Cardiovascular autonomic dysfunction – a neglected risk factor for cardiovascular disease?

Bakgrund:

The autonomic nerve system is responsible for regulation of heart rate, blood pressure and release of various stress hormones. Studies of patients with cardiovascular disease (CVD) have reported increased mortality in patients with cardiovascular autonomic dysfunction (CADys). We hypothesize that CADys is an important, but neglected, risk factor for CVD in the general population.

Målsättning:

The project examines the relationship between cardiovascular autonomic dysfunction (CADys) and development of cardiovascular disease (CVD), and possible mechanisms behind this relationship. We also examine the stability over time for different CADys tests. Specific questions: 1. Is CADys associated with CVD in middle-aged individuals from the general population?

2. Is CADys associated with atherosclerosis in carotid or coronary arteries? 3. Could circulating biomarkers be a link between CADys and atherosclerotic disease?

4. Could Mendelian randomization studies support a causal relationship between CADys and CVD, or between CADys and cardiovascular risk factors? 5. What is the biological variability of the various measures of CADys– are these measures stable over time? 6. What is the normal reference values for deep breathing test in a middle-aged population?

Arbetsplan:

The project is based on SCAPIS Malmö/Lund (n=6251), which includes very extensive information of CADys, atherosclerosis and CVD risk factors. Five minute ECGs, deep breathing tests, orthostatic tests, 24h Holter ECGs and 24h ambulatory blood pressure recordings have been performed. Genetic studies will be performed in Malmö Diet and Cancer cohort.

Betydelse:

Our preliminary results show that CADys is a quite strong risk factor for atherosclerosis. Even small increases in relative risks will be important on a population level since prevalence is high. The results could be important, since CADys potentially could be modified both with nonpharmacological and pharmacological methods.