Analysis of Cardiovascular Hemodynamic and Autonomic Variables in Individuals with Systemic Arterial Hypertension, Type 2 Diabetes Mellitus, and Parkinson’s Disease: A Comparative Study

ABSTRACT

Background

Systemic arterial hypertension (SAH), type 2 diabetes mellitus (T2DM), and Parkinson’s disease (PD) are highly prevalent chronic diseases that can significantly impact the cardiovascular system.

Aim

The aim of this study was to compare hemodynamic and autonomic variables at rest in individuals with SAH, T2DM, or PD.

Methods

Fifty sedentary or insufficiently active individuals (22 men) with SAH (age = 66 ± 5.0 yr), T2DM (age = 52 ± 10 yr) or PD (age = 68 ± 8.0 yr) had their resting blood pressure (BP), arterial stiffness, endothelial function, and heart rate variability (HRV) assessed and compared.

Results

Systolic and diastolic BP were higher in SAH (130 ± 10 / 80 ± 10 mmHg) than T2DM (110 ± 14 / 75 ± 11 mmHg) and PD, and (123 ± 20 / 70 ± 11 mmHg) respectively. T2DM individuals showed lower arterial stiffness (8.4 ± 1.1 m/s), when compared to SAH (10.3 ± 2.3 m/s) and PD (10.6 ± 3.0 m/s). T2DM had greater resting tachycardia showed by the mean RR (759 ± 79 ms), than SAH (962 ± 169 ms) and PD (976 ± 134 ms), which was accompanied by higher sympathetic modulation (low frequency [LF]: 62 ± 19 nu) and lower parasympathetic modulation (high frequency [HF]: 32 ± 16 nu) when compared to SAH (LF: 40 ± 16 nu; HF: 61 ± 33 nu). No differences among groups were found on non-linear HRV markers and endothelial reactivity indexes.

Conclusions

Individuals with T2DM showed impaired levels of cardiac autonomic markers when compared to individuals with SAH and PD, despite of having lower levels of BP and arterial stiffness.

KEYWORDS:

• Arterial pressure
• cardiac control
• chronic disease
• heart rate
• endothelium

Availability of data and material

The data used to support the findings of this study are available from the corresponding author upon request.

Code availability

Not applicable.

Authors’ contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Awassi Yuphiwa Ngomane, Raphael Martins de Abreu, Bianca Fernandes, Isabela Roque Marçal, Guilherme Veiga Guimarães and Emmanuel Gomes Ciolac. The first draft of the manuscript was written by Awassi Yuphiwa Ngomane and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Ethics Committee of the São Paulo State University (School of Sciences- nº 1.311.898) approved all procedures.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Patients signed informed consent regarding publishing their data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2015/09259-2). Awassi Yuphiwa Ngomane and Bianca Fernandes were supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES – Finance Code 001). Isabela Roque Marçal and Emmanuel Gomes Ciolac were supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2018/09695-5) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq #303399/2018-0), respectively.