Gender Difference in Baroreflex Sensitivity to Predict Cardiac and Cerebrovascular Events in Type 2 Diabetic Patients

Yufu, Kunio; Takahashi, Naohiko; Okada, Norihiro; Wakisaka, Osamu; Shinohara, Tetsuji; Nakagawa, Mikiko; Hara, Masahide; Yoshimatsu, Hironobu; Saikawa, Tetsunori

doi:10.1253/circj.cj-10-1122

Cited by 19 publications

(24 citation statements)

References 38 publications

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“…Studies in DM patients have demonstrated that the degree of autonomic (sympathovagal) imbalance determines the extent of BRS impairment [82]. In addition, the extent of BRS impairment is also a determinant factor as a more depressed BRS has been associated with a poorer prognosis [81,83]. Furthermore, as stated in an earlier section, CAN is associated with a more significantly depressed BRS [20] and therefore as can be expected a poorer prognosis.…”

Section: Clinical and Prognostic Consequences Of Diminished Brs (Seementioning

confidence: 96%

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Baroreceptor sensitivity and diabetes mellitus

Rowaiye

Jankowska²,

Ponikowska³

2013

Cardiol J

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Section: Clinical and Prognostic Consequences Of Diminished Brs (Seementioning

confidence: 96%

“…Female diabetic patients have been shown to have lower BRS and worse prognosis than their male counterparts [81]. Also, there exists a negative correlation between the disease duration and the BRS in diabetic patients [82].…”

Section: Clinical and Prognostic Consequences Of Diminished Brs (Seementioning

confidence: 99%

Baroreceptor sensitivity and diabetes mellitus

Rowaiye

Jankowska²,

Ponikowska³

2013

Cardiol J

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“…9, 10 It is well-recognized that gender differences exist in the prevalence and levels of these CV diseases and risk factors. [11][12][13][14][15][16][17][18][19][20][21][22] Despite accumulating data, there is still no evidence on how gender influences the effects of exercise training with body weight (BW) loss on hsCRP levels. A meta-analysis study demonstrated the effects of aerobic exercise on CRP, 23 but did not present separate data for exercise-derived CRP lowering in each gender.…”

Section: Subjectsmentioning

confidence: 99%

Is Gender a Factor in the Reduction of Cardiovascular Risks With Exercise Training?

Morita

Okita

2013

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp for confounding factors, we matched body fat changes and exercise frequency during the intervention period and age, and then analyzed data from both genders. MethodsWe conducted a randomized controlled trial that examined the effects of exercise training on CV risk factors in overweight subjects with other risk factors. 2 Full details of the intervention study design and methods are reported elsewhere. 2, 27 The study was approved by the Institutional Review Board of Sapporo Medical University and was conducted between April, 2003 and October, 2004. Each participant gave informed consent. SubjectsWe examined data from 131 subjects (60 men and 71 women aged 61-79 years) who were exercisers in our previous intervention study. 2,27 Participants in that particular study were aged 40-89 years with a body mass index (BMI) between 24.2 and 34.9 kg/m 2 , with 2 or more of the following CV risk factors: resting systolic BP of 130-179 mmHg, fasting blood glucose level of 110-139 mg/dl or HbA1c (%) >5.8 when non-fasting hysical activity and exercise training reduce the incidence of cardiovascular (CV) diseases by improving almost all risk factors, such as obesity, lack of fitness, and hypertension. 1-8 In addition, aerobic exercise has been shown to lower the level of a potent vascular inflammatory marker, high-sensitivity C-reactive protein (hsCRP), through loss of body fat. 9,10 It is well-recognized that gender differences exist in the prevalence and levels of these CV diseases and risk factors. 11-22Despite accumulating data, there is still no evidence on how gender influences the effects of exercise training with body weight (BW) loss on hsCRP levels. A meta-analysis study demonstrated the effects of aerobic exercise on CRP, 23 but did not present separate data for exercise-derived CRP lowering in each gender. Moreover, there is still no consensus as to gender differences in the efficacy of exercise training in lowering the blood pressure (BP) of individuals with multiple CV risk factors. 24-26To provide more information, we directly compared the effects of a 6-month exercise training intervention on hsCRP, BP and other conventional CV risk factors in older men and women with elevated BP and other CV risk factors. Background: This study compared older men and women with cardiovascular (CV) risk factors in terms of the effects of a 6-month exercise intervention on high-sensitivity C-reactive protein (hsCRP) levels, blood pressure (BP) and other risk factors.

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“…24,25 Further, it has been recently reported that decrease in BRS can predict CV events in Type 2 diabetics. 26,27 Furthermore, it has been documented earlier that decrease in BRS predicts cardiac mortality in myocardial infarction patients. 28,29 Thus, decreased BRS in FDR of Type 2 diabetics as observed in the present study could increase their CV risks and predispose them to adverse CV events.…”

Section: Discussionmentioning

confidence: 95%

Decreased Baroreceptor Refl ex Sensitivity in First-degree Relatives of Type 2 Diabetics is Linked to Sympathovagal Imbalance and Cardiovascular Risks

Pal¹,

Pal²,

Nanda³

et al. 2014

J. Cardiovasc. Dis. Res.

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Background: Though decreased baroreceptor refl ex sensitivity (BRS) promotes cardiovascular (CV) morbidity and CV risks are reported in the fi rst-degree relatives (FDR) of Type 2 diabetics, the pathophysiological mechanisms contributing to CV risks in these subjects are not yet elucidated. Methods and Results: Body mass index (BMI), CV parameters such as heart rate (HR), blood pressure (BP), rate-pressure product (RPP), stroke volume (SV), left-ventricular ejection time (LVET), cardiac output, total peripheral resistance (TPR) and BRS, spectral-indices of heart rate variability (HRV), autonomic function tests (AFT) and fasting blood glucose (FBG) were measured and analyzed in subjects of the study group (FDR of Type 2 diabetics, n = 79) and control group (subjects with no family history of diabetes, n = 115). BMI, HR, BP, RPP, SV, LVET, cardiac output, TPR, low-frequency to the high-frequency ratio (ratio of LF-HF power of HRV) and FBG were increased (P < 0.0001), and BRS was decreased (P < 0.0001) in the study group compared to the control group. AFT and HRV parameters demonstrated sympathovagal imbalance (SVI) in the study group, which was due to concomitant sympathetic activation and vagal inhibition. There was a signifi cant correlation of BRS with BMI, CV parameters and LF-HF ratio, a sensitive marker of SVI. Multiple-regression analysis demonstrated independent contribution LF-HF ratio and hypertension status to BRS in the study group. Bivariate-logistic regression revealed signifi cant prediction (odds ratio: 2.15; confi dence interval: 1.1112-6.856, P = 0.008) of BRS to increased RPP, the marker of CV risk, in the study group. Conclusion: Decreased BRS in FDR of Type 2 diabetics predisposes them to CV dysfunction. BRS is linked to SVI and CV risks in these high-risk subjects.

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Gender Difference in Baroreflex Sensitivity to Predict Cardiac and Cerebrovascular Events in Type 2 Diabetic Patients

Cited by 19 publications

References 38 publications

Baroreceptor sensitivity and diabetes mellitus

Baroreceptor sensitivity and diabetes mellitus

Is Gender a Factor in the Reduction of Cardiovascular Risks With Exercise Training?

Decreased Baroreceptor Refl ex Sensitivity in First-degree Relatives of Type 2 Diabetics is Linked to Sympathovagal Imbalance and Cardiovascular Risks

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