Hypertension, Vol 18, 790-797, Copyright © 1991 by American Heart Association
S Jern
Essential hypertension is closely related to conditions with impaired
glucose tolerance and hyperinsulinemia. To evaluate a possible interaction
between the sympathetic nervous system and carbohydrate ingestion on the
circulatory responses to psychosocial stress, we compared the hemodynamic
effects of an oral glucose challenge with those observed after placebo in
10 glucose-tolerant, normotensive young men at rest and during standardized
mental stress. After glucose, resting cardiac output increased by 20% (p
less than 0.05), which was mainly due to an increased heart rate (+14%; p
less than 0.001). Since total peripheral resistance decreased by 13% (p
less than 0.02), mean arterial pressure was unaffected by glucose. In spite
of this, glucose loading was associated with a slight increase in systolic
blood pressure and a gradual decrease of diastolic blood pressure. Resting
forearm blood flow was unaffected by glucose. The stress response after
placebo was characterized by the expected increase in cardiac output and
mean arterial pressure, and an unchanged total peripheral resistance. By
contrast, in the postprandial state the pressor response to stress was
solely dependent on an increased systemic vascular resistance, and cardiac
output was unaffected by stress. After glucose, the stress-induced muscular
vasodilation in the forearm was reduced to 40% of that observed after
placebo (p less than 0.01). Thus, acute carbohydrate administration has
significant hemodynamic effects in humans. Furthermore, during the
postprandial period there is a marked alteration of the pattern of the
circulatory responses to psychosocial stress, characterized by attenuated
muscular vasodilation and a rise in systemic vascular resistance.
ARTICLES
Effects of acute carbohydrate administration on central and peripheral hemodynamic responses to mental stress
Department of Clinical Physiology, University of Goteborg, Ostra Hospital, Sweden.
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