Effect of postural changes on cardiovascular parameters across gender

Patel, Kartik; Rössler, Andreas; Lackner, Helmut; Trozić, Irhad; Laing, Charles; Lorr, David; Green, David A.; Hinghofer‐Szalkay, Helmut; Goswami, Nandu

doi:10.1097/md.0000000000004149

Cited by 47 publications

(42 citation statements)

References 41 publications

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“…67 increased sympathetic activity to the heart and vasculature (Cooke et al 1999). We extend previous observations on the decrease of the RSA magnitude during HUT (Laitinen et al 2004, Patel et al 2016 showing that during HUT the contribution of the baroreflex to RSA generation is enhanced, as reflected by the significantly increased delta values (indirectionality index) (Fig. 2c).…”

Section: Discussionsupporting

confidence: 87%

Information Domain Analysis of Respiratory Sinus Arrhythmia Mechanisms

Krohová

Czippelová²,

Turianiková³

et al. 2018

Physiol Res

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Ventilation related heart rate oscillations -respiratory sinus arrhythmia (RSA) -originate in human from several mechanisms. Two most important of them -the central mechanism (direct communication between respiratory and cardiomotor centers), and the peripheral mechanism (ventilation-associated blood pressure changes transferred to heart rate via baroreflex) have been described in previous studies. The major aim of this study was to compare the importance of these mechanisms in the generation of RSA non-invasively during various states by quantifying the strength of the directed interactions between heart rate, systolic blood pressure and respiratory volume signals. Seventy-eight healthy volunteers (32 male, age range: 16.02-25.77 years, median age: 18.57 years) participated in this study. The strength of mutual interconnections among the spontaneous beat-to-beat oscillations of systolic blood pressure (SBP), R-R interval (RR signal) and respiration (volume changes -RESP signal) was quantified during supine rest, orthostatic challenge (head-up tilt, HUT) and cognitive load (mental arithmetics, MA) using bivariate and trivariate measures of cardio-respiratory information transfer to separate baroreflex and nonbaroreflex (central) mechanisms. Our results indicate that both basic mechanisms take part in RSA generation in the intact cardiorespiratory control of human subjects. During orthostatic and mental challenges baroreflex based peripheral mechanism becomes more important.

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Section: Discussionsupporting

confidence: 87%

Information Domain Analysis of Respiratory Sinus Arrhythmia Mechanisms

Krohová

Czippelová²,

Turianiková³

et al. 2018

Physiol Res

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“…Firstly , the sample size of the present study, whilst in line with others investigating the effect of gender on the haemodynamic response tilting (Shoemaker et al, 2001; Fu et al, 2005; Patel et al, 2016; Reulecke et al, 2016), is not sufficient to draw any conclusions regarding the relative contribution of gender per se above that of gender-related differences in body size and/or composition. Further investigation is therefore warranted to confirm these results in a larger number of participants and across a larger range of body morphology.…”

Section: Discussionmentioning

confidence: 42%

“…However, whilst a number of studies have now explored gender differences using a single tilt angle (typically between 60° and 80°) compared to supine (Fu et al, 2005; Ndayisaba et al, 2015; Kangas et al, 2016; Patel et al, 2016; Reulecke et al, 2016), fewer studies have investigated these differences in response to graded, incremental tilting (i.e., no return to supine between each tilt angle (Shoemaker et al, 2001). Such studies are warranted as they may provide important information regarding response thresholds and possible gender differences in such thresholds.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Gender and Anthropometry on Haemodynamic Status at Rest and in Response to Graded Incremental Head-Up Tilt in Young, Healthy Adults

Sarafian

Miles-Chan

2017

Front. Physiol.

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The body's ability to rapidly and appropriately regulate blood pressure in response to changing physiological demand is a key feature of a healthy cardiovascular system. Passively tilting the body, thereby changing central blood volume, is a well-recognized and controlled method of evaluating this ability. However, such studies usually involve single tilt angles, or intermittent tilting separated by supine, resting periods; valuable information concerning the adaptive capacity of the regulatory systems involved is therefore currently lacking. Furthermore, despite increasing recognition that men and women differ in the magnitude of their haemodynamic response to such stimuli, little is known about the degree to which gender differences in body composition and anthropometry influence these regulatory pathways, or indeed if these differences are apparent in response to graded, incremental tilting. In the present study we measured, in 23 young, healthy adults (13 men, 10 women), the continuous beat-to-beat haemodynamic response to graded, incremental tilting (0°, 20°, 40°, 60°, and back to 40°) with each tilt angle lasting 16 min. On average, we observed increases in heart rate (+41%), blood pressure (+10%), and total peripheral resistance (+16%) in response to tilting. However, whilst men showed an immediate decrease in cardiac output upon tilting (−8.9%) cardiac output in women did not change significantly from supine values. Interestingly, the decrease in stroke volume observed in women was significantly less than that observed in men (−22 vs. −36%, p < 0.05); although the present study could not determine if this difference was due to gender per se or due to differences in body size (in particular height) between the two gender groups. Such disparities in the magnitude of autonomic response may indicate (in the case of our gradual incremental tilt procedure) a better buffering capacity to progressive changes in central blood volume in women; which warrants further investigation, particularly in light of the well-recognized differences in cardiovascular disease risk between men and women.

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“…Gender has previously demonstrated a mixed contribution to baroreceptor response—with early experiments showing a modest hypertension and increase in SV for males compared with female subjects, yet more recent experiments indicating no gender effect on baroreceptor response during postural change . Hence any gender imbalance within our study populations was not the cause for responses we noted.…”

Section: Discussionmentioning

confidence: 42%

Modulation of the orthostatic blood pressure response by acute nitrate consumption is dependent upon ethnic origin

Allen

Chuter

Fithon

et al. 2018

Clin Exp Pharma Physio

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Orthostatic stress triggers a response to maintain cerebral perfusion and prevent syncope. Given the hypotensive effects of inorganic nitrate this response to orthostasis may be altered by acute supplementation with inorganic nitrate and modified by ethnic origin. Caucasian and SE Asian (n = 30 for both), were recruited and subjected to an 'active stand test' and brachial artery blood pressure (BP), digit blood flow and ECG were recorded. Following inorganic nitrate supplementation, (10 mg/kg body mass) the tests were repeated. For both Caucasian and SE Asians transition to standing increased diastolic pressure (DP) and heart rate (HR) (P < 0.001 for both) and by calculation increased rate-pressure product (P < 0.001) and decreased pulse pressure (P < 0.01 for both) indicative of decreased ventricular filling. Nitrate supplementation decreased both DP (P < 0.001) and HR (P < 0.001). Assessment of HR variability suggested sympathetic nerve activity, was higher throughout in Caucasians (P < 0.05) coupled with higher parasympathetic tone (P < 0.01). Nitrate had no effect on cardiac autonomic nerve activity, as estimated using HR variability, for supine or standing subjects. The tachycardia and hypertension associated with orthostatic stress were preserved in both Caucasian and SE Asian subjects, however, we highlight possible differences in autonomic nervous system activity between Caucasians and SE Asians. SE Asians are resistant to the hypotensive effects of inorganic nitrate supplementation suggesting the absence of a crucial mechanism for activation of the nitrate-nitrite-nitric oxide system.

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Effect of postural changes on cardiovascular parameters across gender

Cited by 47 publications

References 41 publications

Information Domain Analysis of Respiratory Sinus Arrhythmia Mechanisms

Information Domain Analysis of Respiratory Sinus Arrhythmia Mechanisms

The Influence of Gender and Anthropometry on Haemodynamic Status at Rest and in Response to Graded Incremental Head-Up Tilt in Young, Healthy Adults

Modulation of the orthostatic blood pressure response by acute nitrate consumption is dependent upon ethnic origin

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