1,721,187 research outputs found
Medicina dello Sport : l'esercizio fisico come terapia. Metodologia ed ambiti applicativi
No full textPhysical exercise represents the major component of Lyfe style changes as a strategy to maintain health and improve prevention, in a number of disease conditions, particularly for the emerging cardiometabolic epidemic. Compelling evidence indicates the importance of regular physical exercise to improve and sustain health, and recent guidelines offer detailed indications on how to apply theory to individual patients. A skilled mix of physiology, psychology, and clinical knowledge appears necessary to successfully tailor exercise therapy to the unique individual patient
Obesity and stress
No full textObesity is a complex, diffuse premorbid condition, characterized by an array of alterations in regulatory mechanisms, that have been associated with a higher risk for metabolic and cardiovascular diseases. Given the high prevalence of the condition we could accept the concept of 'obese epidemics'. However, in spite of a critical focus both of the medical profession and of mass media, coupled with extremely elevated costs of obesity, some experts state that 'therapy could be more dangerous than the disease'. Obesity derives from a long standing interaction between genetics and environment. Long years of maladaptive life styles (overeating and sedentary habits) are the consequence of an ill-regulated 'reward system'. Altered regulation of alimentary behavior seems critically dependent upon an unbalanced neurohormonal central receptor function. From a practical point of view it might be useful to introduce the concept of stress, as a way to provide quantitative parameters of the environmental effects on individual patients. Spectral analysis of cardiovascular variability provides quantitative indices of the interaction between efferent vagal and sympathetic modulatory activity, and of the influence of obesity. This condition produces autonomic alterations that appear related to attendant hormonal disturbances. From a therapeutical point of view new habits, not diets; an integrated multidisciplinary approach to healthy eating, not simply drugs or ideal weight; an equilibrium between theoretical principles and complex, tailored individual treatments
Autonomic assessment as a tool for individually tailoring life style changes for chronic disease prevention
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Cardiovascular physiology, emotions, and clinical applications : are we ready for prime time?
No full textThis article is related to cardiovascular physiology mechanisms involved in emotions, in particular it shows autonomic nervous system (ANS) role. The role of ANS may be of particular importance when considering that emotional involvement may play an etiopathogenetic role many clinical conditions, such as cardiac ischemic diseases or functional syndromes. This paper describe also a modern technique, autoregressive spectral analysis of cardiovascular variabilities, employed to study in clinical setting ANS, then to study emotional involvement in many clinical conditions
Autonomic dysregulation in essential hypertension: insight from heart rate and arterial pressure variability
No full textEssential hypertension is the most prevalent cardiovascular disorder, affecting more than 50 million people in the USA. Hypertension-related mortality and morbidity figures have been greatly improved over the last three decades by major advances in prevention. Detection and operative suggestions for practicing physicians are available from several guideline treatments derived from grouped data obtained in numerous well-conducted studies on large numbers of patients. However, the disappointing results of some forms of antihypertensive therapies, particularly in preventing coronary artery disease, has shed some doubts on traditional approaches to managing hypertensive patients. At present, in spite of extensive investigations, the exact causal mechanism(s) are far from being fully understood, and consequently, essential hypertension is still managed using a heuristic approach. Persistent elevations in arterial pressure imply some disturbances in the complex and multifactorial cardiovascular control mechanisms. In this context, neurohumoral disturbances might play a special role, in view of the demonstration that an elevated sympathetic drive seems essential in hypertensive patients. In this review, we follow the hypothesis that other allied methods capable of quantitatively assessing some aspects of the regulatory system might support and integrate the usual dichotomous diagnostic procedure based on arterial pressure determinations. In prior studies, we reported that parameters obtained by spectral analysis of heart rate variability (HRV) might furnish useful information on autonomic normal and abnormal nervous system regulation. In the foregoing, we summarize our experience using this approach in the clinical management of hypertensive patients. It is our tenet that spectral analysis of mono or multivariate cardiovascular beat-by-beat variabilities provides potentially important information on alterations in neural control of the circulation accompanying essential hypertension. In spite of an ongoing debate on the interpretation of specific aspects of HRV spectral components, overall, it appears that the available evidence supports the hypothesis that in essential hypertension, there is an increased sympathetic and reduced vagal cardiac drive coupled with an enhancement of vasomotor sympathetic modulation. Prospective studies on large populations, rendered more easy to perform, thanks to improvements in technology and telemedicine applications, might provide an answer to the still open question of how to apply spectral analysis of HRV to a better mechanistic understanding of essential hypertension, and to more satisfactory individually tailored antihypertensive treatments
From stress to functional syndromes: an internist's point of view
No full textIn this brief review we address schematically the relationship between two emerging issues in clinical medicine: stress and functional syndromes. It is becoming increasingly clear that they demand a multidimensional approach, considering simultaneously elements of behavioral therapy with traditional pharmacological treatment, guided by a better physiopathological understanding including autonomic assessment. New techniques, based on innovative analysis of continuous segments of electrocardiogram and non invasive arterial pressure recordings capable to extract hidden oscillations, provide quantitative indices of sympathetic and vagal modulation of the cardiovascular system. This more complete diagnostic process facilitates explanation of symptoms and reassurance of patients, based on functional evidence. The described clinical approach implies in addition an active collaboration of patients requiring the implementation of a creative alliance. Physical exercise, eating habits and muscular–mental relaxation are combined with pharmacological tools as needed
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