1469-8986.2011.01283.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Accepted: 05/24/2011] [Indexed: 11/27/2022]
Abstract
This experiment examined the effects of consuming a high-fat meal on cardiovascular reactivity and the ability of exercise to act as a moderator between dietary fat consumption and cardiovascular reactivity. Forty healthy, college-age students were randomly assigned to one of four experimental groups: (1) low-fat meal, no exercise; (2) low-fat meal, postprandial exercise; (3) high-fat meal, no exercise; and (4) high-fat meal, postprandial exercise. To induce stress, all participants performed a public speaking task, while heart rate and blood pressure reactivity were measured. Multilevel analyses revealed that consuming a high-fat meal led to heightened mean arterial pressure reactivity. Acute high-intensity exercise resulted in attenuated heart rate and mean arterial pressure reactivity. The results of this study offer insight into how diet and exercise may influence cardiovascular reactivity, which is a key determinant of cardiovascular disease.
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Affiliation(s)
- Kathryn E Faulk
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas 78712, USA.
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Jarvis SS, VanGundy TB, Galbreath MM, Shibata S, Okazaki K, Reelick MF, Levine BD, Fu Q. Sex differences in the modulation of vasomotor sympathetic outflow during static handgrip exercise in healthy young humans. Am J Physiol Regul Integr Comp Physiol 2011; 301:R193-200. [PMID: 21508291 DOI: 10.1152/ajpregu.00562.2010] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sex differences in sympathetic neural control during static exercise in humans are few and the findings are inconsistent. We hypothesized women would have an attenuated vasomotor sympathetic response to static exercise, which would be further reduced during the high sex hormone [midluteal (ML)] vs. the low hormone phase [early follicular (EF)]. We measured heart rate (HR), blood pressure (BP), and muscle sympathetic nerve activity (MSNA) in 11 women and 10 men during a cold pressor test (CPT) and static handgrip to fatigue with 2 min of postexercise circulatory arrest (PECA). HR increased during handgrip, reached its peak at fatigue, and was comparable between sexes. BP increased during handgrip and PECA where men had larger increases from baseline. Mean ± SD MSNA burst frequency (BF) during handgrip and PECA was lower in women (EF, P < 0.05), as was ΔMSNA-BF smaller (main effect, both P < 0.01). ΔTotal activity was higher in men at fatigue (EF: 632 ± 418 vs. ML: 598 ± 342 vs. men: 1,025 ± 416 a.u./min, P < 0.001 for EF and ML vs. men) and during PECA (EF: 354 ± 321 vs. ML: 341 ± 199 vs. men: 599 ± 327 a.u./min, P < 0.05 for EF and ML vs. men). During CPT, HR and MSNA responses were similar between sexes and hormone phases, confirming that central integration and the sympathetic efferent pathway was comparable between the sexes and across hormone phases. Women demonstrated a blunted metaboreflex, unaffected by sex hormones, which may be due to differences in muscle mass or fiber type and, therefore, metabolic stimulation of group IV afferents.
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Affiliation(s)
- Sara S Jarvis
- Institute for Exercise and Environmental Medicine, 7232 Greenville Ave., Suite 435, Dallas, TX 75231, USA
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Low-level Pb and cardiovascular responses to acute stress in children: the role of cardiac autonomic regulation. Neurotoxicol Teratol 2010; 33:212-9. [PMID: 20934510 DOI: 10.1016/j.ntt.2010.10.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 09/19/2010] [Accepted: 10/02/2010] [Indexed: 01/04/2023]
Abstract
OBJECTIVE A number of studies suggest that Pb exposure increases cardiovascular disease risk in humans. As a potential mechanism for this effect, we recently reported a significant association between early childhood Pb levels and cardiovascular response to acute stress. The current study considers the association between current Pb levels and the autonomic nervous system activation pattern underlying the cardiovascular response to stress in a new cohort of children. METHODS We assessed blood Pb levels as well as cardiovascular responses to acute stress in 9-11 year old children (N=140). Sympathetic activation (measured with pre-ejection period) and parasympathetic activation (measured with high frequency heart rate variability) were also assessed. RESULTS In a sample with very low levels of blood Pb (M=1.0 μg/dL), we found that increasing blood Pb was associated with coinhibition of sympathetic and parasympathetic activation in response to acute stress. In addition, increasing Pb levels were associated with the hemodynamic stress response pattern typical of coinhibition--significantly greater vascular resistance and reduced stroke volume and cardiac output. CONCLUSIONS Blood Pb levels were associated with significant autonomic and cardiovascular dysregulation in response to acute psychological stress in children. Moreover, these effects were significant at Pb levels considered to be very low and notably well below the 10 μg/dL, the Centers for Disease Control and Prevention definition of an elevated blood Pb level. The potential for autonomic dysregulation at levels of Pb typical for many US children would suggest potentially broad public health ramifications.
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Logan JG, Barksdale DJ. Allostasis and allostatic load: expanding the discourse on stress and cardiovascular disease. J Clin Nurs 2008; 17:201-8. [DOI: 10.1111/j.1365-2702.2008.02347.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brown S, Chitravanshi VC, Sapru HN. Cardiovascular actions of adrenocorticotropin microinjections into the nucleus tractus solitarius of the rat. Neuroscience 2006; 143:863-74. [PMID: 16997487 DOI: 10.1016/j.neuroscience.2006.08.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2006] [Revised: 08/11/2006] [Accepted: 08/16/2006] [Indexed: 11/27/2022]
Abstract
The presence of adrenocorticotropin (ACTH) containing cells and melanocortin (MC) receptors has been reported in the nucleus tractus solitarius (NTS) of the rat. The importance of the NTS in the regulation of cardiovascular function is also well established. Based on these reports, it was hypothesized that ACTH acting within the NTS may modulate the central regulation of cardiovascular function. To test this hypothesis, cardiovascular effects of ACTH in the NTS were investigated in intact urethane-anesthetized and unanesthetized decerebrate, artificially ventilated, adult male Wistar rats. Microinjections of ACTH (0, 0.5, 1, 2, and 4 mM) into the medial subnucleus of NTS (mNTS) elicited decreases in mean arterial pressure (MAP; 0+/-0, 24.4+/-3.5, 35.7+/-4.3, 44.5+/-5.8 and 53.7+/-5.6 mm Hg, respectively) and heart rate (HR; 0+/-0, 25.7+/-5.3, 35.5+/-6.4, 47.5+/-12.1 and 55.0+/-5.6 beats/min, respectively). The onset and duration of the responses to microinjections of ACTH (0.5-4 mM) were 5-10 s and 45-120 s, respectively. Control microinjections of artificial cerebrospinal fluid (aCSF) did not elicit any response. The volume of all microinjections was 100 nl. The concentrations of ACTH that elicited depressor and bradycardic responses when microinjected into the mNTS (e.g. 1 or 2 mM, 100 nl), did not elicit a response when injected i.v. (n=5) or i.c.v. (n=2) indicating that there was no leakage of the drug from the injection site in the mNTS. Microinjections of MC3/4 receptor antagonists (acetyl-[Nle(4), Asp(5), d-2-Nal(7), Lys(10)]-cyclo-alpha-MSH amide, fragments 4-10 (SHU9119) and agouti-related protein (83-132) amide) into the mNTS blocked the responses to ACTH. Microinjections of ACTH (2 mM) into the mNTS decreased efferent greater splanchnic nerve activity. Bilateral vagotomy significantly attenuated ACTH-induced bradycardia. These results indicated that: 1) microinjections of ACTH into the mNTS elicited depressor and bradycardic responses, 2) these responses were mediated via MC3/4 receptors, 3) the depressor effects were mediated via a decrease in the activity of the sympathetic nervous system, and 4) the bradycardic responses were vagally mediated.
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Affiliation(s)
- S Brown
- Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA
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Thomas KS, Nelesen RA, Ziegler MG, Bardwell WA, Dimsdale JE. Job strain, ethnicity, and sympathetic nervous system activity. Hypertension 2004; 44:891-6. [PMID: 15534076 DOI: 10.1161/01.hyp.0000148499.54730.0d] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several studies have demonstrated that blacks have heightened pressor sensitivity in response to the alpha-agonist, phenylephrine. However, studies examining whether psychosocial factors contribute to this difference are scarce. We examined the effects of job strain on pressor sensitivity in 76 whites and 46 blacks who were enrolled in a study of stress, sleep, and blood pressure. Responses to phenylephrine were examined at an inpatient clinical research center. After a 3-minute baseline period, a 100-microgram phenylephrine bolus was administered to participants intravenously. To measure catecholamines, 24-hour urine samples were also collected from participants. There was a significant relationship between job strain and pressor sensitivity, such that individuals with low decisional control and high job demands experienced a greater increase in diastolic pressure after receiving phenylephrine. Low decisional control was also associated with decreased baroreflex sensitivity. There was an interaction between ethnicity and job control on blood pressure responses to phenylephrine and on 24-hour urinary norepinephrine levels. Blacks who perceived less control experienced a greater increase in diastolic pressure after receiving phenylephrine and had elevated norepinephrine levels. These findings suggest possible mechanisms by which job strain may be associated with cardiovascular disease.
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