Sex differences in sympathetic activity in obesity and its related hypertension

Fu, Qi

doi:10.1111/nyas.14095

Cited by 27 publications

(19 citation statements)

References 104 publications

(215 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although not measured here, sympathetic overactivity has also been suggested as a contributing factor to enhancing RMR in hypertension and obesity, 22,23 as supported by epidemiological data 24,25 . However, after accounting for the direct effect of MVO 2 on RMR, other factors not directly associated with lean mass and fat mass could at best explain about 50% of the difference in RMR between hypertensive and normotensive.…”

Section: Discussionsupporting

confidence: 52%

Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms

Pedrianes-Martin

Perez-Valera

Morales-Álamo

et al. 2021

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

The purpose of this investigation was to determine whether differences in body composition, pharmacological treatment, and physical activity explain the increased resting metabolic rate (RMR) and impaired insulin sensitivity in hypertension. Resting blood pressure, RMR (indirect calorimetry), body composition (dual‐energy X‐ray absorptiometry), physical activity (accelerometry), maximal oxygen uptake (VO2max) (ergospirometry), and insulin sensitivity (Matsuda index) were measured in 174 patients (88 men and 86 women; 20–68 years) with overweight or obesity. Hypertension (HTA) was present in 51 men (58%) and 42 women (49%) (p = .29). RMR was 6.9% higher in hypertensives than normotensives (1777 ± 386 and 1663 ± 383 kcal d−1, p = .044). The double product (systolic blood pressure × heart rate) was 18% higher in hypertensive than normotensive patients (p < .001). The observed differences in absolute RMR were non‐significant after adjusting for total lean mass and total fat mass (estimated means: 1702 kcal d−1, CI: 1656–1750; and 1660 kcal d−1, CI: 1611–1710 kcal d−1, for the hypertensive and normotensive groups, respectively, p = .19, HTA × sex interaction p = .37). Lean mass, the double product, and age were the variables with the higher predictive value of RMR in hypertensive patients. Insulin sensitivity was lower in hypertensive than in normotensive patients, but these differences disappeared after accounting for physical activity and VO2max. In summary, hypertension is associated with increased RMR and reduced insulin sensitivity. The increased RMR is explained by an elevated myocardial oxygen consumption due to an increased resting double product, combined with differences in body composition between hypertensive and normotensive subjects.

show abstract

Section: Discussionsupporting

confidence: 52%

Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms

Pedrianes-Martin

Perez-Valera

Morales-Álamo

et al. 2021

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

show abstract

“…In obesity, diabetes, and metabolic syndrome, sympathetic overactivity has been ascribed to high levels of circulating insulin and leptin, which stimulate the sympathetic outflow both centrally and peripherally, and/or to chronic intermittent hypoxia due to obstructive sleep apnea [18,19]. Sympathetic overactivation in turn increases insulin resistance, maintaining a positive feedback loop [20].…”

Section: All Comorbidities Associated With Increased Morbidity/mortalmentioning

confidence: 99%

Sympathetic activation: a potential link between comorbidities and COVID‐19

et al. 2020

View full text Add to dashboard Cite

In coronavirus disease 2019 (COVID‐19), higher morbidity and mortality are associated with age, male gender, and comorbidities, such as chronic lung diseases, cardiovascular pathologies, hypertension, kidney diseases, diabetes mellitus, and obesity. All of the above conditions are characterized by increased sympathetic discharge, which may exert significant detrimental effects on COVID‐19 patients, through actions on the lungs, heart, blood vessels, kidneys, metabolism, and/or immune system. Furthermore, COVID‐19 may also increase sympathetic discharge, through changes in blood gases (chronic intermittent hypoxia, hyperpnea), angiotensin‐converting enzyme (ACE)1/ACE2 imbalance, immune/inflammatory factors, or emotional distress. Nevertheless, the potential role of the sympathetic nervous system has not yet been considered in the pathophysiology of COVID‐19. In our opinion, sympathetic overactivation could represent a so‐far undervalued mechanism for a vicious circle between COVID‐19 and comorbidities.

show abstract

“…To support this notion, previous studies demonstrate that individuals with obesity had increased MSNA and elevated renal norepinephrine spillover, 68‐70 while weight loss via lifestyle modifications decreased MSNA and blood pressure in obese people 71,72 . The pathophysiological mechanisms for sympathetic overactivity in obesity‐related hypertension have been discussed in a previous review article 73 . Briefly, chronic hyperinsulinemia due to insulin resistance, 68,74,75 high circulating plasma levels of leptin, 67,76,77 and/or obesity‐induced obstructive sleep apnea 64,78 may contribute, at least in part, to sympathetic overactivity in obese hypertensive patients.…”

Section: Sex Sympathetic Overactivity In Obesity‐related Hypertensionmentioning

confidence: 96%

“…71,72 The pathophysiological mechanisms for sympathetic overactivity in obesity-related hypertension have been discussed in a previous review article. 73 Briefly, chronic hyperinsulinemia due to insulin resistance, 68,74,75 high circulating plasma levels of leptin, 67,76,77 and/or obesity-induced obstructive sleep apnea 64,78 may contribute, at least in part, to sympathetic overactivity in obese hypertensive patients.…”

Section: Overactivit Y In Obesit Y-related Hypertensionmentioning

confidence: 99%

Impact of sex and age on metabolism, sympathetic activity, and hypertension

Yoo

2020

FASEB j.

Self Cite

View full text Add to dashboard Cite

In this brief review, we summarize the current knowledge on the complex interplay between metabolism, sympathetic activity and hypertension with a focus on sex differences and changes with age in humans. Evidence suggests that in premenopausal women, sex hormones, particularly estrogen exerts a profound cardioprotective effect which may be associated with favorable metabolic profiles, as well as lower sympathetic activity and blood pressure at rest and any given physiological and environmental stimuli compared with men of a similar age. Along this line, premenopausal women seem to be generally protected from obesity‐induced metabolic and cardiovascular complications. However, postmenopausal estrogen deprivation during midlife and older age has a detrimental impact on metabolism, may lead to adipose tissue redistribution from the subcutaneous to abdominal area, and augments sympathetic activity. All these changes could contribute significantly to the higher prevalence of hypertension and greater cardiometabolic risk in older women than older men. It is proposed that obesity‐related hypertension has a neurogenic component which is characterized by sympathetic overactivity, but the impact of sex and age remains largely unknown. Understanding sex and age‐specific differences in obesity and sympathetic neural control of blood pressure is important in the prevention and/or risk reduction of cardiometabolic disorders for both men and women.

show abstract

Sex differences in sympathetic activity in obesity and its related hypertension

Cited by 27 publications

References 104 publications

Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms

Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms

Sympathetic activation: a potential link between comorbidities and COVID‐19

Impact of sex and age on metabolism, sympathetic activity, and hypertension

Contact Info

Product

Resources

About