Relação entre a função endotelial microvascular e a função autonômica em adultos: estudo longitudinal da Saúde do Adulto (ELSA-Brasil)

Abstract

Introduction: Endothelial and autonomic dysfunctions are thought to be associated with the development of cardiovascular diseases, and a common pathway for both dysfunctions has been described. However, the association between autonomic and microvascular endothelial functions assessed by non-invasive methods - heart rate variability (HRV) and peripheral arterial tonometry (PAT), respectively - has been little explored. Participants and methods: In 1,447 participants of the Brazilian Longitudinal Study of Adult Health (ELSABrasil), we investigated the correlation between endothelial microvascular and autonomic functions variables using Spearmans rank correlation test. Subgroup analysis was pre-specified in individuals with diabetes, overweight/obesity, metabolic syndrome, and individuals free of cardiovascular risk factors. Sensitivity analysis was performed for individuals without prevalent CVD and for participants who were not using beta-adrenergic blockers, calcium-channel blockers and alpha-adrenergic agonists. Results: We found weak correlations between basal pulse amplitude (BPA) and mean RR interval (0.064), RMSSD (0.067) and HF (-0.093), and between PAT-ratio and RMSSD (0.058) and HF (0.067). The observed correlations remained weak in subgroup and sensitivity analysis. Conclusion: The association between endothelial function evaluated in the microvasculature and autonomic function assessed by HRV analysis is not relevant, suggesting that they may contribute in different pathways to the development of cardiovascular diseases