Autonomic dysfunction in patients with cerebrovascular diseases and metabolic syndrome

Abstract

Cerebrovascular diseases (CVD) are often associated with autonomicdysfunction. Obesity, hypertension, dyslipidemia anddiabetes mellitus (or glucose intolerance) are risk factors for autonomicdysfunction. We assessed the autonomic nervous systemactivity (sympathetic skin response[SSR]) in patients with CVDand compared it with clinical data (body mass index, cholesterol,fasting glucose, glycated hemoglobin, blood pressure). Thesympathetic skin response was evoked with electrical stimulationat rest and after cold pressor test and hyperventilation. Patientswith CVD and concurrent metabolic syndrome (MetS) more oftenhad autonomic dysfunction (namely, increased sympatheticactivity and worse reaction on cold pressor test and hyperventilation)compared to patients without MetS. Increase of the amplitudeof SSR correlated with high body mass index, elevatedlevels of total cholesterol, low-density lipoprotein, and hightriglycerides, anxiety and depression. The long latency and lowamplitude (autonomic neuropathy) correlated with hyperglycemia,high levels of glycated hemoglobin, and hypertriglyceridemia.Our results indicate that patients with CVD and concurrentMetS have autonomic dysfunction that is associated with obesity,dyslipidemia, anxiety and depression. The evidence of the autonomicnervous system impairment (high sympathetic activity,autonomic neuropathy) in patients with CVD may have importantpredictive value.

Keywords

• cerebrovascular diseases
• metabolic syndrome
• type 2 diabetes
• autonomic nervous system
• autonomic dysfunction
• autonomic neuropathy
• sympathetic skin response
• cold pressor test
• hyperventilation