title: Association between pressure pain sensitivity and autonomic function as assessed by a tilt table test.
abstract: BACKGROUND
  We tested the hypothesis that pressure sensitivity of the sternum (PPS) is associated with autonomic nervous system (ANS) function as assessed by tilt table test (TTT). in patients with stable ischemic heart disease.
  
  
  OBJECTIVE
  (1) To evaluate an association between PPS and systolic blood pressure (SBP) and heart rate (HR) responses to TTT; and (2) to test the hypothesis that a reduction of resting PPS raises the PPS, SBP and HR responses to TTT response and lowers risk factors for ANS dysfunction (ANSD).
  
  
  METHODS
  Cross-sectional study: In 361 patients with stable ischemic heart disease we measured PPS, SBP, and HR during TTT. Intervention study: We reassessed subjects with persistent stress who concluded a stress intervention trial by a second TTT.
  
  
  RESULTS
  Cross-sectional study: Resting PPS and the PPS response to TTT were correlated (r = - 0.37). The PPS response to TTT was correlated with that of SBP (r = 0.44) and HR (r = 0.49), and with the number of risk factors for ANSD (r = - 0.21) (all p < 0.0001). Intervention study: A reduction in resting PPS was associated with an increment in PPS response to TTT (r = - 0.52, p < 0.0001). The greater this increment, the greater was the reduction in ANSD risk factors (r = - 0.23; p = 0.003).
  
  
  CONCLUSIONS
  The results are consistent with the hypothesis that PPS at rest and in response to TTT reflects ANS function.
authors.affiliation: Department of Endocrinology, Herlev University Hospital , Herlev , Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Ballegaard
authors.forename: Natasha
authors.initials: N
authors.lastname: Bergmann
authors.forename: Benny
authors.initials: B
authors.lastname: Karpatschof
authors.forename: Jesper
authors.initials: J
authors.lastname: Kristiansen
authors.forename: Finn
authors.initials: F
authors.lastname: Gyntelberg
authors.forename: Lars
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.forename: Per
authors.initials: P
authors.lastname: Bech
authors.forename: Åke
authors.initials: Å
authors.lastname: Hjalmarson
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology*; D011312:Pressure; D012044:Regression Analysis; D012307:Risk Factors; D018667:Tilt-Table Test
keywords: Autonomic nervous system dysfunction; depression; pressure pain sensitivity; pressure pain threshold; stress; tilt table test