Habituation attenuates the sex-specific associations between ischemic pain, blood pressure, and arterial stiffness in young adults.
Habituation attenuates the sex-specific associations between ischemic pain, blood pressure, and arterial stiffness in young adults.
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习惯减弱了年轻人缺血性疼痛、血压和动脉僵硬度之间的性别特异性关联。
DOI：
10.1152/ajpheart.00567.2022
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Grosicki,GregoryJ
中科院分区：
文献类型：
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作者：
Lincoln,ZoeR;Blumenburg,WesleyT;Cross,BrettL;Vondrasek,JosephD;Watso,JosephC;Flatt,AndrewA;Linder,Braxton;Robinson,AustinT;Grosicki,GregoryJ
身体应激时的心血管反应性（CVR）是心血管疾病发生的预后指标。CVR受感知疼痛的影响。然而，关于性别差异和反复暴露于疼痛刺激对CVR的影响的数据有限。在两项相同的试验中，我们测量了39名成人（20岁/19岁；18-39岁）在静止时、在最大自愿收缩30%的等距握力（HG）运动期间和运动后循环阻塞（PECO）期间的血压（BP）和颈动脉-股动脉脉搏波速度（cf-PWV；动脉僵硬指数）。在每次刺激的第一分钟后，我们使用视觉模拟量表评估参与者的感知疼痛。在每次刺激第2分钟采集血压，在第3分钟采集心电- pwv。在男性受试者中，我们观察到感知疼痛与肱舒张压（ρ = 0.620）和平均血压（ρ = 0.597）变化之间存在中度关联（p≤0.023）；中心舒张压、平均血压和收缩压（ρs = 0.519-0.654）；和cf-PWV （ρ = 0.680）在PECO试验1期间，但试验2没有（p≥0.162）。然而，在女性参与者中，在两项试验中疼痛和CVR指数之间没有关联（Ps≥0.137）。无论性别如何，试验2中相对于试验1中感知疼痛的减少与肱舒张压（ρ = 0.346）、平均血压（ρ = 0.379）和收缩压（ρ = 0.333）的降低呈弱至中度相关（p≤0.038）；中心均值（ρ = 0.400）和收缩压（ρ = 0.369）；cf-PWV （ρ = 0.526）。这些发现表明：1)年轻人CVR的疼痛调节存在性别差异；2)在PECO期间，习惯化会减弱疼痛和CVR，而这与性别无关。新的和值得注意的是，我们证明了缺血性疼痛期间疼痛感知和心血管反应性（CVR）之间的性别差异。我们还证明了在以性别独立的方式反复暴露时对疼痛的习惯和减少的CVR。考虑性别差异和习惯可能会提高CVR的预后效用。
Cardiovascular reactivity (CVR) during physical stress is prognostic for incident cardiovascular disease. CVR is influenced by perceived pain. However, there is limited data on the effect of sex differences and repeated exposures to painful stimuli on CVR. We measured blood pressure (BP) and carotid-femoral pulse wave velocity (cf-PWV; an index of arterial stiffness) at rest, during isometric handgrip (HG) exercise at 30% of maximum voluntary contraction, and during postexercise circulatory occlusion (PECO) during two identical trials in 39 adults (20M/19F; 18–39 yr). We assessed participants’ perceived pain using a visual analog scale after the first minute of each stimulus. We collected BP duringminute 2of each stimulus and cf-PWV duringminute 3of each stimulus. In male participants, we observed moderate associations (Ps ≤ 0.023) between perceived pain and changes in brachial diastolic (ρ = 0.620) and mean BP (ρ = 0.597); central diastolic, mean, and systolic BP (ρs = 0.519–0.654); and cf-PWV (ρ = 0.680) during PECO intrial 1, but nottrial 2 (Ps ≥ 0.162). However, in female participants, there were no associations between pain and CVR indices during either trial (Ps ≥ 0.137). Irrespective of sex, reductions in perceived pain duringtrial 2relative totrial 1were weakly to moderately associated (Ps ≤ 0.038) with reductions in brachial diastolic (ρ = 0.346), mean (ρ = 0.379), and systolic BP (ρ = 0.333); central mean (ρ = 0.400) and systolic BP (ρ = 0.369); and cf-PWV (ρ = 0.526). These findings suggest that1) there are sex differences in pain modulation of CVR in young adults and2) habituation blunts pain and CVR during PECO, irrespective of sex.NEW & NOTEWORTHYWe demonstrate sex differences in the association between pain perception and cardiovascular reactivity (CVR) during ischemic pain. We also demonstrate habituation to pain and reduced CVR during repeated exposure in a sex-independent manner. Accounting for sex differences and habituation may improve the prognostic utility of CVR.