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Prakash K, Ranjan N, Malhotra AS. Blood Pressure Variability is Better Associated with Acute Relative Hyperglycemia Than the Heart Rate Variability in Healthy Young Adults. Exp Clin Endocrinol Diabetes 2024. [PMID: 38569511 DOI: 10.1055/a-2298-9005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
BACKGROUND Deranged cardiovascular autonomic functions are well-reported complications of diabetes mellitus, where chronic hyperglycemia is an important factor. The role of acute relative hyperglycemia on cardiovascular autonomic functions, particularly on blood pressure variability in healthy subjects, has been rarely explored. Therefore, this study aimed to examine the effect of acute relative hyperglycemia on cardiovascular autonomic functions in healthy young adults. METHODS Beat-to-beat blood pressure and electrocardiogram were recorded to assess the heart rate variability and blood pressure variability in 42 young, healthy subjects during fasting and relative hyperglycemic states. Recorded cardiovascular parameters were analyzed in time and frequency domains. Correlations among analyzed parameters of cardiovascular autonomic variabilities were explored during fasting and relative hyperglycemic state. RESULTS A few of the systolic, mean, and diastolic blood-pressure-variability parameters were significantly altered during acute relative hyperglycemia when compared to the fasting state. However, no significant changes were observed in any of the heart-rate-variability parameters. Also, novel significant correlations were found among many of the parameters of cardiovascular autonomic variabilities during fasting and relative hyperglycemic states. CONCLUSIONS The blood pressure variability is affected significantly during acute relative hyperglycemia in healthy young adults; however, the heart rate variability does not show such changes. Also, many blood pressure variability parameters show significant correlations with heart rate variability and baroreflex sensitivity. It may be hypothesized that although the variabilities in heart rate and blood pressure assess cardiovascular autonomic functions, blood pressure variability is a better indicator of cardiovascular autonomic effects of acute relative hyperglycemia.
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Affiliation(s)
- Kiran Prakash
- Government Medical College and Hospital, Chandigarh, India
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2
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Lohman T, Sible IJ, Shenasa F, Engstrom AC, Kapoor A, Alitin JPM, Gaubert A, Thayer JF, Ferrer F, Nation DA. Reliability of beat-to-beat blood pressure variability in older adults. RESEARCH SQUARE 2024:rs.3.rs-4190135. [PMID: 38699342 PMCID: PMC11065081 DOI: 10.21203/rs.3.rs-4190135/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Blood pressure variability (BPV) is emerging as an important risk factor across numerous disease states, including cerebrovascular and neurodegenerative disease in older adults. However, there is no current consensus regarding specific use cases for the numerous available BPV metrics. There is also little published data supporting the ability to reliably measure BPV across metrics in older adults. BPV metrics were derived from continuous beat-to-beat blood pressure monitoring data. Two sequential 7-minute waveforms were analyzed. Absolute and relative reliability testing was performed. Differences between antihypertensive medication users and non-users on BPV metric reliability was also assessed. All sequence and dispersion based BPV metrics displayed good test-retest reliability. A measure of BP instability displayed only moderate reliability. Systolic and diastolic average real variability displayed the highest levels of reliability at ICC= .87 and .82 respectively. Additionally, systolic average real variability was the most reliable metric in both the antihypertensive use group, and the no antihypertensive use group. Beat-to-beat dispersion and sequence-based metrics of BPV can be reliably obtained from older adults using noninvasive continuous blood pressure monitoring. Average real variability may be the most reliable and specific beat-to-beat blood pressure variability metric due to its decreased susceptibility to outliers and low frequency blood pressure oscillations.
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Affiliation(s)
- Trevor Lohman
- University of Southern California, Leonard Davis School of Gerontology
| | | | | | | | | | | | - Aimee Gaubert
- University of Southern California, Leonard Davis School of Gerontology
| | | | - Farrah Ferrer
- University of Southern California, Leonard Davis School of Gerontology
| | - Daniel A Nation
- University of Southern California, Leonard Davis School of Gerontology
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3
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Kissell CE, Young BE, Jarrard CP, Huang M, Allen DR, Okuda DT, Smith SA, Fadel PJ, Davis SL. Reduced resting beat-to-beat blood pressure variability in females with relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2024; 83:105416. [PMID: 38244526 DOI: 10.1016/j.msard.2023.105416] [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: 06/21/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Relapsing-remitting multiple sclerosis (RRMS) is a demyelinating disease of the central nervous system and cardiovascular autonomic dysfunction has been well documented in this population. The sympathetic nervous system contributes to beat-to-beat blood pressure regulation primarily by baroreflex control of the peripheral vasculature which may be impaired in females with RRMS. Even at rest, attenuated sympathetic control of vasomotor tone may result in large and frequent blood pressure excursions (i.e., greater blood pressure variability). Therefore, the primary purpose of this investigation was to test the following hypotheses; (1) females with RRMS have augmented beat-to-beat blood pressure variability compared to healthy controls and (2) reduced sympathetic baroreflex sensitivity in females with RRMS is related to augmented blood pressure variability. METHODS Electrocardiogram and beat-to-beat blood pressure were continuously recorded during 8-10 min of supine rest in 26 females with clinically definite RRMS and 24 sex-, age- and BMI- matched healthy controls. Muscle sympathetic nerve activity (MSNA) was recorded in a subset of participants (MS, n = 15; CON, n = 14). Traditional statistical measurements of dispersions were used to index beat-to-beat blood pressure variability. Spontaneous sympathetic baroreflex sensitivity was quantified by sorting diastolic blood pressures into 3 mmHg bins and calculating MSNA burst incidence within each bin. Weighted linear regression was then used to account for the number of cardiac cycles in each bin and calculate slopes. Spontaneous cardiac baroreflex sensitivity was determined using the sequence method. RESULTS Groups had similar resting mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), MSNA burst frequency and MSNA burst incidence (All P > 0.05). The standard deviation and interquartile range of MAP, SBP and DBP were less in females with RRMS compared to healthy controls (All P < 0.05). There were no between groups differences in sympathetic baroreflex sensitivity or cardiac baroreflex sensitivity (Both P > 0.05) and baroreflex sensitivity measures were not related to any indices of blood pressure variability (Both P > 0.05). CONCLUSION These data suggest that females with RRMS have reduced beat-to-beat blood pressure variability. However, this does not appear to be related to changes in sympathetic or cardiac baroreflex sensitivity.
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Affiliation(s)
- Claire E Kissell
- Department of Applied Physiology and Sport Management, Southern Methodist University, Dallas, TX, USA
| | - Benjamin E Young
- Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Caitlin P Jarrard
- Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mu Huang
- Office of Science, Medicine, and Health, American Heart Association, Dallas, TX, USA
| | - Dustin R Allen
- Department of Health Sciences, Boston University, Boston, Massachusetts, USA
| | - Darin T Okuda
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott A Smith
- Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Scott L Davis
- Department of Applied Physiology and Sport Management, Southern Methodist University, Dallas, TX, USA; Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Nardone M, Foster M, O'Brien MW, Coovadia Y, Xie S, Usselman CW, Kimmerly DS, Taylor CE, Millar PJ. Sympathetic determinants of resting blood pressure in males and females. Am J Physiol Heart Circ Physiol 2024; 326:H612-H622. [PMID: 38214907 DOI: 10.1152/ajpheart.00497.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
Discharge of postganglionic muscle sympathetic nerve activity (MSNA) is related poorly to blood pressure (BP) in adults. Whether neural measurements beyond the prevailing level of MSNA can account for interindividual differences in BP remains unclear. The current study sought to evaluate the relative contributions of sympathetic-BP transduction and sympathetic baroreflex gain on resting BP in young adults. Data were analyzed from 191 (77 females) young adults (18-39 years) who underwent continuous measurement of beat-to-beat BP (finger photoplethysmography), heart rate (electrocardiography), and fibular nerve MSNA (microneurography). Linear regression analyses were computed to determine associations between sympathetic-BP transduction (signal-averaging) or sympathetic baroreflex gain (threshold technique) and resting BP, before and after controlling for age, body mass index, and MSNA burst frequency. K-mean clustering was used to explore sympathetic phenotypes of BP control and consequential influence on resting BP. Sympathetic-BP transduction was unrelated to BP in males or females (both R2 < 0.01; P > 0.67). Sympathetic baroreflex gain was positively associated with BP in males (R2 = 0.09, P < 0.01), but not in females (R2 < 0.01; P = 0.80), before and after controlling for age, body mass index, and MSNA burst frequency. K-means clustering identified a subset of participants with average resting MSNA, yet lower sympathetic-BP transduction and lower sympathetic baroreflex gain. This distinct subgroup presented with elevated BP in males (P < 0.02), but not in females (P = 0.10). Sympathetic-BP transduction is unrelated to resting BP, while the association between sympathetic baroreflex gain and resting BP in males reveals important sex differences in the sympathetic determination of resting BP.NEW & NOTEWORTHY In a sample of 191 normotensive young adults, we confirm that resting muscle sympathetic nerve activity is a poor predictor of resting blood pressure and now demonstrate that sympathetic baroreflex gain is associated with resting blood pressure in males but not females. In contrast, signal-averaged measures of sympathetic-blood pressure transduction are unrelated to resting blood pressure. These findings highlight sex differences in the neural regulation of blood pressure.
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Affiliation(s)
- Massimo Nardone
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Monique Foster
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Myles W O'Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Physiotherapy (Faculty of Health) and Division of Geriatric Medicine (Faculty of Medicine), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Shengkun Xie
- Global Management Studies, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Derek S Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chloe E Taylor
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Sabino-Carvalho JL, Jeong J, Sprick J, DaCosta D, Nardone M, Park J. Augmented resting beat-to-beat blood pressure variability in patients with chronic kidney disease. Clin Auton Res 2023; 33:705-714. [PMID: 37776374 PMCID: PMC10993989 DOI: 10.1007/s10286-023-00979-1] [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: 06/20/2023] [Accepted: 08/24/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE Our aim was to test the hypothesis that patients with chronic kidney disease (CKD) would exhibit augmented resting beat-to-beat blood pressure variability (BPV) that is associated with poor clinical outcomes independent of mean blood pressure (BP). In addition, since the arterial baroreflex plays a critical role in beat-to-beat BP regulation, we further hypothesized that an impaired baroreflex control would be associated with an augmented resting beat-to-beat BPV. METHODS In 25 sedentary patients with CKD stages III-IV (62 ± 9 years) and 20 controls (57 ± 10 years), resting beat-to-beat BP (finger photoplethysmography) and heart rate (electrocardiography) were continuously measured for 10 min. We calculated the standard deviation (SD), average real variability (ARV) and other indices of BPV. The sequence technique was used to estimate spontaneous cardiac baroreflex sensitivity. RESULTS Compared with controls (CON), the CKD group had significantly increased resting BPV. The ARV (2.2 ± 0.6 versus 1.6 ± 0.5 mmHg, P < 0.001; 1.6 ± 0.7 versus 1.3 ± 0.3 mmHg, P = 0.039; 1.4 ± 0.5 versus 1.0 ± 0.2 mmHg, P < 0.001) of systolic, diastolic and mean BP, respectively, was increased in CKD versus controls. Other traditional measures of variability showed similar results. The cardiac baroreflex sensitivity was lower in CKD compared with controls (CKD: 8.4 ± 4.5 ms/mmHg versus CON: 14.0 ± 8.2 ms/mmHg, P = 0.008). In addition, cardiac baroreflex sensitivity was negatively associated with BPV [systolic blood pressure (SBP) ARV; r = -0.44, P = 0.003]. CONCLUSION In summary, our data demonstrate that patients with CKD have augmented beat-to-beat BPV and lower cardiac baroreflex sensitivity. BPV and cardiac baroreflex sensitivity were negatively correlated in this cohort. These findings may further our understanding about cardiovascular dysregulation observed in patients with CKD.
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Affiliation(s)
- Jeann L Sabino-Carvalho
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Jinhee Jeong
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Justin Sprick
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX, USA
| | - Dana DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Massimo Nardone
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA.
- Department of Veterans Affairs Health Care System, Decatur, Georgia.
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Skow RJ, Garza NA, Nandadeva D, Stephens BY, Wright AN, Grotle AK, Young BE, Fadel PJ. Impact of COVID-19 on cardiac autonomic function in healthy young adults: potential role of symptomatology and time since diagnosis. Am J Physiol Heart Circ Physiol 2022; 323:H1206-H1211. [PMID: 36331556 PMCID: PMC9678405 DOI: 10.1152/ajpheart.00520.2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Emerging evidence suggests that COVID-19 may affect cardiac autonomic function; however, the limited findings in young adults with COVID-19 have been equivocal. Notably, symptomology and time since diagnosis appear to influence vascular health following COVID-19, but this has not been explored in the context of cardiac autonomic regulation. Therefore, we hypothesized that young adults who had persistent symptoms following COVID-19 would have lower heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) compared with those who had COVID-19 but were asymptomatic at testing and controls who never had COVID-19. Furthermore, we hypothesized that there would be relationships between cardiac autonomic function measures and time since diagnosis. We studied 27 adults who had COVID-19 and were either asymptomatic (ASYM; n = 15, 6 females); 21 ± 4 yr; 8.4 ± 4.0 wk from diagnosis) or symptomatic (SYM; n = 12, 9 females); 24 ± 3 yr; 12.3 ± 6.2 wk from diagnosis) at testing, and 20 adults who reported never having COVID-19 (24 ± 4 yr, 11 females). Heart rate and beat-to-beat blood pressure were continuously recorded during 5 min of rest to assess HRV and cardiac BRS. HRV [root mean square of successive differences between normal heartbeats (RMSSD); control, 73 ± 50 ms; ASYM, 71 ± 47 ms; and SYM, 84 ± 45 ms; P = 0.774] and cardiac BRS (overall gain; control, 22.3 ± 10.1 ms/mmHg; ASYM, 22.7 ± 12.2 ms/mmHg; and SYM, 24.3 ± 10.8 ms/mmHg; P = 0.871) were not different between groups. However, we found correlations with time since diagnosis for HRV (e.g., RMSSD, r = 0.460, P = 0.016) and cardiac BRS (overall gain, r = 0.470, P = 0.014). These data suggest a transient impact of COVID-19 on cardiac autonomic function that appears mild and unrelated to persistent symptoms in young adults.NEW & NOTEWORTHY The potential role of persistent COVID-19 symptoms on cardiac autonomic function in young adults was investigated. We observed no differences in heart rate variability or cardiac baroreflex sensitivity between controls who never had COVID-19 and those who had COVID-19, regardless of symptomology. However, there were significant relationships between measures of cardiac autonomic function and time since diagnosis, suggesting that COVID-19-related changes in cardiac autonomic function are transient in young, otherwise healthy adults.
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Skow RJ, Nandadeva D, Grotle AK, Stephens BY, Wright AN, Fadel PJ. Impact of breakthrough COVID-19 cases during the omicron wave on vascular health and cardiac autonomic function in young adults. Am J Physiol Heart Circ Physiol 2022; 323:H59-H64. [PMID: 35594069 PMCID: PMC9169822 DOI: 10.1152/ajpheart.00189.2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We and others have previously shown that COVID-19 results in vascular and autonomic impairments in young adults. However, the newest variant of COVID-19 (Omicron) appears to have less severe complications. Therefore, we investigated whether recent breakthrough infection with COVID-19 during the Omicron wave impacts cardiovascular health in young adults. We hypothesized that measures of vascular health and indices of cardiac autonomic function would be impaired in those who had the Omicron variant of COVID-19 when compared with controls who never had COVID-19. We studied 23 vaccinated adults who had COVID-19 after December 25, 2021 (Omicron; age, 23 ± 3 yr; 14 females) within 6 wk of diagnosis compared with 13 vaccinated adults who never had COVID-19 (age, 26 ± 4 yr; 7 females). Macro- and microvascular function were assessed using flow-mediated dilation (FMD) and reactive hyperemia, respectively. Arterial stiffness was determined as carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx). Heart rate (HR) variability and cardiac baroreflex sensitivity (BRS) were assessed as indices of cardiac autonomic function. FMD was not different between control (5.9 ± 2.8%) and Omicron (6.1 ± 2.3%; P = 0.544). Similarly, reactive hyperemia (P = 0.884) and arterial stiffness were not different between groups (e.g., cfPWV; control, 5.9 ± 0.6 m/s and Omicron, 5.7 ± 0.8 m/s; P = 0.367). Finally, measures of HR variability and cardiac BRS were not different between groups (all, P > 0.05). Collectively, these data suggest preserved vascular health and cardiac autonomic function in young, otherwise healthy adults who had breakthrough cases of COVID-19 during the Omicron wave.NEW & NOTEWORTHY We show for the first time that breakthrough cases of COVID-19 during the Omicron wave does not impact vascular health and cardiac autonomic function in young adults. These are promising results considering earlier research showing impaired vascular and autonomic function following previous variants of COVID-19. Collectively, these data demonstrate that the recent Omicron variant is not detrimental to cardiovascular health in young, otherwise healthy, vaccinated adults.
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Affiliation(s)
- Rachel J Skow
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Damsara Nandadeva
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Ann-Katrin Grotle
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Brandi Y Stephens
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Alexis N Wright
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Paul J Fadel
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
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Teixeira AL, Nardone M, Samora M, Fernandes IA, Ramos PS, Sabino-Carvalho JL, Ricardo DR, Millar PJ, Vianna LC. Potentiation of GABAergic synaptic transmission by diazepam acutely increases resting beat-to-beat blood pressure variability in young adults. Am J Physiol Regul Integr Comp Physiol 2022; 322:R501-R510. [PMID: 35348021 DOI: 10.1152/ajpregu.00291.2021] [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: 11/22/2022]
Abstract
Resting beat-to-beat blood pressure variability is a powerful predictor of cardiovascular events and end-organ damage. However, its underlying mechanisms remain unknown. Herein, we tested the hypothesis that a potentiation of GABAergic synaptic transmission by diazepam would acutely increase resting beat-to-beat blood pressure variability. In 40 (17 females) young, normotensive subjects, resting beat-to-beat blood pressure (finger photoplethysmography) was continuously measured for 5 to 10 min, 60 min after the oral administration of either diazepam (10 mg) or placebo. The experiments were conducted in a randomized, double-blinded, and placebo-controlled design. Stroke volume was estimated from the blood pressure waveform (ModelFlow) permitting the calculation of cardiac output and total peripheral resistance. Direct recordings of muscle sympathetic nerve activity (MSNA, microneurography) were obtained in a subset of subjects (N=13) and spontaneous cardiac and sympathetic baroreflex sensitivity calculated. Compared to placebo, diazepam significantly increased the standard deviation of systolic (4.7±1.4 vs. 5.7±1.5 mmHg, P=0.001), diastolic (3.8±1.2 vs. 4.5±1.2 mmHg, P=0.007) and mean blood pressure (3.8±1.1 vs. 4.5±1.1 mmHg, P=0.002), as well as cardiac output (469±149 vs. 626±259 ml/min, P<0.001) and total peripheral resistance (1.0±0.3 vs. 1.4±0.6 mmHg/l/min, P<0.001). Similar results were found using different indices of variability. Furthermore, diazepam reduced MSNA burst frequency (placebo: 22±6 vs. diazepam: 18±8 bursts/min, P=0.025) without affecting the arterial baroreflex control of heart rate (placebo: 18.6±6.7 vs. diazepam: 18.8±7.0 ms/mmHg, P=0.87) and MSNA (placebo: -3.6±1.2 vs. diazepam: -3.4±1.5 bursts/100Hb/mmHg, P=0.55). These findings suggest that GABAA receptors modulate resting beat-to-beat blood pressure variability in young adults.
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Affiliation(s)
- André L Teixeira
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.,NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Massimo Nardone
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Milena Samora
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Igor Alexandre Fernandes
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Plinio Santos Ramos
- Maternity Hospital Therezinha de Jesus, Faculty of Health and Medical Sciences (SUPREMA), Juiz de Fora, MG, Brazil
| | - Jeann L Sabino-Carvalho
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Djalma Rabelo Ricardo
- Maternity Hospital Therezinha de Jesus, Faculty of Health and Medical Sciences (SUPREMA), Juiz de Fora, MG, Brazil
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Lauro C Vianna
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
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Karavaev AS, Skazkina VV, Borovkova EI, Prokhorov MD, Hramkov AN, Ponomarenko VI, Runnova AE, Gridnev VI, Kiselev AR, Kuznetsov NV, Chechurin LS, Penzel T. Synchronization of the Processes of Autonomic Control of Blood Circulation in Humans Is Different in the Awake State and in Sleep Stages. Front Neurosci 2022; 15:791510. [PMID: 35095399 PMCID: PMC8789746 DOI: 10.3389/fnins.2021.791510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/09/2021] [Indexed: 01/09/2023] Open
Abstract
The influence of higher nervous activity on the processes of autonomic control of the cardiovascular system and baroreflex regulation is of considerable interest, both for understanding the fundamental laws of the functioning of the human body and for developing methods for diagnostics and treatment of pathologies. The complexity of the analyzed systems limits the possibilities of research in this area and requires the development of new tools. Earlier we propose a method for studying the collective dynamics of the processes of autonomic control of blood circulation in the awake state and in different stages of sleep. The method is based on estimating a quantitative measure representing the total percentage of phase synchronization between the low-frequency oscillations in heart rate and blood pressure. Analysis of electrocardiogram and invasive blood pressure signals in apnea patients in the awake state and in different sleep stages showed a high sensitivity of the proposed measure. It is shown that in slow-wave sleep the degree of synchronization of the studied rhythms is higher than in the awake state and lower than in sleep with rapid eye movement. The results reflect the modulation of the processes of autonomic control of blood circulation by higher nervous activity and can be used for the quantitative assessment of this modulation.
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Affiliation(s)
- Anatoly S. Karavaev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Viktoriia V. Skazkina
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
| | - Ekaterina I. Borovkova
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Mikhail D. Prokhorov
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | | | - Vladimir I. Ponomarenko
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anastasiya E. Runnova
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
| | - Vladimir I. Gridnev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
| | - Anton R. Kiselev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - Nikolay V. Kuznetsov
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
- Faculty of Mathematics and Mechanics, St. Petersburg State University, St. Petersburg, Russia
- Institute for Problems in Mechanical Engineering RAS, St. Petersburg, Russia
| | - Leonid S. Chechurin
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
- Faculty of Mathematics and Mechanics, St. Petersburg State University, St. Petersburg, Russia
| | - Thomas Penzel
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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10
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Robinson AT, Wenner MM, Charkoudian N. Differential influences of dietary sodium on blood pressure regulation based on race and sex. Auton Neurosci 2021; 236:102873. [PMID: 34509133 PMCID: PMC8627459 DOI: 10.1016/j.autneu.2021.102873] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/19/2021] [Accepted: 08/23/2021] [Indexed: 11/30/2022]
Abstract
There are clear differences between men and women, and differences among races, in the incidence and prevalence of hypertension. Furthermore, there is extensive inter-individual variability among humans in the extent to which sodium ingestion alters blood pressure. Orthostatic intolerance and orthostatic hypotension are more common in women; these are often treated with a high salt diet, which has variable efficacy in increasing blood volume and blood pressure. Conversely, people with certain forms of hypertension are often counseled to decrease their sodium intake. Non-Hispanic Black men and women have higher rates of hypertension compared to non-Hispanic White men and women and other racial/ethnic groups. In aggregate, Black women appear to have better orthostatic tolerance than White women. In the present paper, we summarize and evaluate the current evidence for mechanisms of blood pressure regulation in men and women, as well as differences between Black and White groups, with a focus on cardiovascular responses to salt and differences among these groups. We also provide a brief review of factors that are not traditionally considered to be "biological" - such as socio-economic disparities resulting from historic and contemporary inequity across racial groups. These non-biological factors have direct and substantial influences on cardiovascular mechanisms, as well as implications for the influences of salt and sodium intake on blood pressure and cardiovascular health. We conclude that both biological and socio-economic factors provide critical modulating influences when considering the impacts of sodium on cardiovascular health as functions of race and sex.
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Affiliation(s)
- Austin T Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, United States of America.
| | - Megan M Wenner
- Women's Cardiovascular Research Laboratory, Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, United States of America
| | - Nisha Charkoudian
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
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11
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Karavaev AS, Borovik AS, Borovkova EI, Orlova EA, Simonyan MA, Ponomarenko VI, Skazkina VV, Gridnev VI, Bezruchko BP, Prokhorov MD, Kiselev AR. Low-frequency component of photoplethysmogram reflects the autonomic control of blood pressure. Biophys J 2021; 120:2657-2664. [PMID: 34087217 PMCID: PMC8390904 DOI: 10.1016/j.bpj.2021.05.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/18/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022] Open
Abstract
The question of how much information the photoplethysmogram (PPG) signal contains on the autonomic regulation of blood pressure (BP) remains unsolved. This study aims to compare the low-frequency (LF) and high-frequency components of PPG and BP and assess their correlation with oscillations in interbeat (RR) intervals at similar frequencies. The PPG signal from the distal phalanx of the right index finger recorded using a reflective PPG sensor at green light, the BP signal from the left hand recorded using a Finometer, and RR intervals were analyzed. These signals were simultaneously recorded within 15 min in a supine resting condition in 17 healthy subjects (12 males and 5 females) aged 33 ± 9 years (mean ± SD). The study revealed the high coherence of LF components of PPG and BP with the LF component of RR intervals. The high-frequency components of these signals had low coherence. The analysis of the signal instantaneous phases revealed the presence of high-phase coherence between the LF components of PPG and BP. It is shown that the LF component of PPG is determined not only by local myogenic activity but also reflects the processes of autonomic control of BP.
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Affiliation(s)
- Anatoly S Karavaev
- Saratov State Medical University, Saratov, Russia; Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Anatoly S Borovik
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ekaterina I Borovkova
- Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Eugeniya A Orlova
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | | | - Vladimir I Ponomarenko
- Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State University, Saratov, Russia
| | | | - Vladimir I Gridnev
- Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Boris P Bezruchko
- Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Mikhail D Prokhorov
- Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anton R Kiselev
- Saratov State Medical University, Saratov, Russia; National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia.
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12
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O'Brien MW, Ramsay DJ, O'Neill CD, Petterson JL, Dogra S, Mekary S, Kimmerly DS. Aerobic fitness is inversely associated with neurohemodynamic transduction and blood pressure variability in older adults. GeroScience 2021; 43:2737-2748. [PMID: 34056679 DOI: 10.1007/s11357-021-00389-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022] Open
Abstract
Higher aerobic fitness is independently associated with better cardiovascular health in older adults. The transduction of muscle sympathetic nerve activity (MSNA) into mean arterial pressure (MAP) responses provides important insight regarding beat-by-beat neural circulatory control. Aerobic fitness is negatively associated with peak MAP responses to spontaneous MSNA in young males. Whether this relationship exists in older adults is known. We tested the hypothesis that aerobic fitness was inversely related to sympathetic neurohemodynamic transduction and blood pressure variability (BPV) in older adults. Relative peak oxygen consumption (V̇O2peak, indirect calorimetry) was assessed in 22 older adults (13 males, 65 ± 5 years, 36.3 ± 11.5 ml/kg/min). Peroneal MSNA (microneurography) and arterial pressure (finger photoplethysmography) were recorded during ≥ 10-min of rest. BPV was assessed using the average real variability index. MAP was tracked for 12 cardiac cycles following heartbeats associated with MSNA bursts (i.e., peak ΔMAP). Peak ΔMAP responses (0.9 ± 0.6 mmHg) were negatively associated (all, P < 0.04) with resting burst frequency (30 ± 11 bursts/min; R = -0.47) and burst incidence (54 ± 22 bursts/100 heartbeats; R = -0.51), but positively associated with BPV (ρ = 0.47). V̇O2peak was inversely related to the pressor responses to spontaneous bursts (R = -0.47, P = 0.03) and BPV (ρ = -0.54, P = 0.01), positively related to burst incidence (R = 0.42, P = 0.05), but unrelated to MSNA burst frequency (P = 0.20). The V̇O2peak-BPV relationship remained after controlling for burst frequency, peak ΔMAP, age, and sex. Lower V̇O2peak was associated with augmented neurohemodynamic transduction and BPV in older adults. These negative hemodynamic outcomes highlight the importance of higher aerobic fitness with ageing for optimal cardiovascular health.
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Affiliation(s)
- Myles W O'Brien
- Autonomic Cardiovascular Control and Exercise Laboratory, Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada
| | - Diane J Ramsay
- Autonomic Cardiovascular Control and Exercise Laboratory, Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada
| | - Carley D O'Neill
- Exercise Physiology and Cardiovascular Health Lab, University of Ottawa Heart Institute, Ottawa, ON, Canada.,School of Kinesiology, Acadia University, Wolfville, NS, Canada
| | - Jennifer L Petterson
- Autonomic Cardiovascular Control and Exercise Laboratory, Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada
| | - Shilpa Dogra
- School of Kinesiology, Acadia University, Wolfville, NS, Canada.,Health and Human Performance Laboratory, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Said Mekary
- School of Kinesiology, Acadia University, Wolfville, NS, Canada
| | - Derek S Kimmerly
- Autonomic Cardiovascular Control and Exercise Laboratory, Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada.
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13
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Farrell MC, Giza RJ, Shibao CA. Race and sex differences in cardiovascular autonomic regulation. Clin Auton Res 2020; 30:371-379. [PMID: 32894376 DOI: 10.1007/s10286-020-00723-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022]
Abstract
Racial and ethnic differences in cardiovascular morbidity and mortality persist despite advances in risk factor identification and implementation of evidence-based treatment strategies. African American men and women are disproportionately affected by cardiovascular risk factors, particularly hypertension. In this context, previous studies have identified sex and racial differences in autonomic cardiovascular regulation which may contribute to the development of hypertension and its high morbidity burden among African Americans. In this review, we provide a comprehensive evaluation of the potential pathophysiological mechanisms of blood pressure control and their differences based on sex and race. These mechanisms include obesity-induced sympathetic activation, sympatho-vascular transduction, baroreflex sensitivity and adrenoreceptor vascular sensitivity, which have been the subjects of prior investigation in this field. Understanding the racial differences in the pathophysiology of hypertension and its co-morbid conditions would allow us to implement better treatment strategies tailored to African Americans, with the ultimate goal of reducing cardiovascular mortality in this population.
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Affiliation(s)
| | - Richard J Giza
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Cyndya A Shibao
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University Medical Center, 506 Robinson Research Building, Nashville, TN, 37232-6602, USA.
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14
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Samora M, Teixeira AL, Sabino-Carvalho JL, Vianna LC. Sex differences in cardiac vagal reactivation from the end of isometric handgrip exercise and at the onset of muscle metaboreflex isolation. Auton Neurosci 2020; 228:102714. [PMID: 32829151 DOI: 10.1016/j.autneu.2020.102714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/09/2020] [Accepted: 08/07/2020] [Indexed: 11/18/2022]
Abstract
A parasympathetic reactivation is an underlying mechanism mediating the rapid fall in heart rate (HR) at the onset of post-exercise ischemia (PEI) in humans. Herein, we tested the hypothesis that, compared to men, women present a slower HR recovery at the cessation of isometric handgrip exercise (i.e., onset of PEI) due to an attenuated cardiac vagal reactivation. Forty-seven (23 women) young and healthy volunteers were recruited. Subjects performed 90s of isometric handgrip exercise at 40% of maximal voluntary contraction followed by 3-min of PEI. The onset of PEI was analyzed over the first 30s in 10s windows. Cardiac vagal reactivation was indexed using the HR fall and by HR variability metrics (e.g., RMSSD and SDNN) immediately after the cessation of the exercise. HR was significantly increased from rest during exercise in men and women and increases were similar between sexes. However, following the cessation of exercise, the HR recovery was significantly slower in women compared to men regardless of the time point (women vs. men: ∆-14 ± 8 vs. ∆-18 ± 6 beats.min-1 at 10s; ∆-20 ± 9 vs. ∆-25 ± 8 beats.min-1 at 20s; ∆-22 ± 10 vs. ∆-27 ± 9 beats.min-1 at 30s; P = .027). RMSSD and SDNN increased at the cessation of exercise in greater magnitude in men compared to women. These findings demonstrate that women had a slower HR recovery at the cessation of isometric handgrip exercise and onset of PEI compared to men, suggesting a sex-related difference in cardiac vagal reactivation in healthy young humans.
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Affiliation(s)
- Milena Samora
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - André L Teixeira
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Jeann L Sabino-Carvalho
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Lauro C Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil; Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília, Brasília, DF, Brazil.
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15
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Fadel PJ. Reply from Paul J. Fadel. Exp Physiol 2020. [DOI: 10.1113/ep088847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Paul J. Fadel
- Department of Kinesiology University of Texas at Arlington Arlington TX USA
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16
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Charkoudian N, Fadel PJ, Robinson AT, Zucker IH. Call for papers on racial differences in cardiovascular and cerebrovascular physiology. Am J Physiol Heart Circ Physiol 2020; 319:H249-H250. [PMID: 32618515 DOI: 10.1152/ajpheart.00524.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Nisha Charkoudian
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | | | - Irving H Zucker
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska
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17
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Pendyal A. Augmented resting beat‐to‐beat blood pressure variability in young, healthy, non‐Hispanic black men. Exp Physiol 2020. [DOI: 10.1113/ep088813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Akshay Pendyal
- Novant Health Heart and Vascular Institute Charlotte NC USA
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18
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Millar PJ. Looking beyond the mean: Are racial differences in beat-to-beat blood pressure variability among young men a harbinger for future cardiovascular risk? Exp Physiol 2020; 105:1055-1057. [PMID: 32428314 DOI: 10.1113/ep088726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.,Toronto General Research Institute, Toronto, Ontario, Canada
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