title: Alterations in cardiovascular autonomic function tests in idiopathic hyperhidrosis.
abstract: We performed cardiovascular autonomic function tests to assess sympathetic and parasympathetic functions in patients with idiopathic hyperhidrosis. We studied 35 patients with idiopathic hyperhidrosis and 35 age- and sex-matched controls. A thermoregulatory sweat test (TST) was performed in all subjects. Sweating was qualitatively (Minor's test at 22°C) and quantitatively (skin conductance) evaluated. Orthostatism, tilt to 65°, cold pressor test, deep breathing, Valsalva maneuver and hyperventilation were performed in patients and controls. A greater fall in blood pressure values was observed in patients than in controls in the upright tests (p<0.05). In particular, postural hypotension was present in a subgroup of patients (34%), in whom changes in lying-to-standing blood pressure and heart rate were greater (p<0.001) than those of the remaining patients. The TST revealed that the total body sweat rate (ml/cm(2)/min) was more pronounced in patients with postural hypotension (p<0.001) than in the other patients and controls. The skin conductance values of patients with postural hypotension were higher (p<0.001) than those of the remaining patients. A positive correlation was found between skin conductance values and postural hypotension. Dehydration and poor water intake may play a role in postural hypotension in patients with severe hyperhidrosis and pronounced thermoregulatory sweating. A significantly marked increase in parasympathetic function was observed in patients. Responses to deep breathing, Valsalva maneuver and hyperventilation were significantly greater in patients (p<0.001) than in controls. Idiopathic hyperhidrosis seems to be a complex dysfunction that involves autonomic pathways other than those related to sweating.
authors.affiliation: Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy. m.de.marinis@mclink.it
authors.forename: Milena
authors.initials: M
authors.lastname: De Marinis
authors.forename: Elisa
authors.initials: E
authors.lastname: Colaizzo
authors.forename: Rosa Anna Nives
authors.initials: RA
authors.lastname: Petrelli
authors.forename: Valter
authors.initials: V
authors.lastname: Santilli
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D001833:Body Temperature Regulation / Q000502:physiology; D002319:Cardiovascular System / Q000294:innervation* / Q000503:physiopathology*; D004244:Dizziness; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006334:Heart Function Tests; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis / Q000503:physiopathology*; D006985:Hyperventilation / Q000503:physiopathology; D007455:Iodine; D008297:Male; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D013546:Sweating / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D013696:Temperature; D014636:Valsalva Maneuver; D055815:Young Adult
chemical_list: D007455:Iodine