Diabetes, Metabolic Syndrome and Obesity (Aug 2019)

Impact of arterial hypertension and type 2 diabetes on cardiac autonomic modulation in obese individuals with recommendation for bariatric surgery

  • Carvalho NNC,
  • de Oliveira Junior FA,
  • da Silva G,
  • Baccin Martins VJ,
  • Braga VA,
  • Costa-Silva JH,
  • Fernandes Pimenta FC,
  • de Brito Alves JL

Journal volume & issue
Vol. Volume 12
pp. 1503 – 1511

Abstract

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Nara Nóbrega Crispim Carvalho,1,2 Francisco Antônio de Oliveira Junior,3 Gitana da Silva,4 Vinícius José Baccin Martins,3 Valdir de Andrade Braga,5 João Henrique da Costa-Silva,6 Flávia Cristina Fernandes Pimenta,4 José Luiz de Brito Alves11Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil; 2Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, João Pessoa, Brazil; 3Department of Physiology and Pathology, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil; 4Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil; 5Department of Biotechnology, Center of Biotechnology, Federal University of Paraíba, João Pessoa, Brazil; 6Department of Physical Education and Sport Sciences, Federal University of Pernambuco, Vitória De Santo Antão, PE, BrazilCorrespondence: José Luiz de Brito Alves; Nara Nóbrega Crispim CarvalhoDepartment of Nutrition, Federal University of Paraiba, Campus I – Jd. Cidade Universitária, João Pessoa, PB CEP: 58051-900, BrazilTel/fax +55 8 199 845 5485Email [email protected]; [email protected] and aim: Obese individuals with recommendation for bariatric surgery (BS) exhibit increased cardiovascular risk. The association of obesity with comorbidities, such as arterial hypertension (HTN) and type 2 diabetes mellitus (T2DM) can worsen cardiovascular dysfunction. This study aimed to investigate the effect of HTN on cardiac autonomic function and whether diabetes exacerbates HTN-related impairment of autonomic function in obese subjects.Methods: Samples (n=63) were allocated to three groups: Obese without HTN and T2DM (n=29), Obese with HTN (OHTN, n=17) and OHTN with T2DM (OHTN+T2DM, n=17), in which anthropometric measures, body composition, blood biochemical parameters, blood pressure (BP) and heart rate variability (HRV) were evaluated.Results: The age was higher in OHTN+T2DM and OHTN than in obese groups (p<0.05). OHTN+T2DM individuals had increased neck circumference and compromised glycemic profile when compared to obese and OHTN groups (p<0.05). Mean values for standard deviation of RR (SDRR), square root of the mean squared differences of successive RR interval (RMSSD) and number of pairs of successive normal-to-normal beat intervals that differed by 50 ms (pRR50) were significantly lower in OHTN+T2DM and OHTN groups when compared to patients with obesity alone (p<0.05). The low frequency (LF), low frequency/high frequency (LF/HF) ratio were higher in the OHTN+T2DM and OHTN than subjects with obesity alone (p<0.05). Nonlinear parameters SD2 and SD1 were also lower in the OHTN+T2DM when compared to the obese group (p<0.05). However, the SD2/SD1 ratio was higher in the OHTN+T2DM and OHTN groups than the obese group.&#x00A0Conclusion: T2DM and/or HTN impair the cardiac autonomic function in obese patients. However, the presence of T2DM did not exacerbate the hypertension-related impairment of autonomic function.Keywords: heart rate variability, blood pressure, glucose metabolism, obesity, cardiovascular risk

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