Document Detail

Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight.
MedLine Citation:
PMID:  11794458     Owner:  NLM     Status:  MEDLINE    
Chronic imbalance of the autonomic nervous system is a prevalent and potent risk factor for adverse cardiovascular events, including mortality. Although not widely recognized by clinicians, this risk factor is easily assessed by measures such as resting and peak exercise heart rate, heart rate recovery after exercise, and heart rate variability. Any factor that leads to inappropriate activation of the sympathetic nervous system can be expected to have an adverse effect on these measures and thus on patient outcomes, while any factor that augments vagal tone tends to improve outcomes. Insulin resistance, sympathomimetic medications, and negative psychosocial factors all have the potential to affect autonomic function adversely and thus cardiovascular prognosis. Congestive heart failure and hypertension also provide important lessons about the adverse effects of sympathetic predominance, as well as illustrate the benefits of beta-blockers and angiotensin-converting enzyme inhibitors, 2 classes of drugs that reduce adrenergic tone. Other interventions, such as exercise, improve cardiovascular outcomes partially by increasing vagal activity and attenuating sympathetic hyperactivity.
Brian M Curtis; James H O'Keefe
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  77     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-16     Completed Date:  2002-02-14     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-54     Citation Subset:  AIM; IM    
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MeSH Terms
Adrenergic beta-Agonists / adverse effects
Antihypertensive Agents / adverse effects
Autonomic Nervous System / physiopathology*
Cardiovascular Diseases / physiopathology*,  prevention & control,  psychology
Heart Conduction System / physiopathology*
Heart Rate / physiology
Insulin Resistance / physiology
Risk Factors
Sympathomimetics / adverse effects
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Antihypertensive Agents; 0/Sympathomimetics
Comment In:
Mayo Clin Proc. 2002 Jul;77(7):734-5; author reply 735   [PMID:  12108615 ]
Mayo Clin Proc. 2002 Jan;77(1):7-9   [PMID:  11795250 ]
Mayo Clin Proc. 2002 Apr;77(4):398-9; author reply 399   [PMID:  11936939 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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