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

Autor:	Stewart NR; Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, USA., Heiston EM; Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA.; Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA., Miller SL; Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA., Ballantyne AC; Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA., Cheema US; Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA., Spaeth AM; Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, USA., Kokkinos P; Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, USA., Malin SK; Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, USA.; Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA.; Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, New Jersey, USA.; New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA.; Institute of Translational Medicine and Science, Rutgers University, New Brunswick, New Jersey, USA.
Jazyk:	angličtina
Zdroj:	Journal of vascular research [J Vasc Res] 2022; Vol. 59 (3), pp. 151-162. Date of Electronic Publication: 2022 Mar 10.
DOI:	10.1159/000522063
Abstrakt:	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. (© 2022 S. Karger AG, Basel.)
Databáze:	MEDLINE
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