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Psychosom Med. 2010 Jun;72(5):442-9. doi: 10.1097/PSY.0b013e3181d972c2. Epub 2010 Apr 5.

Heart rate and blood pressure changes during autonomic nervous system challenge in panic disorder patients.

Author information

1
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA. jose.martinez@mssm.edu

Abstract

OBJECTIVE:

To test the hypothesis that panic disorder (PD) patients have a heightened or deregulated autonomic nervous system at rest and during autonomic challenge compared with healthy controls (HC); and to test a second hypothesis that severity of illness differentiates patients'; sympathovagal balance both at rest and during orthostatic challenge.

METHODS:

Spectral analysis of heart rate (HR) and blood pressure was performed on 30 PD and 10 HC participants during an orthostatic challenge (head-up tilt).

RESULTS:

PD patients presented higher HR (p < .001), lower heart rate variability (HRV) (p < .015), higher mean diastolic blood pressure (p < .006), higher low-frequency component of HR (p < .001), and a higher ratio of low-frequency to high-frequency component of HR (LF/HF) (p < .022) than HC at baseline. During tilt, PD patients responded with higher HR (p < .039), lower HRV (p < .043), increased mean diastolic blood pressure (p < .028), and a mild increase in LF/HF, whereas controls responded with a five-fold increase in LF/HF (p < .022). Patients with higher illness severity ratings (Clinical Global Impression Scale) showed higher HR (p < .002), lower HRV (p < .026), and a lower total power of systolic blood pressure (p < .02) compared with less ill patients.

CONCLUSION:

These findings demonstrate a consistently higher or deregulated autonomic arousal in PD patients at rest and during orthostatic challenge compared with HC. These data also reveal a possible association between the level of anxiety illness severity and sympathovagal balance, which may imply greater cardiac risk.

PMID:
20368476
DOI:
10.1097/PSY.0b013e3181d972c2
[Indexed for MEDLINE]

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