Impact of arterial hypertension and type 2 diabetes on cardiac autonomic modulation in obese individuals with recommendation for bariatric surgery
Nara Nóbrega Crispim Carvalho,1,2 Francisco Antônio de Oliveira Junior,3 Gitana da Silva,4 Vinícius José Baccin Martins,3 Valdir de Andrade Braga,5 João Henrique da Costa-Silva,6 Flávia Cristina Fernandes Pimenta,4 José Luiz...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2019
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| Acceso en línea: | https://doaj.org/article/e29f886f8be24bf3b8a15da8cca03605 |
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| Sumario: | Nara Nóbrega Crispim Carvalho,1,2 Francisco Antônio de Oliveira Junior,3 Gitana da Silva,4 Vinícius José Baccin Martins,3 Valdir de Andrade Braga,5 João Henrique da Costa-Silva,6 Flávia Cristina Fernandes Pimenta,4 José Luiz de Brito Alves11Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil; 2Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, João Pessoa, Brazil; 3Department of Physiology and Pathology, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil; 4Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil; 5Department of Biotechnology, Center of Biotechnology, Federal University of Paraíba, João Pessoa, Brazil; 6Department of Physical Education and Sport Sciences, Federal University of Pernambuco, Vitória De Santo Antão, PE, BrazilCorrespondence: José Luiz de Brito Alves; Nara Nóbrega Crispim CarvalhoDepartment of Nutrition, Federal University of Paraiba, Campus I – Jd. Cidade Universitária, João Pessoa, PB CEP: 58051-900, BrazilTel/fax +55 8 199 845 5485Email jose_luiz_61@hotmail.com; naranc@gmail.comBackground and aim: Obese individuals with recommendation for bariatric surgery (BS) exhibit increased cardiovascular risk. The association of obesity with comorbidities, such as arterial hypertension (HTN) and type 2 diabetes mellitus (T2DM) can worsen cardiovascular dysfunction. This study aimed to investigate the effect of HTN on cardiac autonomic function and whether diabetes exacerbates HTN-related impairment of autonomic function in obese subjects.Methods: Samples (n=63) were allocated to three groups: Obese without HTN and T2DM (n=29), Obese with HTN (OHTN, n=17) and OHTN with T2DM (OHTN+T2DM, n=17), in which anthropometric measures, body composition, blood biochemical parameters, blood pressure (BP) and heart rate variability (HRV) were evaluated.Results: The age was higher in OHTN+T2DM and OHTN than in obese groups (p<0.05). OHTN+T2DM individuals had increased neck circumference and compromised glycemic profile when compared to obese and OHTN groups (p<0.05). Mean values for standard deviation of RR (SDRR), square root of the mean squared differences of successive RR interval (RMSSD) and number of pairs of successive normal-to-normal beat intervals that differed by 50 ms (pRR50) were significantly lower in OHTN+T2DM and OHTN groups when compared to patients with obesity alone (p<0.05). The low frequency (LF), low frequency/high frequency (LF/HF) ratio were higher in the OHTN+T2DM and OHTN than subjects with obesity alone (p<0.05). Nonlinear parameters SD2 and SD1 were also lower in the OHTN+T2DM when compared to the obese group (p<0.05). However, the SD2/SD1 ratio was higher in the OHTN+T2DM and OHTN groups than the obese group.&#x00A0Conclusion: T2DM and/or HTN impair the cardiac autonomic function in obese patients. However, the presence of T2DM did not exacerbate the hypertension-related impairment of autonomic function.Keywords: heart rate variability, blood pressure, glucose metabolism, obesity, cardiovascular risk |
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