Muscle sympathetic nervous activity in depressed patients before and after treatment with sertraline.

BACKGROUND: Sympathetic hyperactivity is one of the mechanisms involved in the increased cardiovascular risk associated with depression, and there is evidence that antidepressants decrease sympathetic activity. OBJECTIVES: We tested the following two hypotheses: patients with major depressive disorder with high scores of depressive symptoms (HMDD) have augmented muscle sympathetic nervous system activity (MSNA) at rest and during mental stress compared with patients with major depressive disorder with low scores of depressive symptoms (LMDD) and controls; sertraline decreases MSNA in depressed patients. METHODS: Ten HMDD, nine LMDD and 11 body weight-matched controls were studied. MSNA was directly measured from the peroneal nerve using microneurography for 3 min at rest and 4 min during the Stroop color word test. For the LMDD and HMDD groups, the tests were repeated after treatment with sertraline (103.3 +/- 40 mg). RESULTS: Resting MSNA was significantly higher in the HMDD [29.1 bursts/min (SE 2.9)] compared with LMDD [19.9 (1.6)] and controls [22.2 (2.0)] groups (P = 0.026 and 0.046, respectively). There was a significant positive correlation between resting MSNA and severity of depression. MSNA increased significantly and similarly during stress in all the studied groups. Sertraline significantly decreased resting MSNA in the LMDD group and MSNA during mental stress in LMDD and HMDD groups. Sertraline significantly decreased resting heart rate and heart rate response to mental stress in the HMDD group. CONCLUSION: Moderate-to-severe depression is associated with increased MSNA. Sertraline treatment reduces MSNA at rest and during mental challenge in depressed patients, which may have prognostic implications in this group.

Influência da complacência arterial na capacidade física de indivíduos idosos / Arterial compliance effects on physical capacity of elderly subjects

O enrijecimento arterial é um fator de risco independente para doença cardiovascular, podendo se agravar com a idade e sendo atenuado pelo exercício físico principalmente em idosos. O objetivo deste estudo foi correlacionar à capacidade física de indivíduos idososcom a Velocidade de Onda de Pulso (VOP). Para tanto, foi avaliada a complacência dos grandes vasos de pacientes do sexo masculino obtido através da medida da VOP com o aparelho COMPLIOR II. O nível de capacidade física foi obtido com o teste de esforço submáximo (teste de caminhada de 6 minutos). Nossos dados sugerem que a rigidez arterial aumenta com a idade, que esta rigidez esta intimamente ligada ao nível de aptidão cardiorrespiratória e que este pode sugestivamente influenciar na prevenção do enrijecimento arterial.

The arterial stiffness is an independent cardiovascular risk factor of aging, whichcould be measure by the Pulse Wave Velocity (PWV). The aim of this study was correlate the physical capacity of aging men to the PWV. In order to measure arterial compliance of greatvessels in aging males we used a COMPLIOR II equipment to determine PWV. Physical capacity levels were obtained by 6 minutes walking test. Our data suggest that arterial stiffnessincrease by the age, and it is intimately close to the level of cardiorespiratory fitness. The results also indicate that effects of physical capacity has some influence on the prevention of arterial stiffness.

Comparison of apolipoprotein-B/apolipoprotein-AI in subjects with versus without the metabolic syndrome.

Recent studies have suggested that the apolipoprotein-B (apo-B)/apolipoprotein-AI (apo-AI) ratio predicts cardiovascular risk better than any of the cholesterol indexes. The aim of the present study was to assess if the apo-B/apo-AI ratio is related to the metabolic syndrome and its components. Data were analyzed from 2,964 subjects (mean age 48 years; 1,516 men, 1,448 women) from the National Health and Nutrition Examination Survey III with apolipoprotein data who were evaluated for the metabolic syndrome and its components. The metabolic syndrome was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation. The mean values of the apo-B/apo-AI ratio in subjects with and without the metabolic syndrome were compared. Overall, the median distribution of the apo-B/apo-AI ratio was significantly greater (p <0.0001) in subjects with the Adult Treatment Panel III metabolic syndrome (0.90) than without (0.69). The apo-B/apo-AI ratio was associated significantly with each of the metabolic syndrome components, in descending order of magnitude: low high-density lipoprotein cholesterol (odds ratio [OR] 5.7), high triglycerides (OR 4.7), high waist circumference (OR 2.6), high fasting glucose (OR 1.9), and high blood pressure (OR 1.5). The apo-B/apo-AI ratio was also different between subjects with and without the metabolic syndrome. Mean values of apo-B/apo-AI increased significantly as the numbers of metabolic syndrome components increased in men (p <0.0001) and women (p <0.0001). After excluding high-density lipoprotein cholesterol and triglycerides as criteria for the metabolic syndrome, the association between means persisted (analysis of variance p <0.0001) in men and women. Apo-B/apo-AI was significantly associated with the presence of the metabolic syndrome (OR 5.1, p <0.0001). In conclusion, the apo-B/apo-AI ratio is strongly associated with the presence of individual metabolic syndrome components, with the metabolic syndrome itself, and with insulin resistance. An elevated apo-B/apo-AI ratio may constitute an important feature of the metabolic syndrome and may provide an additional mechanism to explain the increased cardiovascular risk in subjects with this syndrome.