Impact of Type 2 Diabetes Mellitus on Sympathetic Neural Mechanisms in Hypertension

Huggett, Robert J.; Scott, Eleanor M.; Gilbey, S. G.; Stoker, John B.; Mackintosh, Alan; Mary, David A.S.G.

doi:10.1161/01.cir.0000103123.66264.fe

Cited by 268 publications

(218 citation statements)

References 39 publications

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“…For instance, firstly, raised plasma insulin levels and insulin resistance have been related to sympathetic hyperactivity and could be associated with hypertension and obesity. 3,8,42,43 However, the four groups of the present study were not obese and had similar BMI and waist circumference. Furthermore, the groups of women and men with hypertension had similar levels of arterial blood pressure.…”

Section: For Hypertensive Women (F-eht) and Men (M-eht) Normotensivementioning

confidence: 57%

The effect of gender on the sympathetic nerve hyperactivity of essential hypertension

2006

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We planned to determine whether or not there is a difference in the level of muscle sympathetic nerve activity (MSNA) between hypertensive women and hypertensive men. Sympathetic activation of essential hypertension (EHT) has been associated with increased cardiovascular events, which are known to be less likely to occur in women than in men. Normal women have been reported to have less sympathetic nerve activity than men, but no reported data are available regarding gender differences in sympathetic activity in hypertensive subjects. We examined 36 patients with untreated and uncomplicated EHT comprising 18 women and 18 men, and 36 normal controls comprising 18 women and 18 men. MSNA was quantified as the mean frequency of single units and as multiunit bursts using the technique of microneurography. The hypertensive groups had greater sympathetic nerve activity than the control groups. Female hypertensives had lower (Po0.001) single unit hyperactivity (5671.7 impulses/100 cardiac beats) than male hypertensives (7271.7 impulses/100 cardiac beats). Normotensive females had lower (Po0.01) single unit activity (4273.6 impulses/100 cardiac beats) than normotensive males (5674.6 impulses/100 cardiac beats). Similar results were obtained for the frequency of multiunit burst activity. Hypertension in women is associated with a lower level of central sympathetic hyperactivity than in men. It is suggested that this may at least partly explain the observed lower hypertension-related cardiovascular events in women than in men. In addition, the findings may have implications for gender-specific management of hypertension.

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Section: For Hypertensive Women (F-eht) and Men (M-eht) Normotensivementioning

confidence: 57%

The effect of gender on the sympathetic nerve hyperactivity of essential hypertension

2006

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“…The details of such sessions have been published previously [16,24]. Briefly, all investigations were performed under similar conditions between 09.00 and 12.00 hours in order to avoid circadian autonomic variation.…”

Section: Methodsmentioning

confidence: 99%

“…Past studies in patients with type 2 diabetes but no neuropathy have reported an increase or a decrease in plasma noradrenaline levels [13][14][15] and an increase in peripheral muscle sympathetic nerve activity (MSNA) [16]. Also, there are reports that patients with type 2 diabetes have either normal or decreased levels of heart rate variability [14,17,18].…”

Section: Introductionmentioning

confidence: 99%

Disparity of autonomic control in type 2 diabetes mellitus

et al. 2004

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Aims/hypothesis: Acute insulinaemia activates the sympathetic drive in a nonuniform manner. The extent and nature of such activation in type 2 diabetic patients who do not have neuropathy have not yet been addressed despite evidence relating sympathetic activation to cardiovascular risk. We planned to determine the magnitude and extent of the sympathetic drive and its reflex responses in patients with type 2 diabetes and fasting hyperinsulinaemia. Methods: We measured resting muscle sympathetic nerve activity (MSNA) as the mean frequency of multiunit bursts and single unit muscle sympathetic nerve activity (s-MSNA) in 17 overweight patients with type 2 diabetes and two matched normal control groups comprising 17 overweight and 16 normal-weight subjects. We also tested the MSNA and s-MSNA responses to cold pressor and isometric hand-grip tests, along with the effect of sympatho-vagal balance on heart period variability. Results: Both MSNA and s-MSNA in the group with type 2 diabetes (66±3.5 bursts/100 beats and 78±4.5 impulses/100 beats) were greater (at least p<0.0001) than in the overweight control group (42±2.6 bursts/100 beats and 48±3.4 impulses/100 beats) and normal-weight control group (43±6.2 bursts/100 beats and 51±7.1 impulses/100 beats), though the three groups had similar reflex responses, baroreflex sensitivity and sympathovagal balance controlling the heart period. Conclusions/ interpretation: The patients with type 2 diabetes had no evidence of impaired reflex or autonomic control of heart period variability at a time when there was central sympathetic activation to the periphery. Furthermore, being overweight itself was not associated with sympathetic activation.

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“…It is suggested that luseogliflozin can effectively decrease the HR in patients with higher baseline HR. Some patients with type 2 diabetes mellitus have elevated central sympathetic activity, which is exacerbated by a malfunction of the negative feedback mechanism as a result of decreased sensitivity of baroreceptor reflexes5, 6. This results in elevation of peripheral sympathetic activity in the heart, leading to an increase in resting HR.…”

mentioning

confidence: 99%

Changes in heart rate in patients with type 2 diabetes mellitus after treatment with luseogliflozin: Subanalysis of placebo‐controlled, double‐blind clinical trials

Sano

Chen

Imazeki

et al. 2018

J of Diabetes Invest

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Impact of Type 2 Diabetes Mellitus on Sympathetic Neural Mechanisms in Hypertension

Cited by 268 publications

References 39 publications

The effect of gender on the sympathetic nerve hyperactivity of essential hypertension

The effect of gender on the sympathetic nerve hyperactivity of essential hypertension

Disparity of autonomic control in type 2 diabetes mellitus

Changes in heart rate in patients with type 2 diabetes mellitus after treatment with luseogliflozin: Subanalysis of placebo‐controlled, double‐blind clinical trials

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