Relationship of Autonomic Imbalance and Circadian Disruption With Obesity and Type 2 Diabetes in Resistant Hypertensive Patients

Abstract

Background: Hypertension, diabetes and obesity are not isolated findings, but a series of interacting interactive physiologic derangements. Taking into account genetic background and lifestyle behavior, AI (autonomic imbalance) could be a common root for RHTN (resistant hypertension) or RHTN plus type 2 diabetes (T2D) comorbidity development. Moreover, circadian disruption can lead to metabolic and vasomotor impairments such as obesity, insulin resistance and resistant hypertension. In order to better understand the triggered emergence of obesity and T2D comorbidity in resistant hypertension, we investigated the pattern of autonomic activity in the circadian rhythm in RHTN with and without type 2 diabetes (T2D), and its relationship with serum adiponectin concentration.

Novel Mechanism for Disrupted Circadian Blood Pressure Rhythm in a Rat Model of Metabolic Syndrome—The Critical Role of Angiotensin II

“…A large proportion of hypertensive patients with MetS are characterized by disrupted circadian blood pressure (BP) rhythms such as nocturnal nondipper-type, riser-type, or morning surge-type hypertension. 1,2 Such disrupted diurnal BP rhythms are associated with a high rate of cardiovascular events. [3][4][5][6][7][8] However, the precise mechanism of how circadian BP rhythms become disrupted in MetS remains to be defined.…”

Role of autonomic nervous activity, as measured by heart rate variability, on the effect of mortality in disabled older adults with low blood pressure in long‐term care

“…17,24 We hypothesized that the period of suffering from such underlying diseases that accelerate arteriosclerosis is different in each group, as are the therapeutic situations. 29 Second, stroke disturbs the autonomic nervous system and HRV indices. 30 Although we excluded participants with neurodegenerative diseases, patients with stroke, fracture and disuse syndrome were included.…”

Proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel on Renal Sympathetic Denervation

“…Ambulatory BP monitoring is likely to be the metric of choice in future trials. Other projected outcome measures include changes in baseline autonomic nervous system function, as reflected by changes in MSNA and levels of circulating catecholamine; changes in insulin resistance, as reflected by fasting glucose and hemoglobin A 1c levels; renal function based on albuminuria, serum creatinine values, and estimated glomerular filtration rates; activation of the renin-angiotensin-aldosterone system; control of tachyarrhythmias, looking at recurrence rates measured by implantable cardioversion device output or symptomatic recurrence with hospitalization; cardiac geometry and hemodynamics; quality of life; changes in medication use; and cost-effectiveness (37)(38)(39)(40)(41)(42)(43).…”