Emma Rebecca McCourt, Robert D Meade, Brodie J Richards, Nicholas J Koetje, Nicholas B Santucci, James J McCormick, Pierre Boulay, Ronald J Sigal, Glen P Kenny
{"title":"浸脚和颈部降温对暴露于室内过热环境中的老年人心脏自主神经功能的影响:随机交叉试验。","authors":"Emma Rebecca McCourt, Robert D Meade, Brodie J Richards, Nicholas J Koetje, Nicholas B Santucci, James J McCormick, Pierre Boulay, Ronald J Sigal, Glen P Kenny","doi":"10.1139/apnm-2024-0126","DOIUrl":null,"url":null,"abstract":"<p><p>Foot immersion and neck cooling are recommended cooling strategies for protecting heat-vulnerable persons during heat waves. While we recently showed that these strategies do not limit core temperature increases in older adults during prolonged heat exposure, we did observe small reductions in heart rate. Expanding on these findings, we examined the effects of foot immersion with and without neck cooling on cardiac autonomic function. Seventeen adults (9 females; 65-81 years) underwent 3 randomized, 6-hour exposures to 38°C and 35% relative humidity with: no cooling (control), foot immersion (20°C water), or foot immersion with a wet towel (20°C) around the neck. Cardiac autonomic responses were measured at baseline and end-exposure. These included heart rate variability, cardiac and systolic blood pressure responses to standing, indexed via the 30:15 ratio and supine-to-standing systolic pressure change, respectively, and baroreflex sensitivity during repeated sit-to-stand maneuvers. The 30:15 ratio was 0.04 [95% CI: 0.01, 0.07] greater with foot immersion and neck cooling (1.08 (0.04)) relative to control (1.04 (0.06); P=0.018). Similarly, standing systolic pressure was elevated 9 [0, 17] mm Hg with foot immersion and neck cooling (P=0.043). That said, neither difference remained statistically significant after adjusting for multiplicity (Padjusted≥0.054). No differences in 30:15 ratio or standing systolic pressure were observed with foot immersion alone, while heart rate variability and baroreflex sensitivity were unaffected by either cooling intervention. While foot immersion with neck cooling potentially improved cardiac autonomic responses in older adults exposed to simulated indoor overheating, these effects were small and of questionable clinical importance.</p>","PeriodicalId":93878,"journal":{"name":"Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effect of foot immersion and neck cooling on cardiac autonomic function in older adults exposed to indoor overheating : a randomized crossover trial.\",\"authors\":\"Emma Rebecca McCourt, Robert D Meade, Brodie J Richards, Nicholas J Koetje, Nicholas B Santucci, James J McCormick, Pierre Boulay, Ronald J Sigal, Glen P Kenny\",\"doi\":\"10.1139/apnm-2024-0126\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Foot immersion and neck cooling are recommended cooling strategies for protecting heat-vulnerable persons during heat waves. While we recently showed that these strategies do not limit core temperature increases in older adults during prolonged heat exposure, we did observe small reductions in heart rate. Expanding on these findings, we examined the effects of foot immersion with and without neck cooling on cardiac autonomic function. Seventeen adults (9 females; 65-81 years) underwent 3 randomized, 6-hour exposures to 38°C and 35% relative humidity with: no cooling (control), foot immersion (20°C water), or foot immersion with a wet towel (20°C) around the neck. Cardiac autonomic responses were measured at baseline and end-exposure. These included heart rate variability, cardiac and systolic blood pressure responses to standing, indexed via the 30:15 ratio and supine-to-standing systolic pressure change, respectively, and baroreflex sensitivity during repeated sit-to-stand maneuvers. The 30:15 ratio was 0.04 [95% CI: 0.01, 0.07] greater with foot immersion and neck cooling (1.08 (0.04)) relative to control (1.04 (0.06); P=0.018). Similarly, standing systolic pressure was elevated 9 [0, 17] mm Hg with foot immersion and neck cooling (P=0.043). That said, neither difference remained statistically significant after adjusting for multiplicity (Padjusted≥0.054). No differences in 30:15 ratio or standing systolic pressure were observed with foot immersion alone, while heart rate variability and baroreflex sensitivity were unaffected by either cooling intervention. While foot immersion with neck cooling potentially improved cardiac autonomic responses in older adults exposed to simulated indoor overheating, these effects were small and of questionable clinical importance.</p>\",\"PeriodicalId\":93878,\"journal\":{\"name\":\"Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1139/apnm-2024-0126\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1139/apnm-2024-0126","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The effect of foot immersion and neck cooling on cardiac autonomic function in older adults exposed to indoor overheating : a randomized crossover trial.
Foot immersion and neck cooling are recommended cooling strategies for protecting heat-vulnerable persons during heat waves. While we recently showed that these strategies do not limit core temperature increases in older adults during prolonged heat exposure, we did observe small reductions in heart rate. Expanding on these findings, we examined the effects of foot immersion with and without neck cooling on cardiac autonomic function. Seventeen adults (9 females; 65-81 years) underwent 3 randomized, 6-hour exposures to 38°C and 35% relative humidity with: no cooling (control), foot immersion (20°C water), or foot immersion with a wet towel (20°C) around the neck. Cardiac autonomic responses were measured at baseline and end-exposure. These included heart rate variability, cardiac and systolic blood pressure responses to standing, indexed via the 30:15 ratio and supine-to-standing systolic pressure change, respectively, and baroreflex sensitivity during repeated sit-to-stand maneuvers. The 30:15 ratio was 0.04 [95% CI: 0.01, 0.07] greater with foot immersion and neck cooling (1.08 (0.04)) relative to control (1.04 (0.06); P=0.018). Similarly, standing systolic pressure was elevated 9 [0, 17] mm Hg with foot immersion and neck cooling (P=0.043). That said, neither difference remained statistically significant after adjusting for multiplicity (Padjusted≥0.054). No differences in 30:15 ratio or standing systolic pressure were observed with foot immersion alone, while heart rate variability and baroreflex sensitivity were unaffected by either cooling intervention. While foot immersion with neck cooling potentially improved cardiac autonomic responses in older adults exposed to simulated indoor overheating, these effects were small and of questionable clinical importance.