Sympathetic Activity and Markers of Cardiovascular Risk in Nondiabetic Severely Obese Patients: The Effect of the Initial 10% Weight Loss

Lambert, Elisabeth; Rice, Thomas Jackson; Eikelis, Nina; Straznicky, Nora E.; Lambert, Gavin W.; Head, Geoffrey A.; Hensman, Chris; Schlaich, Markus P.; Dixon, John

doi:10.1093/ajh/hpu050

Cited by 37 publications

(31 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We recently demonstrated that in patients achieving 10% weight loss following laparoscopic adjustable gastric band surgery, benefits were already visible. In addition, the weight loss was associated with a substantial reduction in MSNA and improvement in blood pressure and renal function (88). Similar results were noticed 6 mo and 1 yr after vertical sleeve gastrectomy where subjects showed in addition to metabolic and hemodynamic improvements, a substantial decrease in MSNA (142).…”

Section: Interventions To Treat Obesity and Their Role In Modulating supporting

confidence: 75%

Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity?

Lambert

Straznicky

Dixon

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

Self Cite

View full text Add to dashboard Cite

The sympathetic nervous system (SNS) plays a key role in both cardiovascular and metabolic regulation; hence, disturbances in SNS regulation are likely to impact on both cardiovascular and metabolic health. With excess adiposity, in particular when visceral fat accumulation is present, sympathetic activation commonly occurs. Experimental investigations have shown that adipose tissue releases a large number of adipokines, cytokines, and bioactive mediators capable of stimulating the SNS. Activation of the SNS and its interaction with adipose tissue may lead to the development of hypertension and end-organ damage including vascular, cardiac, and renal impairment and in addition lead to metabolic abnormalities, especially insulin resistance. Lifestyle changes such as weight loss and exercise programs considerably improve the cardiovascular and metabolic profile of subjects with obesity and decrease their cardiovascular risk, but unfortunately weight loss is often difficult to achieve and sustain. Pharmacological and device-based approaches to directly or indirectly target the activation of the SNS may offer some benefit in reducing the cardiometabolic consequences of obesity. Preliminary evidence is encouraging, but more trials are needed to investigate whether sympathetic inhibition could be used in obesity to reverse or prevent cardiometabolic disease development. The purpose of this review article is to highlight the current knowledge of the role that SNS plays in obesity and its associated metabolic disorders and to review the potential benefits of sympathoinhibition on metabolic and cardiovascular functions.

show abstract

Section: Interventions To Treat Obesity and Their Role In Modulating supporting

confidence: 75%

Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity?

Lambert

Straznicky

Dixon

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Elevated heart rate in the alerting reaction group provided support for this hypothesis. Furthermore, participants with alerting reaction exhibited multiple factors known to be associated with increased sympathetic nerve activity at rest, including African American race/ethnicity [17], obesity [18,19], older age [20], and insulin resistance [21,22]. These factors alone or in combination may predispose to heightened sympathetic activation during BP cuff inflation.…”

Section: Discussionmentioning

confidence: 99%

Target organ complications and prognostic significance of alerting reaction

Velasco¹,

Ayers

Das

et al. 2016

Journal of Hypertension

View full text Add to dashboard Cite

Objective Noninvasive BP measurement often triggers a transient rise in BP, known as an alerting reaction. However, the prevalence and prognostic significance of the alerting reaction has never been assessed in the general population. Methods We evaluated the association between the alerting reaction and left ventricular mass (LVM) by magnetic resonance imaging and urinary-albumin-to-creatinine ratio (UACR) in the Dallas Heart Study, a large population sample of 3,069 subjects. Participants were categorized into 4 groups based on levels of consecutive BP: 1.normal 1st BP and average 3rd to 5th (avg3-5) BP of <140/90 mmHg (control group), 2.high 1st BP of ≥140/90 mmHg and normal (avg3-5) BP (HN), 3.normal 1st BP and high (avg3-5) BP, and 4.high 1st to 5th BP. Then, associations between BP categories with incident cardiovascular outcomes (coronary heart disease, stroke, atrial fibrillation, heart failure, and cardiovascular death) over a median follow-up period of 9.4 years were assessed. Results The sample-weighted prevalence of isolated hypertension during the first BP measurement was 9.6%. Presence of an alerting reaction was independently associated with increased LVM, UACR, cardiovascular events after adjustment for traditional cardiovascular risk factors and baseline BP (adjusted HR 1.24, 95%CI 1.07-1.43). Conclusions Our study indicated that the alerting reaction is independently associated with increased cardiovascular and renal complications.

show abstract

“…excessively rapid breathing, breathlessness) in the absence of physical exertion?” Our observation is similar to others in that obesity is known to be linked to increased heart rate and difficulty breathing. (36) These changes such as elevated heart rate may however be due to changes in fundamental physiological mechanisms causing increased sympathetic activity (37) and sympathovagal balance (38) with resultant hypertension, insulin resistance, hyperlipidemia, and renal dysfunction (39, 40). This has particular relevance for obese older adults because an elevated heart rate is an independent predictor for mortality (41), and Carnethon et al (42) found that a higher heart rate at baseline was associated with diabetes and mortality.…”

Section: Discussionmentioning

confidence: 99%

Eating Behaviors, Mental Health, and Food Intake Are Associated With Obesity in Older Congregate Meal Participants

Starr

Fischer

Johnson

2014

Journal of Nutrition in Gerontology and Geriatrics

View full text Add to dashboard Cite

The relationship between eating behaviors, food intake, and mental health and the occurrence of obesity in older adults has rarely been investigated. Therefore, the objective of this study was to establish the associative links of these factors with two measures of obesity: class I obesity as indicated by body mass index (OB-BMI; BMI ≥ 30kg/m2) and class I obesity as indicated by waist circumference (OB-WC; WC ≥ 43 inches for men and ≥ 42 inches for women). Older adults participating in the Older American’s Act (OAA) congregate meal program (N = 113, mean age = 74 years, 74% female, 45% African American) were assessed. Eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating), food groups group choices (sweets, salty snacks, and fruits), and mental health indices (depression, anxiety, and stress) were recorded by questionnaire and related to measured occurrence of OB-BMI and OB-WC. In a series of multivariate logistical regression models, we found cognitive restraint to be consistently and robustly associated with both measures of obesity. In the fully adjusted model, cognitive restraint, consumption of sweets, anxiety, and lack of depression were associated with OB-WC. In summary, we found an association of obesity with abnormal eating behaviors, certain food group intakes, and mental health symptoms in this population. These findings may guide the development of future weight management interventions in a congregate meal setting.

show abstract

Sympathetic Activity and Markers of Cardiovascular Risk in Nondiabetic Severely Obese Patients: The Effect of the Initial 10% Weight Loss

Abstract: The initial 10% weight loss induced by LAGB was associated with substantial hemodynamic, metabolic, SNS, and renal function improvements. Changes in waist circumference appear to be an important factor contributing to BP adaptation after LAGB surgery.

Cited by 37 publications

References 38 publications

Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity?

Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity?

Target organ complications and prognostic significance of alerting reaction

Eating Behaviors, Mental Health, and Food Intake Are Associated With Obesity in Older Congregate Meal Participants

Contact Info

Product

Resources

About