| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
From Cattedra di Medicina Interna I, Università di Milano,
Ospedale S Gerardo dei Tintori, Monza (G.G., M.C., B.M.C., G.M.); Centro
Auxologico Italiano, IRCCS, Milano (G.S., B.M.C., F.C., G.M.); and Centro di
Fisiologia Clinica e Ipertensione, IRCCS, Ospedale Maggiore, Milano (G.G.,
G.B., G.M.), Italy.
Correspondence to Professor Giuseppe Mancia, Cattedra di Medicina Interna I, Ospedale S Gerardo dei Tintori, Via Donizetti 103—Monza, Milano, Italy.
Background—Previous studies have
shown that sympathetic cardiovascular outflow is
increased in obese normotensive subjects and that this increase is
associated with a baroreflex impairment. The purpose of this study was
to determine whether these abnormalities are irreversible or can be
favorably affected by body weight reduction.
Methods and Results—In 20 obese normotensive subjects (age,
31.3±1.7 years; body mass index, 37.6±0.9 kg/m2,
mean±SEM), we measured beat-to-beat arterial blood
pressure (Finapres technique), heart rate (ECG), postganglionic muscle
sympathetic nerve activity (microneurography at a peroneal nerve), and
venous plasma norepinephrine (high-performance
liquid chromatography) at rest and during baroreceptor
stimulation and deactivation induced by increases and reductions of
blood pressure via stepwise intravenous infusions of
phenylephrine and nitroprusside. Measurements were repeated
in 10 subjects after a 16-week hypocaloric diet with normal sodium
content (4600 to 5000 J and 210 mmol NaCl/d) and in the remaining
10 subjects after a 16-week observation period without any reduction in
the caloric intake. The hypocaloric diet significantly reduced body
mass index, slightly reduced blood pressure, and caused a significant
and marked decrease in both muscle sympathetic nerve activity (from
50.0±5.1 to 32.9±4.6 bursts per 100 heart beats,
P<.01) and plasma norepinephrine (from
356.2±43 to 258.4±29 pg/mL, P<.05). This was
associated with a significant improvement in the sensitivity of the
baroreceptor heart rate (+71.5±11%, P<.01) and muscle
sympathetic nerve activity (+124.5±22%, P<.001)
reflex. Total body glucose uptake also increased significantly
(+60.8±12.0%, P<.05), indicating an increase in
insulin sensitivity. All variables remained unchanged in subjects
not undergoing caloric restriction.
Conclusions—In obese normotensive subjects, a reduction in body
weight induced by a hypocaloric diet with normal sodium content exerts
a marked reduction in sympathetic activity owing to central
sympathoinhibition. This can be due to the consequences of an increased
insulin sensitivity but also to a restoration of the baroreflex control
of the cardiovascular system with weight loss.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Body Weight Reduction, Sympathetic Nerve Traffic, and Arterial Baroreflex in Obese Normotensive Humans
Key Words: obesity • nervous system, autonomic • reflex • diet
This article has been cited by other articles:
 |
|
 |
|
  I. Biaggioni Should We Target the Sympathetic Nervous System in the Treatment of Obesity-Associated Hypertension? Hypertension, February 1, 2008; 51(2): 168 - 171. [Full Text] [PDF]
|
|
|
|
|
|
M. P. Pricher, K. L. Freeman, and V. L. Brooks Insulin in the Brain Increases Gain of Baroreflex Control of Heart Rate and Lumbar Sympathetic Nerve Activity Hypertension, February 1, 2008; 51(2): 514 - 520. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Daubert, M.-Y. Chung, and V. L. Brooks Insulin resistance and impaired baroreflex gain during pregnancy Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2007; 292(6): R2188 - R2195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Gentile, J. S. Orr, B. M. Davy, and K. P. Davy Modest weight gain is associated with sympathetic neural activation in nonobese humans Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2007; 292(5): R1834 - R1838. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ryan, S. Ward, C. Heneghan, and W. T. McNicholas Predictors of Decreased Spontaneous Baroreflex Sensitivity in Obstructive Sleep Apnea Syndrome Chest, April 1, 2007; 131(4): 1100 - 1107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Heusser, S. Engeli, J. Tank, A. Diedrich, S. Wiesner, J. Janke, F. C. Luft, and J. Jordan Sympathetic Vasomotor Tone Determines Blood Pressure Response to Long-Term Sibutramine Treatment J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1560 - 1563. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Narkiewicz Obesity and hypertension--the issue is more complex than we thought Nephrol. Dial. Transplant., February 1, 2006; 21(2): 264 - 267. [Full Text] [PDF]
|
|
|
|
|
|
N. E. Straznicky, E. A. Lambert, G. W. Lambert, K. Masuo, M. D. Esler, and P. J. Nestel Effects of Dietary Weight Loss on Sympathetic Activity and Cardiac Risk Factors Associated with the Metabolic Syndrome J. Clin. Endocrinol. Metab., November 1, 2005; 90(11): 5998 - 6005. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. E. Alvarez, B. M. Davy, T. P. Ballard, S. D. Beske, and K. P. Davy Weight loss increases cardiovagal baroreflex function in obese young and older men Am J Physiol Endocrinol Metab, October 1, 2005; 289(4): E665 - E669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. G Haynes Role of leptin in obesity-related hypertension Exp Physiol, September 1, 2005; 90(5): 683 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Engeli, J. Bohnke, K. Gorzelniak, J. Janke, P. Schling, M. Bader, F. C. Luft, and A. M. Sharma Weight Loss and the Renin-Angiotensin-Aldosterone System Hypertension, March 1, 2005; 45(3): 356 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Astrand, M. Bohlooly-Y, S. Larsdotter, M. Mahlapuu, H. Andersen, J. Tornell, C. Ohlsson, M. Snaith, and D. G. A. Morgan Mice lacking melanin-concentrating hormone receptor 1 demonstrate increased heart rate associated with altered autonomic activity Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2004; 287(4): R749 - R758. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Koomans, P. J. Blankestijn, and J. A. Joles Sympathetic Hyperactivity in Chronic Renal Failure: A Wake-up Call J. Am. Soc. Nephrol., March 1, 2004; 15(3): 524 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Seals and C. Bell Chronic Sympathetic Activation: Consequence and Cause of Age-Associated Obesity? Diabetes, February 1, 2004; 53(2): 276 - 284. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. Aneja, F. El-Atat, S. I. McFarlane, and J. R. Sowers Hypertension and Obesity Recent Prog. Horm. Res., January 1, 2004; 59(1): 169 - 205. [Abstract] [Full Text]
|
|
|
|
|
|
S. J. Swoap, D. Weinshenker, R. D. Palmiter, and G. Garber Dbh(-/-) mice are hypotensive, have altered circadian rhythms, and have abnormal responses to dieting and stress Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2004; 286(1): R108 - R113. [Abstract] [Full Text]
|
|
|
|
 |
|
 P. Abete, F. Cacciatore, N. Ferrara, C. Calabrese, D. de Santis, G. Testa, G. Galizia, S. Del Vecchio, D. Leosco, M. Condorelli, et al. Body mass index and preinfarction angina in elderly patients with acute myocardial infarction Am. J. Clinical Nutrition, October 1, 2003; 78(4): 796 - 801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Tank, J. Jordan, A. Diedrich, C. Schroeder, R. Furlan, A. M. Sharma, F. C. Luft, and G. Brabant Bound Leptin and Sympathetic Outflow in Nonobese Men J. Clin. Endocrinol. Metab., October 1, 2003; 88(10): 4955 - 4959. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. C. Trombetta, L. T. Batalha, M. U. P. B. Rondon, M. C. Laterza, F. H. S. Kuniyoshi, M. M. G. Gowdak, A. C. P. Barretto, A. Halpern, S. M. F. Villares, and C. E. Negrao Weight loss improves neurovascular and muscle metaboreflex control in obesity Am J Physiol Heart Circ Physiol, August 7, 2003; 285(3): H974 - H982. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Anson, Z. Guo, R. de Cabo, T. Iyun, M. Rios, A. Hagepanos, D. K. Ingram, M. A. Lane, and M. P. Mattson Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake PNAS, May 13, 2003; 100(10): 6216 - 6220. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. J. He, G. A. MacGregor, G. Grassi, G. Foglia, R. Dell'Oro, F. Quarti-Trevano, G. Seravalle, and G. Mancia Salt Intake and Sympathetic Activity * Response Circulation, April 29, 2003; 107 (16): e108 - e108. [Full Text] [PDF]
|
|
|
|
|
|
G. E. Alvarez, S. D. Beske, T. P. Ballard, and K. P. Davy Sympathetic Neural Activation in Visceral Obesity Circulation, November 12, 2002; 106(20): 2533 - 2536. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Bonsignore, G. Parati, G. Insalaco, O. Marrone, P. Castiglioni, S. Romano, M. Di Rienzo, G. Mancia, and G. Bonsignore Continuous Positive Airway Pressure Treatment Improves Baroreflex Control of Heart Rate during Sleep in Severe Obstructive Sleep Apnea Syndrome Am. J. Respir. Crit. Care Med., August 1, 2002; 166(3): 279 - 286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. HEINDL, M. LEHNERT, C.-P. CRIEE, G. HASENFUSS, and S. ANDREAS Marked Sympathetic Activation in Patients with Chronic Respiratory Failure Am. J. Respir. Crit. Care Med., August 15, 2001; 164(4): 597 - 601. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Negrao, I. C. Trombetta, L. T. Batalha, M. M. Ribeiro, M. U. P. B. Rondon, T. Tinucci, C. L. M. Forjaz, A. C. P. Barretto, A. Halpern, and S. M. F. Villares Muscle metaboreflex control is diminished in normotensive obese women Am J Physiol Heart Circ Physiol, August 1, 2001; 281(2): H469 - H475. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bergholm, J. Westerbacka, S. Vehkavaara, A. Seppälä-Lindroos, T. Goto, and H. Yki-Järvinen Insulin Sensitivity Regulates Autonomic Control of Heart Rate Variation Independent of Body Weight in Normal Subjects J. Clin. Endocrinol. Metab., March 1, 2001; 86(3): 1403 - 1409. [Abstract] [Full Text]
|
|
|
|
|
|
M. Emdin, A. Gastaldelli, E. Muscelli, A. Macerata, A. Natali, S. Camastra, and E. Ferrannini Hyperinsulinemia and Autonomic Nervous System Dysfunction in Obesity : Effects of Weight Loss Circulation, January 30, 2001; 103(4): 513 - 519. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Rudas, A. A. Crossman, C. A. Morillo, J. R. Halliwill, K. U. O. Tahvanainen, T. A. Kuusela, and D. L. Eckberg Human sympathetic and vagal baroreflex responses to sequential nitroprusside and phenylephrine Am J Physiol Heart Circ Physiol, May 1, 1999; 276(5): H1691 - H1698. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Soderberg, B. Ahren, B. Stegmayr, O. Johnson, P.-G. Wiklund, L. Weinehall, G. Hallmans, and T. Olsson Leptin Is a Risk Marker for First-Ever Hemorrhagic Stroke in a Population-Based Cohort Stroke, February 1, 1999; 30(2): 328 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Williams, J. B. Chambers, R. P. Henderson, M. E. Rashotte, and J. M. Overton Cardiovascular responses to caloric restriction and thermoneutrality in C57BL/6J mice Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2002; 282(5): R1459 - R1467. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Abete, G. Testa, N. Ferrara, D. De Santis, P. Capaccio, L. Viati, C. Calabrese, F. Cacciatore, G. Longobardi, M. Condorelli, et al. Cardioprotective effect of ischemic preconditioning is preserved in food-restricted senescent rats Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H1978 - H1987. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Jordan, J. Tank, J. R. Shannon, A. Diedrich, A. Lipp, C. Schroder, G. Arnold, A. M. Sharma, I. Biaggioni, D. Robertson, et al. Baroreflex Buffering and Susceptibility to Vasoactive Drugs Circulation, March 26, 2002; 105(12): 1459 - 1464. [Abstract] [Full Text] [PDF]
|
|