Metaboreflex activation by rhythmic exercise as a cardiovascular risk in metabolic syndrome and obesity

Abstract

Introduction: There is increasing prevalence of metabolic syndrome (MS) and obesity. Dysregulation in a mechanism causing cardiovascular adjustments during exercise (Metaboreflex; a feed-back mechanism originating in skeletal muscle due to local metabolites) has been studied in MS and obesity. Aims and objective: To see the effect of metaboreflex by rhythmic handgrip exercise on hemodynamic parameters (Blood pressure (BP), cardiac output(CO), stroke volume(SV), pulse rate (PR), systemic vascular resistance(SVR)) in subjects with MS and obesity. Method and materials: 46 subjects, aged 25 to 45 years of both sex were enrolled and classified into a) subjects without MS with normal or overweight BMI b) subjects without MS with obese BMI c) subjects with MS with obese BMI and d) subjects with MS with morbid obese BMI. Hemodynamic parameters were evaluated by impedance cardiovasography in supine position. Maximum Voluntary Contraction was measured by Handgrip Dynamometer. Rhythmic handgrip exercise was done at 30% of the subjects MVC (for 2 mins), followed by post exercise cuff occlusion to enhance metaboreflex, for 2 mins (20 mm Hg above systolic). The parameters were assessed post-rhythmic exercise. Results and conclusion: Following exercise, there was vasoconstriction mediated pressor response (statistically significant increase in diastolic BP) and flow mediated pressor response (statistically significant increase in systolic BP) in normal or overweight subjects without MS. In subjects without MS with obese BMI and subjects with MS with obese BMI, statistically significant decrease in SVR was found. In subjects with metabolic syndrome with morbid obese BMI, decrease in SV and statistically significant increase in PR was found.