The data suggest that autonomic cardiovascular regulation in FMS is impaired in terms of reduced sympathetic and parasympathetic influences, as well as baroreflex malfunctioning. Furthermore, autonomic cardiovascular adjustment to acute stress is blunted. The inverse association between BRS and pain severity reflects the well-documented pain inhibition through the baroreceptor system. On account of this and the reduced baroreflex function in FMS, one may assume deficient ascending pain inhibition arising from the cardiovascular system, which may contribute to hyperalgesia that is characteristic of the disorder.
This study tests the spontaneous sequence method for the evaluation of the cardiac, vasomotor, and myocardial branches of the baroreflex. Systolic blood pressure (SBP), interbeat interval (IBI), stroke volume (SV), preejection period (PEP), and total peripheral resistance (TPR) were continuously recorded in 33 physically active and 25 sedentary participants at rest and during a mental arithmetic task. Sequences of spontaneous covariation between SBP and IBI (for the cardiac branch), SV and PEP (for the myocardial branch), and TPR (for the vasomotor branch) were located. The slope of the regression line between values in the sequences produced an estimate of baroreflex sensitivity (BRS), and the proportion of progressive SBP changes that elicited reflex modulations yielded an estimate of baroreflex effectiveness (BEI). The active group showed greater BRS in all three branches than the sedentary group. Cardiac and vasomotor BEI decreased during the arithmetic task in the sedentary group but not in the active one. Only cardiac BRS decreased during the arithmetic task. In conclusion, the method appears appropriate for the simultaneous assessment of the three baroreflex branches. The assessment of the vascular branch of the baroreflex may have prognostic relevance in the development of hypertension or other cardiometabolic diseases.
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