Evolution of blood pressure and cholesterol in stage 1 hypertension: role of autonomic nervous system activity

Palatini, Paolo; Longo, Daniele; Zaetta, Vania; Perkovic, Davor; Garbelotto, Raffaella; Pessina, Achille C.

doi:10.1097/01.hjh.0000234118.25401.1c

Cited by 53 publications

(36 citation statements)

References 33 publications

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“…Although the predictive value for HDL cholesterol is not entirely in line with our previous results-we only found a cross-sectional relationship between HDL cholesterol and HR-it does match with other cross-sectional results (17,19,62). Our BP and HDL cholesterol findings perfectly match those of Palatini et al (6). In a study on hypertension and lipid abnormalities, they reported that subjects with sympathetic predominance (high sympathetic activity relative to low parasympathetic activity) showed increased BP (systolic as well as diastolic) and total cholesterol levels at 6-year follow-up compared to the subjects without autonomic dysregulations.…”

Section: Discussionsupporting

confidence: 82%

Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome

Licht

Geus

Penninx

2013

The Journal of Clinical Endocrinology &Amp; Metabolism

123

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Context:Stress is suggested to lead to metabolic dysregulations as clustered in the metabolic syndrome. Although dysregulation of the autonomic nervous system is found to associate with the metabolic syndrome and its dysregulations, no longitudinal study has been performed to date to examine the predictive value of this stress system in the development of the metabolic syndrome.Objective: We examined whether autonomic nervous system functioning predicts 2-year development of metabolic abnormalities that constitute the metabolic syndrome.Design: Data of the baseline and 2-year follow-up assessment of a prospective cohort: the Netherlands Study of Depression and Anxiety was used.Setting: Participants were recruited in the general community, primary care, and specialized mental health care organizations.Participants: A group of 1933 participants aged 18 -65 years. Main outcome measures:The autonomic nervous system measures included heart rate (HR), respiratory sinus arrhythmia (RSA; high RSA reflecting high parasympathetic activity), pre-ejection period (PEP; high PEP reflecting low sympathetic activity), cardiac autonomic balance (CAB), and cardiac autonomic regulation (CAR). Metabolic syndrome was based on the updated Adult Treatment Panel III criteria and included high waist circumference, serum triglycerides, blood pressure, serum glucose, and low high-density lipoprotein (HDL) cholesterol.Results: Baseline short PEP, low CAB, high HR, and CAR were predictors of an increase in the number of components of the metabolic syndrome during follow-up. High HR and low CAB were predictors of a 2-year decrease in HDL cholesterol, and 2-year increase in diastolic and systolic blood pressure. Short PEP and high CAR also predicted a 2-year increase in systolic blood pressure, and short PEP additionally predicted 2-year increase in diastolic blood pressure. Finally, a low baseline RSA was predictive for subsequent decreases in HDL cholesterol. Conclusion:Increased sympathetic activity predicts an increase in metabolic abnormalities over time. These findings suggest that a dysregulation of the autonomic nervous system is an important predictor of cardiovascular diseases and diabetes through dysregulating lipid metabolism and blood pressure over time.

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Section: Discussionsupporting

confidence: 82%

Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome

Licht

Geus

Penninx

2013

The Journal of Clinical Endocrinology &Amp; Metabolism

123

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“…Sympathetic predominance is both a risk factor for developing sustained hypertension [2] and for developing cardiovascular disease (CVD) in those with sustained hypertension [3,4]. Markers of sympathetic activity such as norepinephrine (NE) levels are generally higher in hypertensives than normotensives, both at baseline and when confronted with a psychosocial stressor [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Changes in plasma lipids with psychosocial stress are related to hypertension status and the norepinephrine stress response

et al. 2009

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Hypertension is a known risk factor for cardiovascular disease. Hypertensive individuals show exaggerated norepinephrine (NE) reactivity to stress. Norepinephrine is a known lipolytic factor. It is unclear if, in hypertensive individuals, stress-induced increases in NE are linked with the elevations in stress-induced circulating lipid levels. Such a mechanism could have implications for atherosclerotic plaque formation. In a cross-sectional, quasi-experimentally controlled study, 22 hypertensive and 23 normotensive men (mean +/-SEM, 45 +/-3 years) underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience. We measured plasma NE and the plasma lipid profile (total cholesterol [TC], low-density-lipoprotein cholesterol [LDL-C], high-density-lipoprotein cholesterol, and triglycerides) immediately before and after stress and at 20 and 60 minutes of recovery. All lipid levels were corrected for stress hemoconcentration. Compared with normotensives, hypertensives had greater TC (P = .030) and LDL-C (P = .037) stress responses. Independent of each other, mean arterial pressure (MAP) upon screening and immediate increase in NE predicted immediate stress change in TC (MAP: beta = .41, P = .003; NE: beta = .35, P = .010) and LDL-C (MAP: beta = .32, P = .024; NE: beta = .38, P = .008). Mean arterial pressure alone predicted triglycerides stress change (beta = .32, P = .043) independent of NE stress change, age, and BMI. The MAP-by-NE interaction independently predicted immediate stress change of high-density-lipoprotein cholesterol (beta = -.58, P < .001) and of LDL-C (beta = -.25, P < .08). We conclude that MAP and NE stress reactivity may elicit proatherogenic changes of plasma lipids in response to acute psychosocial stress, providing one mechanism by which stress might increase cardiovascular risk in hypertension.

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“…There are data that strongly indicate that hypertension in the young occurs in those with sympathetic predominance [75]. Younger hypertensives do indeed have an approximate 2-fold increase in sympathetic activity compared to normotensive controls [76], closely linked to obesity and the biochemical changes associated with the metabolic syndrome [57,77].…”

Section: B)mentioning

confidence: 97%

Are we misunderstanding beta-blockers

Cruickshank¹

2007

International Journal of Cardiology

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Evolution of blood pressure and cholesterol in stage 1 hypertension: role of autonomic nervous system activity

Cited by 53 publications

References 33 publications

Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome

Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome

Changes in plasma lipids with psychosocial stress are related to hypertension status and the norepinephrine stress response

Are we misunderstanding beta-blockers

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