Acute intermittent hypercapnic hypoxia and sympathetic neurovascular transduction in men

Abstract

Acute intermittent hypercapnic hypoxia (IH) induces long‐lasting elevations in sympathetic vasomotor outflow and blood pressure in healthy humans. It is unknown whether IH alters sympathetic neurovascular transduction (sNVT), measured as the relationship between sympathetic vasomotor outflow and either forearm vascular conductance (FVC; regional sNVT) or diastolic blood pressure (systemic sNVT). We tested the hypothesis that IH augments sNVT by exposing healthy males to 40 consecutive 1 min breathing cycles, each comprising 40 s of hypercapnic hypoxia (urn:x-wiley:00223751:media:tjp13923:tjp13923-math-0001: +4 ± 3 mmHg above baseline; urn:x-wiley:00223751:media:tjp13923:tjp13923-math-0002: 48 ± 3 mmHg) and 20 s of normoxia (n = 9), or a 40 min air‐breathing control (n = 7). Before and after the intervention, lower body negative pressure (LBNP; 3 min at –15, –30 and –45 mmHg) was applied to elicit reflex increases in muscle sympathetic nerve activity (MSNA, fibular microneurography) when clamping end‐tidal gases at baseline levels. Ventilation, arterial pressure [systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP)], brachial artery blood flow (urn:x-wiley:00223751:media:tjp13923:tjp13923-math-0003BA), FVC (urn:x-wiley:00223751:media:tjp13923:tjp13923-math-0004BA/MAP) and MSNA burst frequency were measured continuously. Following IH, but not control, ventilation [5 L min–1; 95% confidence interval (CI) = 1–9] and MAP (5 mmHg; 95% CI = 1–9) were increased, whereas FVC (–0.2 mL min–1 mmHg–1; 95% CI = –0.0 to –0.4) and mean shear rate (–21.9 s–1; 95% CI = –5.8 to –38.0; all P < 0.05) were reduced. Systemic sNVT was increased following IH (0.25 mmHg burst–1 min–1; 95% CI = 0.01–0.49; P < 0.05), whereas changes in regional forearm sNVT were similar between IH and sham. Reductions in vessel wall shear stress and, consequently, nitric oxide production may contribute to heightened systemic sNVT and provide a potential neurovascular mechanism for elevated blood pressure in obstructive sleep apnoea.