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New york Times Article - Why Exercise Can Be So Draining for People With Rheumatoid Arthritis, 2021

Discussion in 'Other health news and research' started by Amw66, May 8, 2021.

  1. Amw66

    Amw66 Senior Member (Voting Rights)

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    pteropus, Louie41, Yessica and 6 others like this.
  2. Trish

    Trish Moderator Staff Member

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    Here's the paper it was based on:
    Increased sympathetic and haemodynamic responses to exercise and muscle metaboreflex activation in post-menopausal women with rheumatoid arthritis

    Key points: Rheumatoid arthritis (RA) patients present exacerbated blood pressure responses to exercise, but little is known regarding the underlying mechanisms involved. This study assessed autonomic and haemodynamic responses to exercise and to the isolated activation of muscle metaboreflex in post-menopausal women with RA. Participants with RA showed augmented pressor and sympathetic responses to exercise and to the activation of muscle metaboreflex. These responses were associated with multiple pro- and anti-inflammatory cytokines and with pain. The results of the present study support the suggestion that an abnormal reflex control of circulation is an important mechanism underlying the exacerbated cardiovascular response to exercise and increased cardiovascular risk in RA.

    Abstract: Studies have reported abnormal cardiovascular responses to exercise in rheumatoid arthritis (RA) patients, but little is known regarding the underlying mechanisms involved. This study assessed haemodynamic and sympathetic responses to exercise and to the isolated activation of muscle metaboreflex in women diagnosed with RA. Thirty-three post-menopausal women diagnosed with RA and 10 matched controls (CON) participated in this study. Mean arterial pressure (MAP), heart rate (HR) and muscle sympathetic nerve activity (MSNA frequency and incidence) were measured during a protocol of isometric knee extension exercise (3 min, 30% of maximal voluntary contraction), followed by post-exercise ischaemia (PEI).

    Participants with RA showed greater increases in MAP and MSNA during exercise and PEI than CON (ΔMAPexercise = 16 ± 11 vs. 9 ± 6 mmHg, P = 0.03; ΔMAPPEI = 15 ± 10 vs. 5 ± 5 mmHg, P = 0.001; ΔMSNAexercise = 17 ± 14 vs. 7 ± 9 bursts min-1 , P = 0.04; ΔMSNAPEI = 14 ± 10 vs. 6 ± 4 bursts min-1 , P = 0.04). Autonomic responses to exercise showed significant (P < 0.05) association with pro- (i.e. IFN-γ, IL-8, MCP-1 and TNFα) and anti-inflammatory (i.e. IL-1ra and IL-10) cytokines and with pain.

    In conclusion, post-menopausal women with RA showed augmented pressor and sympathetic responses to exercise and to the activation of muscle metaboreflex. These findings provide mechanistic insights that may explain the abnormal cardiovascular responses to exercise in RA.
     
    Ryan31337, Louie41, Michelle and 7 others like this.
  3. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    Looking longingly through the candy store window at this research. At initial reading, the reactions to exertion are quite familiar, including the extended, cardiovascular reaction to exertion.

    RA, an absolutey horrendous disease. Much, much progress needed there as well.
     
    Mithriel, Louie41, Michelle and 4 others like this.
  4. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Potentially a very interesting area of study.
    It is odd that exercise puts your blood pressure up but in doing so makes it go down the rest of the time and does you good!
    The question I would ask is what is the significance of exercise putting the blood pressure up for longer? Is it more good, less good or irrelevant?
    I also wonder if patients will tend to have greater pressor responses to things than controls just because they are in a different frame of mind being 'patients'.
    Maybe this group should compare RA patients with spondarthropathy patients, who may have a quite different pathophysiology in relation to blood vessels.
     
    LilyHBopp, MEMarge, Louie41 and 10 others like this.
  5. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    It improves performance when fatigued, so I'd argue it is 'more good'. Or rather, a beneficial response, rather than a perpetuating factor. This is a normal response to the stimulation of the metabo-sensitive muscle afferents and is associated with 'central fatigue'. I strongly doubt this is specific to RA patients.
     
    Louie41, DokaGirl, Michelle and 3 others like this.

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