Facioli Tábata P, Gastaldi Ada C, Dutra Sabrina G V, Felix Ana C S, Philbois Stella V, Sánchez-Delgado Juan C, Souza Hugo C D
Department of Biomechanics, Medicine and Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
University of Santander, Bucaramanga, Colombia.
Blood Press Monit. 2018 Oct;23(5):260-270. doi: 10.1097/MBP.0000000000000338.
Heart rate (HR) and blood pressure (BP) autonomic modulation and baroreflex sensitivity (BRS) are important indexes of cardiovascular homeostasis. However, methodological errors are often observed, such as joint analysis of men and women. Another important aspect is that we still do not know whether cardiorespiratory fitness influences these autonomic parameters in healthy individuals.
This study aimed to investigate whether sex can affect BRS, autonomic modulation of HR and BP variabilities (HRV and BPV, respectively), as well as the influence of cardiorespiratory fitness on these autonomic parameters.
Healthy men and women (N=120) were assigned to groups according to the peak oxygen consumption (VO2 peak) obtained in the cardiorespiratory test: low cardiorespiratory fitness (VO2 peak: 22-38 ml/kg/min), moderate cardiorespiratory fitness (VO2 peak: 38-48 ml/kg/min), and high cardiorespiratory fitness (VO2 peak>48 ml/kg/min). HRV and BPV evaluations were performed for all groups in the frequency domain by spectral analysis. Spontaneous BRS was assessed using the sequence method.
Women presented lower BP values compared with men. HR did not differ between sexes, but showed an inverse relationship with cardiorespiratory performance. The HRV analysis showed greater sympathetic modulation for men and greater vagal modulation for women. Men and women presented similar results for systolic BPV and BRS, and cardiorespiratory performance did not influence any of the autonomic parameters evaluated.
Cardiorespiratory fitness does not interfere with HRV and BPV autonomic modulation or BRS. However, the cardiac modulatory balance differs between sexes, with a greater influence of the autonomic vagal component in women and the sympathetic component in men.
心率（HR）和血压（BP）的自主神经调节以及压力反射敏感性（BRS）是心血管稳态的重要指标。然而，经常会观察到方法学上的错误，比如对男性和女性进行联合分析。另一个重要方面是，我们仍然不知道心肺适能是否会影响健康个体的这些自主神经参数。
本研究旨在调查性别是否会影响BRS、HR和BP变异性（分别为HRV和BPV）的自主神经调节，以及心肺适能对这些自主神经参数的影响。
根据心肺测试中获得的峰值耗氧量（VO2峰值），将120名健康男性和女性分为几组：低心肺适能（VO2峰值：22 - 38毫升/千克/分钟）、中等心肺适能（VO2峰值：38 - 48毫升/千克/分钟）和高心肺适能（VO2峰值>48毫升/千克/分钟）。通过频谱分析在频域对所有组进行HRV和BPV评估。使用序列法评估自发BRS。
与男性相比，女性的BP值较低。男女之间HR无差异，但HR与心肺功能呈负相关。HRV分析显示男性的交感神经调节更强，女性的迷走神经调节更强。男性和女性在收缩期BPV和BRS方面呈现相似结果，并且心肺功能并未影响所评估的任何自主神经参数。
心肺适能不会干扰HRV和BPV的自主神经调节或BRS。然而，心脏调节平衡存在性别差异，女性中自主迷走神经成分的影响更大，男性中交感神经成分的影响更大。
