Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

Parati, Gianfranco; Ochoa, Juan Eugenio; Bilo, Grzegorz

doi:10.1007/s11906-012-0290-7

Cited by 117 publications

(104 citation statements)

References 119 publications

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“…Importantly, many physical activities of daily living for healthy older adults that may occur in the cold have brief and submaximal components in the forearm musculature (e.g., gripping snow shovels, scraping ice, etc.). While these brief bouts of isometric contractions are likely occurring in the context of dynamic whole body exercise, they presumably result in transient increases in MSNA and BP, and these repeated responses may increase both short-and long-term cardiovascular risk (45). Therefore, understanding the acute physiological responses to isometric forearm muscle contractions in the cold is clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

Muscle sympathetic nerve activity during cold stress and isometric exercise in healthy older adults

Greaney

Stanhewicz

Kenney

et al. 2014

Journal of Applied Physiology

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Greaney JL, Stanhewicz AE, Kenney WL, Alexander LM. Muscle sympathetic nerve activity during cold stress and isometric exercise in healthy older adults. J Appl Physiol 117: 648 -657, 2014. First published August 7, 2014 doi:10.1152/japplphysiol.00516.2014.-Cardiovascular mortality increases in cold weather in older adults, and physical activity may impart even greater cardiovascular risk than cold exposure alone. Human aging is associated with exaggerated pressor responses to whole body cooling; however, the sympathetic response to cold stress alone and in combination with isometric exercise is unknown. We hypothesized that cold stress would 1) increase muscle sympathetic nerve activity (MSNA) and 2) augment the MSNA response to isometric handgrip in older adults. Whole body cooling (water-perfused suit) was conducted in 11 young (23 Ϯ 1 yr) and 12 healthy older adults (60 Ϯ 2 yr). Blood pressure (BP; Finometer) and MSNA (microneurography) were measured throughout cooling and during isometric handgrip at 30% maximal voluntary contraction performed at a mean skin temperature (T sk) of 34 and 30.5°C. MSNA was greater in older adults at T sk ϭ 34.0°C and throughout cooling (P Ͻ 0.05). MSNA increased during cooling in older, but not young, adults (young: ⌬0 Ϯ 1 vs. older: ⌬8 Ϯ 1 bursts/min; P Ͻ 0.05). The cooling-induced increase in BP was greater in older adults (P Ͻ 0.05). During handgrip, the increases in MSNA and BP were not different between conditions in either young (⌬14 Ϯ 2 T sk 34°C vs. ⌬12 Ϯ 3 Tsk 30.5°C bursts/min; ⌬20 Ϯ 3 Tsk 34°C vs. ⌬19 Ϯ 3 Tsk 30.5°C mmHg; both P Ͼ 0.05) or older adults (⌬12 Ϯ 1 Tsk 34°C vs. ⌬8 Ϯ 1 Tsk 30.5°C bursts/min; ⌬18 Ϯ 3 Tsk 34°C vs. ⌬17 Ϯ 2 Tsk 30.5°C mmHg; both P Ͼ 0.05). In summary, MSNA increased during cold stress in older, but not young, adults. Furthermore, concomitant cold stress did not alter the sympathetic responses to isometric exercise in either age group, suggesting preserved sympathetic responsiveness during exercise in the cold in healthy aging. blood pressure; aging; handgrip; whole body cooling AGING IS A PRIMARY RISK FACTOR for cardiovascular disease, the leading cause of death in the United States (18). Furthermore, cardiovascular-related morbidity and mortality increase at low ambient temperatures, especially in older adults (5,38,44,50,63). The acute systemic physiological responses to cold exposure include peripheral and visceral vasoconstriction, elevated plasma norepinephrine, and increased blood pressure (BP) (9,52,62). Therefore, alterations in the acute responses to cold may contribute to the clinical relation between cold temperatures and increased cardiovascular-related mortality in primary aging. Perturbations that further challenge systemic physiological function during cold exposure, such as static or dynamic exercise, may result in increased sympathetic activation and excessive increases in BP, imparting even greater risk for an acute cardiovascular event in older adults. As such, understanding age-related changes in the acute sympathetic and...

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Section: Discussionmentioning

confidence: 99%

Muscle sympathetic nerve activity during cold stress and isometric exercise in healthy older adults

Greaney

Stanhewicz

Kenney

et al. 2014

Journal of Applied Physiology

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“…Significant relation of adverse cardiovascular events with BPV and the non-dipper phenomenon, in addition to average BP, have recently been reported in hypertensive patients. 3,12 Non-dipper hypertension is a clinical situation with blunted decrease in BP at nighttime. Increased cardiovascular morbidity and mortality have been demonstrated in non-dipper patients when compared with the dipper patients in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…But nowadays, independent of average BP, blood pressure variability (BPV) has emerged as a new risk factor for adverse cardiovascular events in hypertensive patients. 2 Additionally, BPV is considered to have a role in development and progression of these end-organ injuries, 3 so it can be a novel therapeutic target.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Short‐term Blood Pressure Variability in Patients With Ascending Aortic Dilatation

Karataş

İpek

Çanga

et al. 2015

Clinical Cardiology

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Background: Blood pressure variability (BPV) is a novel parameter related to adverse cardiovascular findings and events, especially in hypertensive patients. The aim of the present study was to investigate the relationship between short-term BPV and ascending aortic dilatation (AAD). Hypothesis: Hypertensive patients with AAD may exhibit higher short-term BPV compared to hypertensive patients with normal diameter ascending aorta and BPV may be correlated with aortic sizes. Methods: Seventy-six hypertensive patients with AAD and 181 hypertensive patients with a normal-diameter ascending aorta were retrospectively enrolled in the study. Clinical data, echocardiographic characteristics, and 24-hour ambulatory blood pressure monitoring characteristics were compared between the 2 groups. Standard deviation (SD) and of BP were used as parameters of BPV. Results: Although 24-hour mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similar between the 2 groups, the SD of SBP and SD of DBP values were significantly higher in AAD patients (17.2 ± 6.8 vs 13.8 ± 3.5, P < 0.01; and 12.1 ± 5.1 vs 10.7 ± 3.1, P = 0.02, respectively). Daytime SD of SBP values were higher in AAD patients, whereas nighttime SD of SBP values did not differ between groups. In multivariate linear regression analysis, 24-hour SD of SBP, 24-hour SBP, daytime SD of SBP, daytime SBP, and left ventricular mass index were independently correlated with aortic size index. Conclusions: Our study revealed higher levels of short-term BPV in hypertensive patients with AAD. This conclusion warrants further study.

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“…Increased cardiovascular variability is a recognized risk factor for cardiovascular diseases (Lombardi, 2002;Narkiewicz and Grassi, 2008;Parati et al, 2012) and its complications such as stroke (Lattanzi et al 2015a). Furthermore, Lattanzi and colleagues reported in aseries of clinical studies (Lattanzi et al, 2014a;2014b, 2015b) that patients suffering from Alzheimer disease exhibit greater BP variability compared to age-matched controls, and that greater SBP variability in this patient population predicted faster cognitive decline, supporting the concept that vascular disease aggravates cognitive impairment.…”

Section: Discussionmentioning

confidence: 89%

Over-expression of V1A receptors in PVN modulates autonomic cardiovascular control

Lozić

Tasić

Martin

et al. 2016

Pharmacological Research

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The hypothalamic paraventricular nucleus (PVN) is a key integrative site for the neuroendocrine control of the circulation and of the stress response. It is also a major source of the neuropeptide hormone vasopressin (VP), and co-expresses V1a receptors (V1aR). We thus sought to investigate the role of V1aR in PVN in cardiovascular control in response to stress.Experiments were performed in male Wistar rats equipped with radiotelemetric device. The right PVN was transfected with adenoviral vectors (Ads) engineered to over-express V1aR along with an enhanced green fluorescent protein (eGFP) tag. Control groups were PVN transfected with Ads expressing eGFP alone, or wild-type rats (Wt). Rats were recorded with and without selective blockade of V1aR (V1aRX) in PVN under both baseline and stressed conditions. Blood pressure (BP), heart rate (HR), their short-term variabilities, and baroreflex sensitivity (BRS) were evaluated using spectral analysis and the sequence method, respectively. Under baseline physiological conditions,V1aR rats exhibited reduced BRS and a marked increase of BP and HR variability during exposure to stress. These effects were all prevented by V1aRX pretreatment. In Wt rats, V1aRX did not modify cardiovascular parameters under baseline conditions, and prevented BP variability increase by stress.However, V1aRX pretreatment did not modify baroreflex desensitization by stress in either rat strain. It follows that increased expression of V1aR in PVN influences autonomic cardiovascular regulation and demarcates vulnerability to stress. We thus suggest a possible role of hypothalamic V1aR in cardiovascular pathology. KeywordsVasopressin, V1a receptor, paraventricular nucleus, adenoviral vector, baroreflex, blood pressure variability, heart rate variability Abbreviations BRS, baroreflex sensitivity; VLF, very low frequency short-term variability; LF, low frequency short-term variability; HF, high frequency short-term variability; VP, vasopressin;OT, oxytocin; OTR, oxytocin receptor; V1aR, vasopressin V1a receptor; V1bR, vasopressin V1b receptor; V2R, vasopressin V2 receptor; V1aRX, vasopressin V1a receptor antagonist, PVN, paraventricular nucleus; NTS, nucleus of the solitary tract; RVLM; rostroventrolateral medulla; IML, intermediolateral column of the spinal cord.

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Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

Cited by 117 publications

References 119 publications

Muscle sympathetic nerve activity during cold stress and isometric exercise in healthy older adults

Muscle sympathetic nerve activity during cold stress and isometric exercise in healthy older adults

Assessment of Short‐term Blood Pressure Variability in Patients With Ascending Aortic Dilatation

Over-expression of V1A receptors in PVN modulates autonomic cardiovascular control

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