Premium
Heart rate variability, overnight urinary norepinephrine and C‐reactive protein: evidence for the cholinergic anti‐inflammatory pathway in healthy human adults
Author(s) -
Thayer J. F.,
Fischer J. E.
Publication year - 2009
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2008.02023.x
Subject(s) - medicine , autonomic nervous system , cholinergic , sympathetic nervous system , population , inflammation , c reactive protein , heart rate variability , white blood cell , endocrinology , heart rate , urinary system , physiology , blood pressure , environmental health
. Objectives. C‐reactive protein (CRP) has been identified as an independent predictor of cardiovascular mortality and morbidity in population‐based studies. Recent advances have suggested a prominent role for the autonomic nervous system (ANS) in the regulation of inflammation. However, no in vivo human studies have examined indices of sympathetic and parasympathetic nervous system activity simultaneously in relationship to inflammatory markers in apparently healthy adults. Therefore, the objective of this study was to assess the immunomodulatory effects of the ANS. Methods and results. The study population comprised 611 apparently healthy employees of an airplane manufacturing plant in southern Germany. Urinary NE was positively associated with white blood cell count (WBC) in the total sample. We found an inverse association between indices of vagally mediated heart rate variability and plasma levels of (CRP), which was significantly larger in females than in males after controlling for relevant covariates including NE. Similar results were found using the percentage of interbeat interval differences >50 ms and WBC. Conclusions. We report here for the first time, in a large sample of healthy human adults, evidence supporting the hypothesis of a clinically relevant cholinergic anti‐inflammatory pathway after controlling for sympathetic nervous system activity. This suggests an important role for the vagal control of systemic inflammatory activity in cardiovascular disease.