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Nocturnal Cardiovascular Activity in Essential Hypotension: Evidence of Differential Autonomic Regulation.
MedLine Citation:
PMID:  23107844     Owner:  NLM     Status:  Publisher    
ObjectiveEssential hypotension represents a form of chronic low blood pressure (BP) not explained by medical or orthostatic conditions. The pathogenesis of essential hypotension may involve sympathetic hypoactivation and other forms of autonomic dysregulation. The aim of the current study was to investigate autonomic and cardiovascular activity during sleep in individuals with essential hypotension.MethodsA case-control study was conducted in 14 individuals with essential hypotension (mean [standard error] = 23.4 [0.6] years, all women) and 14 controls (mean [standard error] age = 22.2 [0.4] years, all women). The following measures were collected over a night of sleep: BP, heart rate (HR), stroke volume, cardiac output (CO), preejection period (PEP), total peripheral resistance, and time-domain measures of HR variability. ResultsHypotensive participants had consistently lower BP, HR, and CO than did normotensives. Cardiac autonomic variables revealed enhanced parasympathetic tone (proportion of adjacent normal-to-normal intervals that differed in length by more than 50 milliseconds = 40.8 [6.3] versus 23.4 [4.5], p = .03) and reduced sympathetic drive in hypotensives (PEP = 99.4 [3.6] versus 86.1 [4.3], p = .02). Analysis of temporal profiles showed that HR, stroke volume, and CO decreased throughout the night in both groups, whereas PEP and HR variability increased. Unlike controls, BP remained essentially unchanged in hypotensives, as the decrease in CO was counterbalanced by a parallel rise in total peripheral resistance. ConclusionsThese findings suggest that nocturnal cardiac sympathetic withdrawal combined with vagal hyperactivity is a characteristic of the autonomic regulation in essential hypotension.
Naima Covassin; Massimiliano de Zambotti; Nicola Cellini; Michela Sarlo; Luciano Stegagno
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-29
Journal Detail:
Title:  Psychosomatic medicine     Volume:  -     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of General Psychology (N.C, M.d.Z., N.C., M.S., L.S.), University of Padova, Padova, Italy.
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