Role of Blood Pressure Responses to Exercise and Vascular Insulin Sensitivity with Nocturnal Blood Pressure Dipping in Metabolic Syndrome.

IF 1.8 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Journal of Vascular Research Pub Date : 2022-01-01 Epub Date: 2022-03-10 DOI:10.1159/000522063

Nathan R Stewart, Emily M Heiston, Stephanie L Miller, Anna C Ballantyne, Udeyvir S Cheema, Andrea M Spaeth, Peter Kokkinos, Steven K Malin

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引用次数: 0

Abstract

Introduction: Nocturnal systolic blood pressure (SBP) dipping is independently related to cardiovascular disease risk, but it is unclear if vascular insulin sensitivity associates with SBP dipping in patients with metabolic syndrome (MetS).

Methods: Eighteen adults with MetS (ATP III criteria 3.3 ± 0.6; 53.2 ± 6.5 years; body mass index 35.8 ± 4.5 kg/m2) were categorized as "dippers" (≥10% change in SBP; n = 4 F/3 M) or "non-dippers" (<10%; n = 9 F/2 M). Twenty-four-hour ambulatory blood pressure was recorded to assess SBP dipping. A euglycemic-hyperinsulinemic clamp (40 mU/m2/min, 90 mg/dL) with ultrasound (flow mediated dilation) was performed to test vascular insulin sensitivity. A graded, incremental exercise test was conducted to estimate sympathetic activity. Heart rate (HR) recovery after exercise was then used to determine parasympathetic activity. Metabolic panels and body composition (DXA) were also tested.

Results: Dippers had greater drops in SBP (16.63 ± 5.2 vs. 1.83 ± 5.6%, p < 0.01) and experienced an attenuated rise in both SBPslope (4.7 ± 2.3 vs. 7.2 ± 2.5 mm Hg/min, p = 0.05) and HRslope to the incremental exercise test compared to non-dippers (6.5 ± 0.9 vs. 8.2 ± 1.7 bpm/min, p = 0.03). SBP dipping correlated with higher insulin-stimulated flow-mediated dilation (r = 0.52, p = 0.03), although the relationship was no longer significant after covarying for HRslope (r = 0.42, p = 0.09).

Conclusion: Attenuated rises in blood pressure and HR to exercise appear to play a larger role than vascular insulin sensitivity in SBP dipping in adults with MetS.

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代谢综合征患者夜间血压下降时血压对运动和血管胰岛素敏感性的影响

夜间收缩压(SBP)下降与心血管疾病风险独立相关，但代谢综合征(MetS)患者的血管胰岛素敏感性是否与收缩压下降相关尚不清楚。方法:18例成人met (ATP III标准3.3±0.6;53.2±6.5岁;体重指数(35.8±4.5 kg/m2)为“下降者”(收缩压变化≥10%;n = 4 F/3 M)或“非浸水者”(<10%;n = 9 F/2 M)。记录24小时动态血压以评估收缩压下降。采用正糖-高胰岛素钳夹(40 mU/m2/min, 90 mg/dL)和超声(血流介导扩张)检测血管胰岛素敏感性。进行分级、增量运动试验来估计交感神经活动。然后用运动后的心率(HR)恢复来测定副交感神经活动。代谢组和体成分(DXA)也进行了测试。结果:与非滴水者相比，滴水者的收缩压下降幅度更大(16.63±5.2比1.83±5.6%，p < 0.01)，而在增量运动试验中，SBPslope(4.7±2.3比7.2±2.5 mmhg /min, p = 0.05)和HRslope的上升幅度减弱(6.5±0.9比8.2±1.7 bpm/min, p = 0.03)。收缩压下降与较高的胰岛素刺激的血流介导的舒张相关(r = 0.52, p = 0.03)，尽管在HRslope协变后关系不再显著(r = 0.42, p = 0.09)。结论:与血管胰岛素敏感性相比，运动引起的血压和心率升高的减弱在met成人收缩压下降中起着更大的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Research 医学-生理学

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The ''Journal of Vascular Research'' publishes original articles and reviews of scientific excellence in vascular and microvascular biology, physiology and pathophysiology. The scope of the journal covers a broad spectrum of vascular and lymphatic research, including vascular structure, vascular function, haemodynamics, mechanics, cell signalling, intercellular communication, growth and differentiation. JVR''s ''Vascular Update'' series regularly presents state-of-the-art reviews on hot topics in vascular biology. Manuscript processing times are, consistent with stringent review, kept as short as possible due to electronic submission. All articles are published online first, ensuring rapid publication. The ''Journal of Vascular Research'' is the official journal of the European Society for Microcirculation. A biennial prize is awarded to the authors of the best paper published in the journal over the previous two years, thus encouraging young scientists working in the exciting field of vascular biology to publish their findings.