In healthy young subjects there is direct evidence for sympathetic vasoconstrictor activation after drinking water, but this is not accompanied by an increase in arterial blood pressure. A marked pressor response to water ingestion has, however, been observed in elderly subjects and in patients with autonomic failure. We examined the effect of water ingestion on haemodynamic variables and heart rate variability (HRV) markers of cardiac vagal control in ten healthy young subjects and four cardiac transplant recipients with confirmed persistent cardiac vagal denervation. In a random order crossover protocol, changes in heart rate, blood pressure and measures of high frequency (HF) HRV were compared over time following the ingestion of 500ml and 20ml (control) of tap water. In healthy subjects, after drinking 500ml of water the heart rate fell from 67.6±2.0 (mean±S.E.M.) to 60.7±2.4 beats/min (P<0.01), and the bradycardic response peaked between 20 and 25min. There were no significant changes in arterial blood pressure. Over the same time course, water ingestion caused increases in measurements of HF HRV: root-mean-square of successive RR interval differences (RMSSD) increased by 13±2.7ms after 500ml versus 2±3.1ms after 20ml (P<0.05); HF power increased by 686±400 versus -63±322 (P<0.01). In transplant recipients water ingestion was followed by a pressor response (range 13 to 29mmHg). These results provide evidence that water ingestion in normal subjects is followed by an increase in cardiac vagal control that may counteract the pressor effects of sympathetic activation. We suggest that in the elderly, in transplant recipients and in autonomic failure, loss of this buffering mechanism explains the pressor response to drinking water.
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Research Article|
July 08 2002
Cardiac vagal response to water ingestion in normal human subjects
Helen C. ROUTLEDGE;
*Department of Cardiology, Division of Medical Sciences, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Correspondence: Dr H. Routledge (e-mail [email protected]).
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Saqib CHOWDHARY;
Saqib CHOWDHARY
*Department of Cardiology, Division of Medical Sciences, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
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John H. COOTE;
John H. COOTE
†Department of Physiology, University of Birmingham Medical School, Edgbaston, Birmingham B15 2TH, U.K.
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Jonathan N. TOWNEND
Jonathan N. TOWNEND
*Department of Cardiology, Division of Medical Sciences, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
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Publisher: Portland Press Ltd
Received:
October 30 2001
Revision Received:
January 30 2002
Accepted:
April 22 2002
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2002
2002
Clin Sci (Lond) (2002) 103 (2): 157–162.
Article history
Received:
October 30 2001
Revision Received:
January 30 2002
Accepted:
April 22 2002
Citation
Helen C. ROUTLEDGE, Saqib CHOWDHARY, John H. COOTE, Jonathan N. TOWNEND; Cardiac vagal response to water ingestion in normal human subjects. Clin Sci (Lond) 1 August 2002; 103 (2): 157–162. doi: https://doi.org/10.1042/cs1030157
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