Susceptibility to diarrhea is related to hemodynamic markers of sympathetic activation in the general population

Figures & data

Table 1. Study population characteristics.

	GI symptoms (n = 509)	No GI symptoms (n = 1585)	p-value
Age, years	39.1 (13.4)	41.1 (13.9)	.004
Sex, % women	66.4	49.8	<.001
Smoking, %	19.1	14.3	.010
BMI, kg*m2^-1	26.0 (5.3)	25.8 (4.5)	.497
Chronic stress, %	61.8	43.5	<.001
Diabetes, %	2.9	3.1	.869
CAD, %	0.8	1.0	.652

BMI: body mass index; CAD: coronary artery disease.

Continuous measurements are displayed as mean (standard deviation) and dichotomous variables as % of total number of subjects. Chronic stress was defined as self-reported stress during the past year. Linear regression and Pearson’s Chi² test. p < .05 was considered statistically significant.

Table 2. The relation between hemodynamic measurements and reported GI symptoms.

	GI symptoms (n = 509)	No GI symptoms (n = 1585)	P	p-adjusted (age, sex)	p-adjusted (age, sex, smoking, chronic stress)
Office measurements
SBP supine, mmHg	115.5 (14.9)	118.7 (15.8)	<.001	.217	.216
DBP supine, mmHg	71.8 (9.3)	73.6 (10.1)	.001	.051	.017
SBP standing, mmHg	117.3 (15.8)	120.4 (17.6)	<.001	.361	.273
DBP standing, mmHg	81.2 (9.4)	83.4 (10.5)	<.001	.009	.002
Delta-SBP, mmHg	1.6 (8.4)	1.61 (8.9)	.980	.883	.867
Delta-DBP, mmHg	9.3 (5.8)	9.8 (6.4)	.132	.153	.096
Orthostatic hypotension, %	0.8	1.6	.218	–	–
Resting heart rate, bpm	63.4 (9.9)	62.6 (10.3)	.203	.932	.745
24-h measurements
Mean SBP, mmHg	120.3 (13.4)	124.9 (13.5)	<.001	.047	.018
Intra-SD, mmHg	14.0 (3.7)	14.5 (3.6)	.040	.864	.528
Mean DBP, mmHg	70.0 (10.3)	73.9 (9.9)	<.001	.028	.008
Intra-SD, mmHg	11.6 (2.8)	11.9 (2.7)	.202	.840	.414
Mean HR, mmHg	71.6 (8.9)	69.9 (8.8)	.005	.039	.169
Intra-SD, mmHg	8.5 (2.3)	8.8 (2.4)	.016	.443	.218

GI: gastrointestinal; SBP: systolic blood pressure; DBP: diastolic blood pressure; bpm: beats per minute; SD: standard deviation.

Bold values are the statistically significant values.

Continuous measurements are displayed as mean (standard deviation (SD)) and dichotomous variables as % of total number of subjects. Intra-SD equals the intra-subject standard deviation of measurements. Linear regression and Pearson’s Chi² test. p < .05 was considered statistically significant.

Table 3. Spearman’s correlation between office measurement of hemodynamic parameters and specific symptoms.

	N	Rs	p-value
SBP
Abdominal pain	464	−0.042	.364
Diarrhea	450	−0.019	.684
Constipation	442	−0.138	.004
Bloating and flatulence	463	−0.158	.001
Vomiting and nausea	429	−0.122	.011
Psychological well-being	480	−0.139	.002
DBP
Abdominal pain	464	0.049	.293
Diarrhea	450	0.050	.291
Constipation	442	−0.075	.115
Bloating and flatulence	463	−0.085	.069
Vomiting and nausea	429	−0.023	.631
Psychological well-being	480	−0.027	.557
Heart rate
Abdominal pain	311	0.063	.270
Diarrhea	297	0.054	.352
Constipation	292	0.003	.959
Bloating and flatulence	313	−0.035	.542
Vomiting and nausea	279	0.018	.760
Psychological well-being	325	−0.001	.992
SBP 24 h
Abdominal pain	274	0.094	.120
Diarrhea	267	0.197	.001
Constipation	268	0.041	.504
Bloating and flatulence	275	0.023	.701
Vomiting and nausea	264	0.101	.103
Psychological well-being	278	0.082	.171
DBP 24 h
Abdominal pain	274	0.077	.201
Diarrhea	267	0.173	.004
Constipation	268	−0.002	.969
Bloating and flatulence	275	−0.012	.849
Vomiting and nausea	264	0.059	.341
Psychological well-being	278	0.084	.163
Heart rate 24 h
Abdominal pain	274	0.014	.823
Diarrhea	267	0.134	.028
Constipation	268	0.083	.178
Bloating and flatulence	275	−0.101	.094
Vomiting and nausea	264	0.140	.023
Psychological well-being	278	0.068	.256

SBP: systolic blood pressure; DBP: diastolic blood pressure; 24 h: 24-h measurement; N: number of observations.

Bold values are the statistically significant values.

Correlations between visual analog scale (VAS) (0-100 mm) for specific symptoms and hemodynamic parameters in patients who reported any kind of gastrointestinal symptoms during the past 2 weeks (n = 509). Spearman’s rank correlation test (r_s). For consistence in relation to the other parameters, the variable psychological well-being was inverted, i.e. a lower VAS meaning a higher well-being. p < .05 was considered statistically significant.

Figure 1. The relationship between the severity of diarrhea and 24-hour hemodynamic measurements. The reported severity of diarrhea among subjects with gastrointestinal symptoms (n = 509) in relation to 24-hour systolic blood pressure (blue bars), diastolic blood pressure and heart rate . P-values indicate significance in mean differences between VAS diarrhea quartile four and combined quartiles one to three, using linear regression including age, sex, smoking and self-reported chronic stress as covariates. Q: quartile; VAS: visual analogue scale; bpm: beats per minute.

Data availability

All data can be obtained from the authors upon request.