Influence of the Autonomic Nervous System in Response to Exercise in Hypertensive Individuals
Summary
Systemic arterial hypertension (SAH) has a direct association with endothelial dysfunction and major cardiovascular events. Evidence points to possible benefits of aerobic training in the endothelial function analyzed by the flow mediated dilation technique (flow mediated dilatation - FMD) in individuals with SAH. However, little is known about the influence of the autonomic nervous system (ANS) on the results of brachial artery FMD after different types of acute exercise in individuals with SAH. Thus, the objective of the research is to analyze the influence of the ANS on the FMD of the brachial artery of individuals with SAH after a session of aerobic (EA), resistance (ER) and combined (EC) exercise. For this, thirty-nine hypertensive individuals aged 35 to 55 years will be recruited and will be randomized to 2 sessions of AS, ER or EC. Also, within each modality, they will be randomized to α1-adrenergic block (Doxazosin 0.05 mg / kg-1) or placebo. The FMD will be performed by ultrasound 10 minutes before, as well as 10, 40 and 70 minutes after the exercise sessions and the autonomic control will be monitored (Finometer) for 10 minutes before each FMD. Arterial stiffness will also be analyzed, using the pulse wave velocity (PWV) by the Complior Analyzer. It is expected to demonstrate with this research the influence of the ANS on the FMD of the brachial artery in individuals with SAH in different physical exercises. This knowledge contributes to a better training prescription in this population.
Timeline
- Start
- 2020-04-30
- Primary completion
- 2020-12-20
- Completion
- 2021-12-23
Publications
- Background Gimbrone MA Jr, Garcia-Cardena G. Endothelial Cell Dysfunction and the Pathobiology of Atherosclerosis. Circ Res. 2016 Feb 19;118(4):620-36. doi: 10.1161/CIRCRESAHA.115.306301.
- Background Vanhoutte PM, Shimokawa H, Feletou M, Tang EH. Endothelial dysfunction and vascular disease - a 30th anniversary update. Acta Physiol (Oxf). 2017 Jan;219(1):22-96. doi: 10.1111/apha.12646. Epub 2016 Jan 25.
- Background Iantorno M, Campia U, Di Daniele N, Nistico S, Forleo GB, Cardillo C, Tesauro M. Obesity, inflammation and endothelial dysfunction. J Biol Regul Homeost Agents. 2014 Apr-Jun;28(2):169-76.
- Background Lind L. Lipids and endothelium-dependent vasodilation--a review. Lipids. 2002 Jan;37(1):1-15. doi: 10.1007/s11745-002-0858-6.
- Background ESH/ESC Task Force for the Management of Arterial Hypertension. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2013 Oct;31(10):1925-38. doi: 10.1097/HJH.0b013e328364ca4c. No abstract available.
- Background Grassi G, Ram VS. Evidence for a critical role of the sympathetic nervous system in hypertension. J Am Soc Hypertens. 2016 May;10(5):457-66. doi: 10.1016/j.jash.2016.02.015. Epub 2016 Mar 4.
- Background Ghorayeb N, Stein R, Daher DJ, Silveira ADD, Ritt LEF, Santos DFPD, Sierra APR, Herdy AH, Araujo CGS, Colombo CSSS, Kopiler DA, Lacerda FFR, Lazzoli JK, Matos LDNJ, Leitao MB, Francisco RC, Alo ROB, Timerman S, Carvalho T, Garcia TG. The Brazilian Society of Cardiology and Brazilian Society of Exercise and Sports Medicine Updated Guidelines for Sports and Exercise Cardiology - 2019. Arq Bras Cardiol. 2019 Mar;112(3):326-368. doi: 10.5935/abc.20190048. No abstract available.
- Background Brandao AA, Amodeo C, Alcantara C, Barbosa E, Nobre F, Pinto F, Vilela-Martin JF, Bastos JM, Yugar-Toledo JC, Mota-Gomes MA, Neves MF, Malachias MV, Rodrigues MC, Passarelli O Junior, Jardim PC, Cunha PG, Povoa R, Fonseca T, Dias VP, Barroso WS, Oigman W. I Luso-Brazilian Positioning on Central Arterial Pressure. Arq Bras Cardiol. 2017 Feb;108(2):100-108. doi: 10.5935/abc.20170011. Epub 2017 Feb 13. No abstract available.
- Background Thijssen DHJ, Bruno RM, van Mil ACCM, Holder SM, Faita F, Greyling A, Zock PL, Taddei S, Deanfield JE, Luscher T, Green DJ, Ghiadoni L. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J. 2019 Aug 7;40(30):2534-2547. doi: 10.1093/eurheartj/ehz350.
- Results Soloviev MA, Kulakova NV, Semiglazova TA, Borodulina EV, Udut VV. Correction of endothelial dysfunction in patients with arterial hypertension. Bull Exp Biol Med. 2011 Jun;151(2):183-5. doi: 10.1007/s10517-011-1284-1.
- Results Abebe W, Mozaffari M. Endothelial dysfunction in diabetes: potential application of circulating markers as advanced diagnostic and prognostic tools. EPMA J. 2010 Mar;1(1):32-45. doi: 10.1007/s13167-010-0012-7. Epub 2010 Mar 10.
- Results Kublickiene K, Fu XD, Svedas E, Landgren BM, Genazzani AR, Simoncini T. Effects in postmenopausal women of estradiol and medroxyprogesterone alone and combined on resistance artery function and endothelial morphology and movement. J Clin Endocrinol Metab. 2008 May;93(5):1874-83. doi: 10.1210/jc.2007-2651. Epub 2008 Mar 4.
- Results Pahkala K, Heinonen OJ, Simell O, Viikari JS, Ronnemaa T, Niinikoski H, Raitakari OT. Association of physical activity with vascular endothelial function and intima-media thickness. Circulation. 2011 Nov 1;124(18):1956-63. doi: 10.1161/CIRCULATIONAHA.111.043851. Epub 2011 Oct 3.
- Results Green DJ, Dawson EA, Groenewoud HM, Jones H, Thijssen DH. Is flow-mediated dilation nitric oxide mediated?: A meta-analysis. Hypertension. 2014 Feb;63(2):376-82. doi: 10.1161/HYPERTENSIONAHA.113.02044. Epub 2013 Nov 25.
- Results Dawson EA, Cable NT, Green DJ, Thijssen DHJ. Do acute effects of exercise on vascular function predict adaptation to training? Eur J Appl Physiol. 2018 Mar;118(3):523-530. doi: 10.1007/s00421-017-3724-8. Epub 2017 Dec 12.
- Results Martinez DG, Nicolau JC, Lage RL, Toschi-Dias E, de Matos LD, Alves MJ, Trombetta IC, Dias da Silva VJ, Middlekauff HR, Negrao CE, Rondon MU. Effects of long-term exercise training on autonomic control in myocardial infarction patients. Hypertension. 2011 Dec;58(6):1049-56. doi: 10.1161/HYPERTENSIONAHA.111.176644. Epub 2011 Oct 24.
- Results Hansen AH, Nyberg M, Bangsbo J, Saltin B, Hellsten Y. Exercise training alters the balance between vasoactive compounds in skeletal muscle of individuals with essential hypertension. Hypertension. 2011 Nov;58(5):943-9. doi: 10.1161/HYPERTENSIONAHA.111.176529. Epub 2011 Sep 6.
- Results Nyberg M, Mortensen SP, Hellsten Y. Physical activity opposes the age-related increase in skeletal muscle and plasma endothelin-1 levels and normalizes plasma endothelin-1 levels in individuals with essential hypertension. Acta Physiol (Oxf). 2013 Mar;207(3):524-35. doi: 10.1111/apha.12048. Epub 2013 Jan 10.
- Results Inaba Y, Chen JA, Bergmann SR. Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis. Int J Cardiovasc Imaging. 2010 Aug;26(6):631-40. doi: 10.1007/s10554-010-9616-1. Epub 2010 Mar 26.
- Results Morishima T, Tsuchiya Y, Iemitsu M, Ochi E. High-intensity resistance exercise with low repetitions maintains endothelial function. Am J Physiol Heart Circ Physiol. 2018 Sep 1;315(3):H681-H686. doi: 10.1152/ajpheart.00281.2018. Epub 2018 Jun 1.
- Results Atkinson CL, Lewis NC, Carter HH, Thijssen DH, Ainslie PN, Green DJ. Impact of sympathetic nervous system activity on post-exercise flow-mediated dilatation in humans. J Physiol. 2015 Dec 1;593(23):5145-56. doi: 10.1113/JP270946. Epub 2015 Nov 15.
- Results Waclawovsky G, Umpierre D, Figueira FR, De Lima ES, Alegretti AP, Schneider L, Matte US, Rodrigues TC, Schaan BD. Exercise on Progenitor Cells in Healthy Subjects and Patients with Type 1 Diabetes. Med Sci Sports Exerc. 2016 Feb;48(2):190-9. doi: 10.1249/MSS.0000000000000764.
- Results Torvik D, Madsbu HP. An open one-year comparison of doxazosin and prazosin for mild to moderate essential hypertension. Am J Cardiol. 1987 May 29;59(14):68G-72G. doi: 10.1016/0002-9149(87)90160-3.
- Results Atala MM, Goulart A, Guerra GM, Mostarda C, Rodrigues B, Mello PR, Casarine DE, Irigoyen MC, Pereira AC, Consolim-Colombo FM. Arg16Gly and Gln27Glu beta2 adrenergic polymorphisms influence cardiac autonomic modulation and baroreflex sensitivity in healthy young Brazilians. Am J Transl Res. 2015 Jan 15;7(1):153-61. eCollection 2015.
- Waclawovsky G, Boll LFC, Neto SG, Irigoyen MCC, Lehnen AM. Effects of autonomic nervous system activation on endothelial function in response to acute exercise in hypertensive individuals: study protocol for a randomized double-blind study. Trials. 2021 Aug 19;22(1):548. doi: 10.1186/s13063-021-05516-x.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Doxazosin | Small molecule | 0.05 mg/kg | — |