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Autonomic Cardiovascular Control and Executive Function in Chronic Hypotension

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Chronic low blood pressure (hypotension) is characterized by complaints such as fatigue, reduced drive, dizziness, and cold limbs. Additionally, deficits in attention and memory have been observed. Autonomic dysregulation is considered to be involved in the origin of this condition.

Purpose

The study explored autonomic cardiovascular control in the context of higher cognitive processing (executive function) in hypotension.

Methods

Hemodynamic recordings were performed in 40 hypotensive and 40 normotensive participants during execution of four classical executive function tasks (number-letter task, n-back task, continuous performance test, and flanker task). Parameters of cardiac sympathetic control, i.e., stroke volume, cardiac output, pre-ejection period, total peripheral resistance, and parasympathetic control, i.e., respiratory sinus arrhythmia and baroreflex sensitivity, were obtained.

Results

The hypotensive group exhibited lower stroke volume and cardiac output, as well as higher pre-ejection period and baroreflex sensitivity during task execution. Increased error rates in hypotensive individuals were observed in the n-back and flanker tasks. In the total sample, there were positive correlations of error rates with pre-ejection period, baroreflex sensitivity and respiratory sinus arrhythmia, and negative correlations with cardiac output.

Conclusions

Group differences in stroke volume, cardiac output, and pre-ejection period suggest diminished beta-adrenergic myocardial drive during executive function processing in hypotension, in addition to increased baroreflex function. Although further research is warranted to quantify the extent of executive function impairment in hypotension, the results from correlation analysis add evidence to the notion that higher sympathetic inotropic influences and reduced parasympathetic cardiac influences are accompanied by better cognitive performance.

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Acknowledgements

The study was supported by the Anniversary Fund of the Austrian National Bank (project 16289). We are grateful to Maximilian Stefani, Angela Bair, Revan Karaca, and Marlon Klein for their help with acquisition of participants and data analysis.

Author information

Authors and Affiliations

  1. Institute of Psychology, UMIT—University of Health Sciences Medical informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria

    Stefan Duschek PhD & Alexandra Hoffmann MSc

  2. Institute of Psychology, University of Jaén, Jaén, Spain

    Gustavo A. Reyes del Paso PhD

  3. Department of Psychology, University of Bonn, Bonn, Germany

    Ulrich Ettinger PhD

Authors
  1. Stefan Duschek PhD
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  2. Alexandra Hoffmann MSc
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  3. Gustavo A. Reyes del Paso PhD
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Corresponding author

Correspondence to Stefan Duschek PhD.

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Conflicts of Interest

The authors Stefan Duschek, Alexandra Hoffmann, Gustavo A. Reyes del Paso, and Ulrich Ettinger declare that they have no conflict of interest.

Ethical 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 amends of comparable ethical standards.

The study was approved by the Board for Ethical Questions in Science of the University of Innsbruck, Austria. Informed consent was obtained from all individual participants included in the study.

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Duschek, S., Hoffmann, A., Reyes del Paso, G.A. et al. Autonomic Cardiovascular Control and Executive Function in Chronic Hypotension. ann. behav. med. 51, 442–453 (2017). https://doi.org/10.1007/s12160-016-9868-7

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  • DOI: https://doi.org/10.1007/s12160-016-9868-7

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