Document Detail


Heart rate and blood pressure changes during autonomic nervous system challenge in panic disorder patients.
MedLine Citation:
PMID:  20368476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that panic disorder (PD) patients have a heightened or deregulated autonomic nervous system at rest and during autonomic challenge compared with healthy controls (HC); and to test a second hypothesis that severity of illness differentiates patients'; sympathovagal balance both at rest and during orthostatic challenge. METHODS: Spectral analysis of heart rate (HR) and blood pressure was performed on 30 PD and 10 HC participants during an orthostatic challenge (head-up tilt). RESULTS: PD patients presented higher HR (p < .001), lower heart rate variability (HRV) (p < .015), higher mean diastolic blood pressure (p < .006), higher low-frequency component of HR (p < .001), and a higher ratio of low-frequency to high-frequency component of HR (LF/HF) (p < .022) than HC at baseline. During tilt, PD patients responded with higher HR (p < .039), lower HRV (p < .043), increased mean diastolic blood pressure (p < .028), and a mild increase in LF/HF, whereas controls responded with a five-fold increase in LF/HF (p < .022). Patients with higher illness severity ratings (Clinical Global Impression Scale) showed higher HR (p < .002), lower HRV (p < .026), and a lower total power of systolic blood pressure (p < .02) compared with less ill patients. CONCLUSION: These findings demonstrate a consistently higher or deregulated autonomic arousal in PD patients at rest and during orthostatic challenge compared with HC. These data also reveal a possible association between the level of anxiety illness severity and sympathovagal balance, which may imply greater cardiac risk.
Authors:
Jose M Martinez; Amir Garakani; Horacio Kaufmann; Cindy J Aaronson; Jack M Gorman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-04-05
Journal Detail:
Title:  Psychosomatic medicine     Volume:  72     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  442-9     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA. jose.martinez@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Agoraphobia / diagnosis,  physiopathology
Arousal / physiology
Autonomic Nervous System / physiopathology*
Blood Pressure / physiology*
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Panic Disorder / diagnosis*,  physiopathology*
Personality Inventory
Severity of Illness Index
Sympathetic Nervous System / physiopathology
Tilt-Table Test / methods,  statistics & numerical data*
Vagus Nerve / physiopathology
Grant Support
ID/Acronym/Agency:
M01-RR-00071/RR/NCRR NIH HHS; R01 071827-01A2//PHS HHS

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


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