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Nocturnal variation in human sympathetic baroreflex sensitivity

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TLDR
Sympathetic BRS was significantly lower during sleep than while subjects were awake in the evening, and it remained low after the subjects woke up in the morning, and this sympathetic BRS pattern may contribute to diurnal haemodynamic variables and may account, at least in part, for the connection between circadian rhythm and cardiovascular disease.
Abstract
To determine whether or not there are nocturnal variations in sympathetic baroreflex sensitivity (BRS), we measured spontaneous sympathetic BRSs in eight normal subjects (average 24.5 years old) between 2300 and 0700 h. Electrocardiogram, blood pressure, polysomnography, and muscle sympathetic nerve activity (MSA) using microneurography were recorded. We defined cardiac 'baroreflex sequences' as those that contain three or more adjacent pulses, with the systolic blood pressure and the subsequent pulse interval either continuously increased or decreased. A similar analysis was applied to sympathetic BRSs. We selected three or more adjacent pulses during which diastolic blood pressures continuously increased or decreased. Total activity in MSA was defined as burst per minute x burst amplitude and we calculated the regression coefficients between the diastolic blood pressure and the subsequent total activities in MSA. The regression coefficients were classified as either negative or positive ones. When they were less than zero, we termed them 'baroreflex sequences'. Cardiac and sympathetic BRSs were estimated from the average slope of the baroreflex sequences. Sympathetic BRS was significantly lower during sleep than while subjects were awake in the evening (P < 0.05), and it remained low after the subjects woke up in the morning (P < 0.05). Conversely, cardiac BRS had a tendency to increase during sleep in the night, but not statistically significant. This sympathetic BRS pattern may contribute to diurnal haemodynamic variables and may account, at least in part, for the connection between circadian rhythm and cardiovascular disease.

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References
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Journal ArticleDOI

Circadian variation and triggers of onset of acute cardiovascular disease.

TL;DR: Recognition of the circadian variation--and the possibility of frequent triggering--of onset of acute disease suggests the need for pharmacologic protection of patients during vulnerable periods, and provides clues to mechanism, which may lead to improved methods of prevention.
Journal ArticleDOI

Sympathetic-Nerve Activity during Sleep in Normal Subjects

TL;DR: REM sleep is associated with profound sympathetic activation in normal subjects, possibly linked to changes in muscle tone and the hemodynamic and sympathetic changes during REM sleep could play a part in triggering ischemic events in patients with vascular disease.
Journal ArticleDOI

Reflex Regulation of Arterial Pressure during Sleep in Man: A Quantitative Method of Assessing Baroreflex Sensitivity

TL;DR: It is concluded that the baroreceptor reflex are can be rapidly reset, particularly during sleep, and the lower arterial pressures during sleep may be actively maintained in some subjects by increased baroreflex sensitivity.
Journal ArticleDOI

Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population.

TL;DR: Investigation of physiologic changes occurring during the period of increased incidence of sudden cardiac death may provide increased insight into its causes and suggest possible means of prevention.
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