The association between the adrenergic hyperactivity and blood pressure values in people with multiple sclerosis
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ORIGINAL ARTICLE
The association between the adrenergic hyperactivity and blood pressure values in people with multiple sclerosis Mario Habek 1,2 & Dunja Pucić 2 & Tomislav Mutak 2 & Luka Crnošija 1 & Mila Lovrić 3 & Magdalena Krbot Skorić 1,4 Received: 18 November 2019 / Accepted: 16 April 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objectives To evaluate the evolution of adrenergic baroreflex sensitivity (BRSa) over 2-year follow-up and to investigate the effect of baseline BRSa indices on blood pressure values after 2 years in people with multiple sclerosis (pwMS). Methods The following data were analysed at baseline and after 2 years: BRSa measured with BRSa1, α-BRSa and β-BRSa, supine and tilted levels of epinephrine and norepinephrine, supine and tilted systolic and diastolic blood pressure levels. Results Compared to baseline values, there was no change in α-BRSa (6.96 ± 2.56 vs. 6.64 ± 2.24, p = 0.379) at month 24. αBRSa at month 24 positively correlated with tilted levels of norepinephrine at month 24 (rp = 0.357, p = 0.005). Univariable linear regression analysis revealed that α-BRSa at baseline predicts the value of tilted systolic and diastolic blood pressure at month 24 (B = 2.724, 95% CI 1.357–4.091, p < 0.001 and B = 1.489, 95% CI 0.459–2.519, p = 0.005). Conclusion This study provides further evidence for possible role of α-BRSa as a marker of adrenergic hyperactivity in pwMS. These results may explain increased risk for cardiovascular diseases in pwMS. Keywords Autonomic nervous system . Adrenergic hyperactivity . Multiple sclerosis . Arterial hypertension . Comorbidities
Introduction There are several factors that influence multiple sclerosis (MS) outcomes, among which comorbidities play a very important role. The importance of comorbidities in MS is evident from several studies showing that they cause delay in the diagnosis [1], increase in mortality [1], and delay in starting disease modifying therapy (DMT) [2]. Furthermore, the presence of comorbidities in a person with MS (pwMS) is Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04432-3) contains supplementary material, which is available to authorized users. * Mario Habek [email protected] 1
Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
2
School of Medicine, University of Zagreb, Zagreb, Croatia
3
Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
4
Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia
associated with lower incomes and dissolved intimate relationships [3]. Recent recommendations for observational studies of comorbidity in multiple sclerosis stress out the importance of establishing age- and sex-specific incidence and prevalence estimates and evaluation of the effect of several comorbidities on disability, quality of life, brain atrophy and other imaging parameters,
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