Plasma Brain-Derived Neurotrophic Factor and Reverse Dipping Pattern of Nocturnal Blood Pressure in Patients with Cardiovascular Risk Factors

Abstract

ContextBasic studies have shown that brain-derived neurotrophic factor (BDNF) has critical roles in the survival, growth, maintenance, and death of central and peripheral neurons, while it is also involved in regulation of the autonomic nervous system. Furthermore, recent clinical studies have suggested potential role of plasma BDNF in the circulatory system.ObjectiveWe investigated the mutual relationships among plasma BDNF, patterns of nocturnal blood pressure changes (dippers, non-dippers, extra-dippers, and reverse-dippers), and cardiac autonomic function as determined by heart rate variability (HRV).DesignThis was a cross-sectional study of patients registered in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) Study from October 2010 to November 2012.PatientsTwo-hundred fifty patients with 1 or more cardiovascular risk factor(s) (obesity, smoking, presence of cardiovascular event history, hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease) were enrolled.ResultsPlasma BDNF levels (natural logarithm transformed) were significantly (p = 0.001) lower in reverse-dipper patients (7.18±0.69 pg/ml, mean ± SD, n = 36) as compared to dippers (7.86±0.86 pg/ml, n = 100). Multiple logistic regression analysis showed that BDNF (odds ratios: 0.417, 95% confidence interval: 0.228–0.762, P = 0.004) was the sole factor significantly and independently associated with the reverse-dippers as compared with dippers. Furthermore, plasma BDNF level was significantly and positively correlated with the time-domain (SDNN, SDANN5, CVRR) and frequency-domain (LF) of HRV parameters. Finally, multiple logistic regression analyses showed that the relationship between plasma BDNF and the reverse-dippers was weakened, yet remained significant or borderline significant even after adjusting for HRV parameters.ConclusionsLow plasma BDNF was independently associated with patients showing a reverse-dipper pattern of nocturnal blood pressure, in which an imbalance of cardiac autonomic function may be partly involved.

Plasma brain-derived neurotrophic factor concentration is a predictor of chronic kidney disease in patients with cardiovascular risk factors – Hyogo Sleep Cardio-Autonomic Atherosclerosis study

“…Nocturnal SBP fall (%) was calculated as 100 x [1-sleep SBP/awake SBP ratio], as previously described in detail [20]. …”

Plasma leptin level is associated with cardiac autonomic dysfunction in patients with type 2 diabetes: HSCAA study

“…To evaluate cardiac autonomic function, HRV was determined using an Active Tracer (AC-301A, Arm Electronics, Tokyo, Japan), as previously described [ 24 ]. According to the recommendations for clinical use of HRV [ 13 ], the standard deviation of the NN(RR) interval (SDNN) and standard deviation of the average NN(RR) intervals for each 5-min (SDANN5) period were calculated.…”

Serum hs-CRP, YKL-40 and brain-derived neurotrophic factor (BDNF) associated biomarkers in non-dipper hypertension profile?

“…Kasselman et al (37) suggested that BDNF, as a neurotrophic factor can exert effect upon perivascular inflammation via stimulating effect on sympathetic neurons, and by creating sympathetic dysfunction in inflammatory disease. On the other hand, Kadoya et al (38) reported a powerful association between reduced levels of BDNF in the plasma and a specific abnormal circadian variation in BP known as the reverse-dipper pattern. However, these authors also failed to demonstrate an association between plasma BDNF levels and non-dippers.…”