Display options
Cite
Park J, Quyyumi AA, Middlekauff HR. Exercise pressor response and arterial baroreflex unloading during exercise in chronic kidney disease. J Appl Physiol (1985). 2012;114(5):538-49doi: 10.1152/japplphysiol.01037.2012.
Park, J., Quyyumi, A. A., & Middlekauff, H. R. (2013). Exercise pressor response and arterial baroreflex unloading during exercise in chronic kidney disease. Journal of applied physiology (Bethesda, Md. : 1985), 114(5), 538-49. https://doi.org/10.1152/japplphysiol.01037.2012
Park, Jeanie, et al. "Exercise pressor response and arterial baroreflex unloading during exercise in chronic kidney disease." Journal of applied physiology (Bethesda, Md. : 1985) vol. 114,5 (2013): 538-49. doi: https://doi.org/10.1152/japplphysiol.01037.2012
Park J, Quyyumi AA, Middlekauff HR. Exercise pressor response and arterial baroreflex unloading during exercise in chronic kidney disease. J Appl Physiol (1985). 2013 Mar 01;114(5):538-49. doi: 10.1152/japplphysiol.01037.2012. Epub 2012 Dec 13. PMID: 23239869; PMCID: PMC3615589.
Copy Download .nbib Format: NLM
Share it on

J Appl Physiol (1985). 2013 Mar 01;114(5):538-49. doi: 10.1152/japplphysiol.01037.2012. Epub 2012 Dec 13.

Exercise pressor response and arterial baroreflex unloading during exercise in chronic kidney disease.

Journal of applied physiology (Bethesda, Md. : 1985)

Jeanie Park, Arshed A Quyyumi, Holly R Middlekauff

Affiliations

  1. Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA. [email protected]

PMID: 23239869 PMCID: PMC3615589 DOI: 10.1152/japplphysiol.01037.2012

Abstract

Patients with chronic kidney disease (CKD) have poor exercise capacity, which contributes to cardiovascular risk. We sought to determine whether patients with stage 2 or stage 3 CKD have an augmented blood pressure (BP) response during exercise, and if so, whether overactivation of the sympathetic nervous system (SNS) during exercise might play a role. In 13 patients with CKD and hypertension and 13 controls with hypertension, we measured hemodynamics and muscle sympathetic nerve activity (MSNA) during the following maneuvers: low-level rhythmic handgrip (RHG 20%), which primarily stimulates mechanoreceptors, and moderate static handgrip exercise (SHG 30%) followed by posthandgrip circulatory arrest (PHGCA), which isolates metaboreceptors. During baseline studies, patients with CKD had significantly greater increases in mean arterial pressure (MAP) during SHG 30% (P = 0.045), RHG 20% (P = 0.031), and PHGCA (P = 0.043); however, the MSNA response was not augmented in patients with CKD compared with controls. We hypothesized that an augmented SNS response during exercise might be revealed in CKD if arterial baroreflex constraint was equalized using nitroprusside (NTP). These exercise maneuvers were repeated in patients with CKD during NTP infusion to equalize the BP response between groups, thereby relieving baroreflex-mediated suppression of SNS activity. With NTP infusion, patients with CKD had significantly increased MSNA responses during SHG 30% (P = 0.0044), and RHG 20% (P = 0.0064), but not during PHGCA (P > 0.05), suggesting increased reflex activation of the SNS during exercise, which may be mediated by mechanoreceptors but not metaboreceptors. Patients with CKD have an exaggerated BP response during rhythmic and static exercise with underlying SNS overactivation that is revealed during arterial baroreflex unloading during exercise.

References

  1. J Am Soc Nephrol. 2003 Dec;14(12):3239-44 - PubMed
  2. J Hypertens. 2006 May;24(5):881-7 - PubMed
  3. Am J Physiol Heart Circ Physiol. 2004 Nov;287(5):H1944-9 - PubMed
  4. Am J Physiol Heart Circ Physiol. 2004 Nov;287(5):H1937-43 - PubMed
  5. Am J Physiol Heart Circ Physiol. 2011 Oct;301(4):H1191-204 - PubMed
  6. N Engl J Med. 1999 Apr 29;340(17):1321-8 - PubMed
  7. J Appl Physiol (1985). 1997 Apr;82(4):1107-11 - PubMed
  8. J Appl Physiol (1985). 1994 Sep;77(3):1399-402 - PubMed
  9. J Physiol. 2011 Mar 1;589(Pt 5):1209-20 - PubMed
  10. Circ Res. 2004 Jan 9;94(1):37-45 - PubMed
  11. Circ Res. 1995 Jan;76(1):127-31 - PubMed
  12. J Appl Physiol (1985). 2005 Jul;99(1):5-22 - PubMed
  13. Acta Physiol Scand. 1972 Jan;84(1):82-94 - PubMed
  14. Acta Physiol Scand. 1972 Jan;84(1):65-81 - PubMed
  15. J Clin Invest. 1990 Dec;86(6):1855-61 - PubMed
  16. Clin Neurophysiol. 2006 Nov;117(11):2357-84 - PubMed
  17. Annu Rev Physiol. 1988;50:565-76 - PubMed
  18. Br J Anaesth. 2012 Feb;108(2):202-10 - PubMed
  19. Lancet. 2010 Jun 12;375(9731):2073-81 - PubMed
  20. Circulation. 1990 Jul;82(1):188-95 - PubMed
  21. Br J Anaesth. 2010 Sep;105(3):264-72 - PubMed
  22. Circulation. 1994 Jul;90(1):248-53 - PubMed
  23. Exerc Sport Sci Rev. 1991;19:313-49 - PubMed
  24. J Physiol. 2007 Sep 15;583(Pt 3):835-45 - PubMed
  25. J Appl Physiol (1985). 1999 Feb;86(2):767-72 - PubMed
  26. Physiol Rev. 1979 Oct;59(4):919-57 - PubMed
  27. Am J Physiol. 1991 Sep;261(3 Pt 2):R690-6 - PubMed
  28. Clin Auton Res. 2002 Dec;12(6):429-39 - PubMed
  29. Ann Intern Med. 2006 Aug 15;145(4):247-54 - PubMed
  30. J Clin Invest. 1992 Nov;90(5):1657-65 - PubMed
  31. J Appl Physiol (1985). 2001 May;90(5):1714-9 - PubMed
  32. Circulation. 1991 Nov;84(5):2034-9 - PubMed
  33. Am J Physiol Heart Circ Physiol. 2012 Mar 1;302(5):H1031-49 - PubMed
  34. Circ Res. 1985 Sep;57(3):461-9 - PubMed
  35. Am J Hypertens. 2006 Sep;19(9):951-7 - PubMed
  36. J Am Soc Nephrol. 2003 Feb;14(2):425-30 - PubMed
  37. Heart Rhythm. 2010 Dec;7(12):1900-6 - PubMed
  38. J Hum Hypertens. 2001 May;15(5):353-6 - PubMed
  39. J Physiol. 2003 Mar 15;547(Pt 3):971-6 - PubMed
  40. Am J Physiol Regul Integr Comp Physiol. 2008 Oct;295(4):R1188-94 - PubMed
  41. J Appl Physiol (1985). 1994 Mar;76(3):1077-81 - PubMed
  42. Am J Physiol Heart Circ Physiol. 2001 Aug;281(2):H469-75 - PubMed
  43. Circulation. 1998 Aug 11;98(6):528-34 - PubMed

Substances

MeSH terms

Publication Types

Grant support