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Circadian Variations in Sympathetic Vasoconstriction in Older Adults with and Without Type 2 Diabetes

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Abstract

Introduction

An impact of the sympathetic nervous system in the higher rate of cardiovascular events in the early morning compared to the evening has been claimed. Augmented sympathetic vasoconstriction increases cardiovascular risk by augmenting pulse pressure and cardiac afterload. Type 2 diabetes (T2DM) further increases sympathetic neurovascular transduction and cardiovascular risk.

Aim

We assessed whether peripheral vasoconstriction triggered by a standardized sympathetic stressor is augmented at 6am vs 9pm in adults between 50–80 years with type 2 diabetes (T2DM50-80) vs healthy ones (H50-80).

Methods

Mean values of sympathetic vasoconstrictor responsiveness (SVR), vascular conductance (VC), brachial artery blood flow, and mean arterial pressure were measured on the contralateral forearm over two 5-minute bouts of rest and handgrip-mediated sympathetic stimulation, respectively.

Results

Although baseline VC values were lower (p < 0.01) in the morning vs evening in both groups, SVR values in response to sympathoexcitation were similar in H50-80 (− 0.43 ± 12.44 vs − 2.57 ± 11.63 %, p = 0.73) and T2DM50-80 (+6.64 ± 10.67 vs +5.21 ± 7.64 %, p = 0.90), but higher (p < 0.01) in T2DM50-80 vs H50-80 at both day hours. Individuals with T2DM reported positive SVR values and VC change-scores, while healthy individuals reported statistically different (p < 0.02) negative SVR values and VC change-scores.

Conclusion

Peripheral vasoconstriction triggered by a standardized sympathetic stressor is similar between morning and evening, regardless of T2DM and different baseline VC values. However, peripheral vasoconstriction responsiveness is blunted in individuals with T2DM as handgrip-mediated sympathoexcitation induces vasodilation in the contralateral forearm in adults with T2DM and vasoconstriction in healthy age-matched controls, highlighting a neurovascular response altered by T2DM.

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Authors and Affiliations

  1. Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy

    Alessandro Gentilin, Antonio Cevese, Federico Schena & Cantor Tarperi

  2. Italian Institute for Cardiovascular Research (INRC), Bologna, Italy

    Alessandro Gentilin, Antonio Cevese, Anna Vittoria Mattioli & Federico Schena

  3. Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

    Paolo Moghetti

  4. Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41121, Modena, Italy

    Anna Vittoria Mattioli

Authors
  1. Alessandro Gentilin
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  2. Paolo Moghetti
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Correspondence to Alessandro Gentilin.

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Ethical Statement

The study was approved by the Ethics Board of the University of Verona (3293CESC) and conducted following the declaration of Helsinki. Informed oral and written consent was obtained from all participants before starting any test.

Funding

None declared.

Data Availability

The data are available from the corresponding author on reasonable request.

Authors’ contributions

Study concept and design (AG); subject recruitment, data acquisition and analysis (AG); formal analysis and investigation (AG); data interpretation (AG, AC, PM, AVM, FS, CT); original draft preparation (AG); review and critical revision of the manuscript (AG, AC, PM, AVM, FS, CT); all authors read and approved the final version of this manuscript.

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Gentilin, A., Moghetti, P., Cevese, A. et al. Circadian Variations in Sympathetic Vasoconstriction in Older Adults with and Without Type 2 Diabetes. High Blood Press Cardiovasc Prev 30, 55–62 (2023). https://doi.org/10.1007/s40292-022-00557-y

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