Interactive Effect of Heart Rate and Muscle Sympathetic Nerve Activity on Blood Pressure

Narkiewicz, Krzysztof; Somers, Virend K.

doi:10.1161/01.cir.100.25.2514

Cited by 32 publications

(28 citation statements)

References 47 publications

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“…[3][4][5] In the present study, we were also not able to demonstrate an independent link between MSNA and office blood pressure. However, MSNA interacted significantly with the variability characteristics and diurnal blood pressure profile recorded in the ambulatory setting.…”

Section: Discussioncontrasting

confidence: 98%

“…1,2 Surprisingly, previous studies found no direct relationship between muscle sympathetic nerve activity (MSNA) and office blood pressure in normal subjects. [3][4][5] Ambulatory monitoring provides a more accurate estimate of the true blood pressure than office (casual) measurements. This has been attributed both to the greater number of readings and to the fact that they are taken under more representative circumstances than the clinic setting.…”

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confidence: 99%

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Relationship Between Muscle Sympathetic Nerve Activity and Diurnal Blood Pressure Profile

et al. 2002

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Abstract-The physiological mechanisms mediating the variability and diurnal rhythm of blood pressure are unclear. We tested the hypothesis that resting sympathetic activity is linked to the variability characteristics and 24-hour profile of ambulatory blood pressure measurements. We evaluated the relationship between muscle sympathetic nerve activity (MSNA) and the level, variability, and nocturnal fall of ambulatory blood pressure in 69 normal men. Subjects were subdivided according to the tertiles of MSNA distributions. Mean 24-hour blood pressure was not significantly different across the 3 groups. Compared with subjects in the first tertile (lowest MSNA, Ͻ18 bursts/min), subjects in the third tertile (highest MSNA, Ͼ25 bursts/min) had significantly greater daytime blood pressure variability, whether expressed as absolute values (10.2Ϯ0.5 versus 8.1Ϯ0.4 mm Hg for systolic blood pressure and 9.4Ϯ0.4 versus 7.2Ϯ0.4 mm Hg for diastolic blood pressure; PϽ0.01 for both comparisons) or as variation coefficients (8.1Ϯ0.4% versus 6.6Ϯ0.3% for systolic blood pressure and 12.7Ϯ0.7% versus 10.1Ϯ0.6% for diastolic blood pressure; PϽ0.01 for both comparisons). Subjects in the third tertile also had a more striking absolute and percentage fall in systolic blood pressure from daytime to nighttime than subjects in the first tertile (17Ϯ2 versus 10Ϯ2 mm Hg, Pϭ0.02, or 13Ϯ1% versus 8.2Ϯ1.4%, Pϭ0.02). In conclusion, higher resting measurements of sympathetic traffic are associated with greater daytime blood pressure variability and a more marked nocturnal decline in blood pressure in normal subjects. These findings suggest that sympathetic neural mechanisms may contribute importantly to the regulation of blood pressure over the 24-hour period. (Hypertension. 2002;39:168-172.)

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confidence: 98%

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Relationship Between Muscle Sympathetic Nerve Activity and Diurnal Blood Pressure Profile

et al. 2002

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“…17 Furthermore, in men but not women MSNA has interactive effects on HR and systolic BP. 18 We suggest that the faster HR in lean women may 68.170.6 (45.6-100.0) Abbreviations: BMI, body mass index; DHR, daytime heart rate; DSBP, daytime systolic blood pressure; DDBP, daytime diastolic blood pressure; NHR, night time heart rate; NDBP, night time diastolic blood pressure; NSBP, night time systolic blood pressure.…”

Section: Discussionmentioning

confidence: 94%

“…Alternatively, the effect of higher sympathetic vasoconstriction on BP in lean men may be blunted by slowing of HR owing to an increase in vagal tone. 18 It is known that in obesityassociated hypertension, renal sympathetic tone, as measured by noradrenaline 'spillover' into the renal veins, is high. 19 However, whether there is a difference in sympathetic nerve hyperactivity between obese men and women is unclear.…”

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confidence: 99%

Gender differences in ambulatory blood pressure monitoring profile in obese, overweight and normal subjects

Kagan

Faibel²,

Ben-Arie

et al. 2006

J Hum Hypertens

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The incidence of obesity has increased enormously in the past several decades, and has been described as a modern epidemic. Obesity is a major factor contributing to hypertension. To the best of our knowledge, no study of ambulatory blood pressure monitoring (ABPM) comparing men with women in relation to body mass indexes (BMI) has been performed. From December 2002 to May 2006, we performed 24-h ABPM in 5950 subjects (3102 men and 2848 women), with a wide range of BMI (range 15.9-53.2 kg/m 2 ). We defined obese subjects as those with BMIX30.0 kg/m 2 , overweight subjects as those with BMI425.0 and o30.0 kg/m 2 , and normal subjects as those with BMIp25.0 kg/m 2 . Data on 989 subjects (501 men and 488 women) aged from X18 to p69 years without antihypertensive treatment, atrial fibrillation or diabetes were included for analysis. We consistently found that obese men had the expected increased heart rate compared to normal and overweight men, whereas women (normal, overweight and obese) had similar HRs. In addition, normal and obese women had similar diastolic blood pressures (BP), as opposed to obese men, who had raised diastolic BP. These results may indicate that different pathogenetic mechanisms may be involved in the relationship between obesity and hypertension in men and women.

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“…2 In most longitudinal studies, this association has been found to be independent of traditional risk factors for atherosclerosis or cardiovascular events, such as age and sex. 3 Several studies have shown that higher HR values are associated with increased blood pressure (BP) levels 4 and that sympathetic hyperactivity is a major determinant of both hypertension and tachycardia; 5 in human hypertension; however, the prognostic significance of HR is based on a few prospective studies showing a positive association between HR and cardiovascular mortality in men but not in women. [6][7][8][9] Furthermore, the relationship between HR and target organ damage (TOD), a powerful predictor of coronary and cerebrovascular events in the hypertensive population, has been investigated by a few studies yielding conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory heart rate and target organ damage in never-treated essential hypertensives

et al. 2007

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Limited evidence is available about the relationship between ambulatory heart rate (HR) and target organ damage (TOD) in uncomplicated hypertension. We sought to investigate the association between ambulatory HR and subclinical cardiac, vascular and renal markers of TOD in never-treated essential hypertensives. A total of 580 subjects with recently diagnosed (p1 year) grade 1 and 2 hypertension, categorized by tertiles of HR levels, assessed by two 24-h ambulatory blood pressure monitoring at 1-to 4-week interval, sex and the presence or absence of TOD were considered for this analysis. All subjects also underwent laboratory and ultrasonographic investigations searching for microalbuminuria (MA), left ventricular hypertrophy (LVH) and carotid atherosclerosis (carotid thickening/plaque). In the whole population, as well as in both genders, LVH, carotid atherosclerosis and MA prevalence rates did not significantly increase with 48-h HR tertiles. When patients were categorized according to the presence or absence of TOD (that is, LVH, carotid atherosclerosis or MA) no significant intergroup differences in 48-h HR were found. Furthermore, average 48-h HR was similar in patients without organ involvement as in those with one, two or three TOD signs. Finally, in a multivariate analysis age, 48-h systolic blood pressure and metabolic syndrome assessed by ATP III criteria, but not HR were independently associated with TOD. Our findings showing that 48-h ambulatory HR is not associated with markers of TOD do not support the view that a faster HR may have an additive value in predicting organ damage in the early phases of essential hypertension.

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Interactive Effect of Heart Rate and Muscle Sympathetic Nerve Activity on Blood Pressure

Cited by 32 publications

References 47 publications

Relationship Between Muscle Sympathetic Nerve Activity and Diurnal Blood Pressure Profile

Relationship Between Muscle Sympathetic Nerve Activity and Diurnal Blood Pressure Profile

Gender differences in ambulatory blood pressure monitoring profile in obese, overweight and normal subjects

Ambulatory heart rate and target organ damage in never-treated essential hypertensives

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