Document Type : Original Article
Authors
Government Medical College, Bhavnagar, Gujarat, India
Abstract
BACKGROUND: Sympathetic overactivity mediates abnormal cardiovascular outcome that is affected
by stress, lack of physical activity (PA), and familial hypertension (HTN). It can be assessed by blood
pressure‑based sympathetic function tests.
OBJECTIVE: We studied sympathetic function tests in young nonathletic males in relation to measures
of obesity, PA, and familial HTN.
METHODOLOGY: We recruited 100 males (mean age: 19 years) and measured body mass
index (BMI) and body composition parameters by tetrapolar bioelectrical impedance such as total body
fat, visceral fat, subcutaneous fat, and skeletal muscle mass. Using instrument cardiac autonomic
neuropathy system of Recorders and Medicare System Company, India, blood pressures (supine,
standing, and post hand grip) were recorded and studied quantitatively and qualitatively.
RESULTS: Physically active and inactive individuals (n = 50 each) had comparable age, BMI,
measures of obesity, and sympathetic function tests. However, individuals with familial HTN (n = 37)
showed significantly higher obesity measures and blood pressures (supine: systolic blood
pressure [SBP] – 133 vs. 115 and diastolic blood pressure [DBP] – 79 vs. 76; standing: SBP – 136 vs.
122 and DBP – 80 vs. 76; post hand grip: SBP – 136 vs. 125 and DBP – 86 vs. 81). Qualitatively,
postural hypotension was seen in only two individuals, while worst grading was in post hand grip
test significantly and more so in physically inactive group (30%, 28%, and 42% vs. 16%, 20%, and
64%) and individuals with positive familial HTN (32%, 38%, and 30% vs. 17%, 13%, and 70%).
CONCLUSION: Familial HTN, but not physical inactivity, affects sympathetic functioning in nonathletic
young male medical personnel. It asks for other lifestyle modifications for better cardiovascular health
as primary prevention.
Keywords
Noncommunicable Diseases 2010. Geneva, Switzerland: WHO
Press; 2011.
2. Rahmouni K. Obesity, sympathetic overdrive, and hypertension:
The leptin connection. Hypertension 2010;55:844‑5.
3. Brotman DJ, Golden SH, Wittstein IS. The cardiovascular toll of
stress. Lancet 2007;370:1089‑100.
4. Ino‑Oka E, Sekino H, Ohtaki Y, Inooka H. Effects of daily physical
activity level on the degree of sympathetic tone. Intern Med
2009;48:19‑24.
5. Goldstein IB, Shapiro D, Weiss RE. How family history and risk
factors for hypertension relate to ambulatory blood pressure in
healthy adults. J Hypertens 2008;26:276‑83.
6. Zygmunt A, Stanczyk J. Methods of evaluation of autonomic
nervous system function. Arch Med Sci 2010;6:11‑8.
7. Kenney WL. Parasympathetic control of resting heart rate:
Relationship to aerobic power. Med Sci Sports Exerc 1985;17:451‑5.
8. Guyenet PG. The sympathetic control of blood pressure. Nat Rev
Neurosci 2006;7:335‑46.
9. Patil SG, Dhanakshirur G, Aithala MR, Das KK. Comparison of the
effects of yoga and lifestyle modification on grade‑I hypertension
in elderly males: A preliminary study. Int J Clin Exp Physiol
2014;1:68‑72.
10. Anjana RM, Pradeepa R, Das AK, Deepa M, Bhansali A, Joshi SR,
et al. Physical activity and inactivity patterns in India – Results
from the ICMR‑INDIAB study (Phase‑1) [ICMR‑INDIAB‑5]. Int
J Behav Nutr Phys Act 2014;11:26.
11. Mueller PJ. Exercise training and sympathetic nervous system
activity: Evidence for physical activity dependent neural
plasticity. Clin Exp Pharmacol Physiol 2007;34:377‑84.
12. Laitinen T, Hartikainen J, Vanninen E, Niskanen L, Geelen G,
Länsimies E, et al. Age and gender dependency of baroreflex
sensitivity in healthy subjects. J Appl Physiol(1985) 1998;84:576‑83.
13. Kuo TB, Lin T, Yang CC, Li CL, Chen CF, Chou P, et al. Effect of
aging on gender differences in neural control of heart rate. Am J
Physiol 1999;277:H2233‑9.
14. Iellamo F, Legramante JM, Pigozzi F, Spataro A, Norbiato G,
Lucini D, et al. Conversion from vagal to sympathetic
predominance with strenuous training in high‑performance
world class athletes. Circulation 2002;105:2719‑24.
15. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA,
et al. Physical activity and public health: Updated recommendation
for adults from the American College of Sports Medicine
and the American Heart Association. Med Sci Sports Exerc
2007;39:1423‑34.
16. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G,
et al. Trends in sudden cardiovascular death in young competitive
athletes after implementation of a preparticipation screening
program. JAMA 2006;296:1593‑601.
17. Dahlin M, Joneborg N, Runeson B. Stress and depression
among medical students: A cross‑sectional study. Med Educ
2005;39:594‑604.
18. Ranasinghe P, Cooray DN, Jayawardena R, Katulanda P. The
influence of family history of hypertension on disease prevalence
and associated metabolic risk factors among Sri Lankan adults.
BMC Public Health 2015;15:576.
19. Kyvelou SM, Vyssoulis GP, Karpanou EA, Adamopoulos DN,
Deligeorgis AD, Cokkinos DV, et al. Arterial stiffness in
offspring of hypertensive parents: A pilot study. Int J Cardiol
2008;129:438‑40.
20. Kyvelou SM, Vyssoulis GP, Karpanou EA, Adamopoulos DN,
Gialernios TP, Spanos PG, et al. Arterial hypertension parental
burden affects arterial stiffness and wave reflection to the aorta
in young offsprings. Int J Cardiol 2010;144:156‑60.
21. McEniery CM, Yasmin, Hall IR, Qasem A, Wilkinson IB,
Cockcroft JR, et al. Normal vascular aging: Differential effects on
wave reflection and aortic pulse wave velocity: The Anglo‑Cardiff
collaborative trial (ACCT). J Am Coll Cardiol 2005;46:1753‑60.
22. Garg R, Malhotra V, Kumar A, Dhar U, Tripathi Y. Effect of
isometric handgrip exercise training on resting blood pressure
in normal healthy adults. J Clin Diagn Res 2014;8:BC08‑10.
23. Bhandari B, Kumar L, Datta A, Sircar S. Effect of sub maximal
dynamic and static exercises on QTc interval in healthy young
men. J Clin Diagn Res 2015;9:CC01‑4.
24. Chrysant SG. Current evidence on the hemodynamic and
blood pressure effects of isometric exercise in normotensive
and hypertensive persons. J Clin Hypertens (Greenwich)
2010;12:721‑6.
25. Solanki JD, Mehta HB, Shah CJ. Pulse wave analyzed
cardiovascular parameters in young first degree relatives of type 2
diabetics‑ a cross‑sectional study. Indian Heart J 2018;70:341‑5.
26. Solanki JD, Mehta HB, Shah CJ. Pulse wave analyzed
cardiovascular parameters in young first degree relatives of
hypertensives. J Res Med Sci 2018;23:72.
27. Paffenbarger RS Jr., Wing AL, HydeRT, Jung DL. Physical activity
and incidence of hypertension in college alumni. Am J Epidemiol
1983;117:245‑57.
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