Skip to main content
Download PDF
  • Research Article
  • Open access
  • Published:

Peripheral blood flow regulation in response to sympathetic stimulation in individuals with down syndrome

Artery Research volume 24, pages 16–21 (2018)Cite this article

Abstract

Background

Individuals with Down syndrome (DS) experience autonomic dysfunction, with reduced sympathetic and parasympathetic control. This results in alterations in resting heart rate and blood pressure and attenuated responses to sympathoexcitatory stimuli. It is unknown to what extent this impacts the regulation of peripheral blood flow in response to sympathetic stimuli, which is an important prerequisite to exercise and perform work. Therefore, we aimed to investigate differences in peripheral blood flow regulation in response to lower body negative pressure (LBNP) between individuals with and without DS

Methods

Participants (n = 10 males with DS and n = 11 male controls, mean age 23.7 years ± 3.2) underwent 5 min of LBNP stimulations (−20 mmHg), after resting supine for 10 min. One minute steady state blood pressure and blood flow at baseline and during LBNP were obtained for analysis. Mean flow velocity and arterial diameters were recorded with ultrasonography; foreram blood flow (FBF), shear rate and forearm vascular conductance (FVC) were calculated using brachial blood pressure measured right before ultrasound recordings

Results

Participants with DS responded differently (consistent with reduced vasoconstrictive control) to the LBNP stimulus (significant ConditionxGroup interaction effect) for mean velocity (p = 0.02), FBF (p = 0.04), shear rate (p = 0.02) and FVC (p = 0.03), compared to participants without DS.

Conclusion

Young males with DS exhibit reduced peripheral blood flow regulation in response to LBNP compared to controls, indicating a blunted sympathetic control of blood flow. Further research is necessary to explore the impact of these findings on exercise and work capacity.

References

  1. Parker SE, Mai CT, Canfield MA, Rickard R, Wang Y, Meyer RE, et al. Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004–2006. Birth Defects Res A Clin Mol Teratol 2010;88:1008–16.

    Google Scholar 

  2. Janicki MP, Dalton AJ, Henderson CM, Davidson PW. Mortality and morbidity among older adults with intellectual disability: health services considerations. Disabil Rehabil 1999;21:284–94.

    Google Scholar 

  3. Perkins EA, Moran JA. Aging adults with intellectual disabilities. J Am Med Assoc 2010;304:91–2.

    Google Scholar 

  4. Colvin KL,Yeager ME. What people with Down Syndrome can teach us about cardiopulmonary disease. Eur Respir Rev 2017;26.

  5. Capone GT, Chicoine B, Bulova P, Stephens M, Hart S,Crissman B, et al. Co-occurring medical conditions in adults with Down syndrome: a systematic review toward the development of health care guidelines. Am J Med Genet A 2018;176:116–33.

    Google Scholar 

  6. de Winter CF, Bastiaanse LP, Hilgenkamp TI, Evenhuis HM, Echteld MA. Overweight and obesity in older people with intellectual disability. Res Dev Disabil 2012;33:398–405.

    Google Scholar 

  7. Temple VA, Stanish HI. Pedometer-measured physical activity of adults with intellectual disability: predicting weekly step counts. Am J Intellect Dev Disabil 2009;114:15–22.

    Google Scholar 

  8. Hilgenkamp TI, van Wijck R, Evenhuis HM. Subgroups associated with lower physical fitness in older adults with ID: results of the HA-ID study. Res Dev Disabil 2014;35:439–47.

    Google Scholar 

  9. Draheim CC, Geijer JR, Dengel DR. Comparison of intima-media thickness of the carotid artery and cardiovascular disease risk factors in adults with versus without the Down syndrome. Am J Cardiol 2010;106:1512–6.

    Google Scholar 

  10. Draheim CC, McCubbin JA, Williams DP. Differences in cardiovascular disease risk between nondiabetic adults with mental retardation with and without Down syndrome. Am J Ment Retard 2002;107:201–11.

    Google Scholar 

  11. Murdoch JC, Rodger JC, Rao SS, Fletcher CD, Dunnigan MG. Down’s syndrome: an atheroma-free model? Br Med J 1977;2: 226–8.

  12. Yla-Herttuala S, Luoma J, Nikkari T, Kivimaki T. Down’s syndrome and atherosclerosis. Atherosclerosis 1989;76:269–72.

    Google Scholar 

  13. Rigoldi C, Galli M, Albertini G. Gait development during lifespan in subjects with Down syndrome. Res Dev Disabil 2011;32: 158–63.

    Google Scholar 

  14. Fernhall B, Mendonca GV, Baynard T. Reduced work capacity in individuals with down syndrome: a consequence of autonomic dysfunction? Exerc Sport Sci Rev 2013;41:138–47.

    Google Scholar 

  15. Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2010;141:122–31.

    Google Scholar 

  16. Chang YW, Lin JD, Chen WL, Yen CF, Loh CH, Fang WH, et al. Metabolic syndrome and short-term heart rate variability in adults with intellectual disabilities. Res Dev Disabil 2012;33: 1701–7.

    Google Scholar 

  17. Fernhall B, McCubbin JA, Pitetti KH, Rintala P, Rimmer JH, Millar AL, et al. Prediction of maximal heart rate in individuals with mental retardation. Med Sci Sports Exerc 2001;33:1655–60.

    Google Scholar 

  18. Guerra M, Llorens N, Fernhall B. Chronotropic incompetence in persons with down syndrome. Arch Phys Med Rehabil 2003;84: 1604–8.

    Google Scholar 

  19. Fernhall B, Otterstetter M. Attenuated responses to sympathoexcitation in individuals with Down syndrome. J Appl Physiol 2003;94:2158–65.

    Google Scholar 

  20. Figueroa A, Collier SR, Baynard T, Giannopoulou I, Goulopoulou S, Fernhall B. Impaired vagal modulation of heart rate in individuals with Down syndrome. Clin Auton Res 2005; 15:45–50.

    Google Scholar 

  21. Iellamo F, Galante A, Legramante JM, Lippi ME, Condoluci C, Albertini G, et al. Altered autonomic cardiac regulation in individuals with Down syndrome. Am J Physiol Heart Circ Physiol 2005;289:H2387–91.

  22. Agiovlasitis S, Collier SR, Baynard T, Echols GH, Goulopoulou S, Figueroa A, et al. Autonomic response to upright tilt in people with and without Down syndrome. Res Dev Disabil 2010;31: 857–63.

    Google Scholar 

  23. Fernhall B, Baynard T, Collier SR, Figueroa A, Goulopoulou S, Kamimori GH, et al. Catecholamine response to maximal exercise in persons with Down syndrome. Am J Cardiol 2009;103: 724–6.

    Google Scholar 

  24. Kitano A, Shoemaker JK, Ichinose M, Wada H, Nishiyasu T. Comparison of cardiovascular responses between lower body negative pressure and head-up tilt. J Appl Physiol (1985) 2005; 98:2081–6.

  25. Halliwill JR, Lawler LA, Eickhoff TJ, Joyner MJ, Mulvagh SL. Reflex responses to regional venous pooling during lower body negative pressure in humans. J Appl Physiol (1985) 1998;84: 454–8.

  26. Baynard T, Pitetti KH, Guerra M, Unnithan VB, Fernhall B. Age-related changes in aerobic capacity in individuals with mental retardation: a 20-yr review. MedSciSportsExerc 2008;40:1984–9.

    Google Scholar 

  27. Fernhall B, Tymeson G. Graded exercise testing of mentally retarded adults: a study of feasibility. Arch Phys Med Rehabil 1987;68:363–5.

    Google Scholar 

  28. Fernhall B, Pitetti KH, Rimmer JH, McCubbin JA, Rintala P, Millar AL, et al. Cardiorespiratory capacity of individuals with mental retardation including Down syndrome. Med Sci Sports Exerc 1996;28:366–71.

    Google Scholar 

  29. Thijssen DH, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, et al. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol 2011;300:H2–12.

  30. Tschakovsky ME, Hughson RL. Rapid blunting of sympathetic vasoconstriction in the human forearm at the onset of exercise. J Appl Physiol (1985) 2003;94:1785–92.

  31. Pagano G, Castello G. Oxidative stress and mitochondrial dysfunction in Down syndrome. Adv Exp Med Biol 2012;724: 291–9.

    Google Scholar 

  32. Valenti D, Braidy N, De Rasmo D, Signorile A, Rossi L, Atanasov AG, et al. Mitochondria as pharmacological targets in Down syndrome. Free Radical Biol Med 2018;114:69–83.

    Google Scholar 

  33. Cappelli-Bigazzi M, Santoro G, Battaglia C, Palladino MT, Carrozza M, Russo MG, et al. Endothelial cell function in patients with Down’s syndrome. Am J Cardiol 2004;94:392–5.

    Google Scholar 

  34. Saltin B, Radegran G, Koskolou MD, Roach RC. Skeletal muscle blood flow in humans and its regulation during exercise. Acta Physiol Scand 1998;162:421–36.

    Google Scholar 

  35. Hu M, Yan H, Ranadive SM, Agiovlasitis S, Fahs CA, Atiq M, et al. Arterial stiffness response to exercise in persons with and without Down syndrome. Res Dev Disabil 2013;34:3139–47.

    Google Scholar 

  36. Parra P, Costa R, de Asua DR, Moldenhauer F, Suarez C. Atherosclerotic surrogate markers in adults with down syndrome: a case-control study. J Clin Hypertens (Greenwich) 2017;19:205–11.

    Google Scholar 

  37. Rodrigues AN, Coelho LC, Goncalves WL, Gouvea SA, Vasconcellos MJ, Cunha RS, et al. Stiffness of the large arteries in individuals with and without Down syndrome. Vasc Health Risk Manag 2011;7:375–81.

    Google Scholar 

  38. Wee SO, Pitetti KH, Goulopoulou S, Collier SR, Guerra M, Baynard T. Impact of obesity and Down syndrome on peak heart rate and aerobic capacity in youth and adults. Res Dev Disabil 2014;36C:198–206.

  39. Richards JC, Crecelius AR, Larson DG, Dinenno FA. Acute ascorbic acid ingestion increases skeletal muscle blood flow and oxygen consumption via local vasodilation during graded handgrip exercise in older adults. Am J Physiol Heart Circ Physiol 2015;309:H360–8.

  40. Clifford PS, Hellsten Y. Vasodilatory mechanisms in contracting skeletal muscle. J Appl Physiol (1985) 2004;97:393–403.

    Google Scholar 

Download references

Author information

Author notes

  1. Sang Ouk Wee

    Present address: California State University San Bernardino, 5500 University Parkway, 92407, San Bernardino, CA, USA

Authors and Affiliations

  1. Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 West Taylor Street, 502A AHSB (MC 517), 60612, Chicago, IL, USA

    Thessa I. M. Hilgenkamp, Sang Ouk Wee, Elizabeth C. Schroeder, Tracy Baynard & Bo Fernhall

Authors
  1. Thessa I. M. Hilgenkamp
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sang Ouk Wee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth C. Schroeder
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tracy Baynard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bo Fernhall
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thessa I. M. Hilgenkamp.

Rights and permissions

This is an open access article distributed under the CC BY-NC license https://doi.org/creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hilgenkamp, T.I.M., Wee, S.O., Schroeder, E.C. et al. Peripheral blood flow regulation in response to sympathetic stimulation in individuals with down syndrome. Artery Res 24, 16–21 (2018). https://doi.org/10.1016/j.artres.2018.10.001

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.artres.2018.10.001

Keywords

Artery Research

ISSN: 1876-4401

Contact us