By Sarah Wilson: MD
The inability of patients with fibromyalgia to maintain blood pressure in response to stressors like standing is related to a decrease in quality of life and increased pain, a study suggests.
Fibromyalgia is a long-term condition characterized by chronic widespread pain. Autonomic function and cardiovascular control have been previously investigated in fibromyalgia. The prior studies have reported findings derived from an analysis of spontaneous fluctuations in the beat-to-beat interval (heart period; HP) and systolic arterial pressure (SAP).
There is currently no data on the association between cardiovascular parameters derived from the HP and SAP and the quality of life in fibromyalgia patients.
The study, “The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients,” was published in the journal Plos One.
Researchers sought to evaluate the relationship between quality of life in women with fibromyalgia and parameters of cardiovascular function based on HP and SAP variabilities.
The study involved 35 women who had been diagnosed with fibromyalgia between 2013 and 2015. All measurements were taken at specific times (mornings), temperatures (71.5 degrees F) and humidity (40-60 percent) to minimize the impact of circadian rhythms on cardiovascular variables.
Quality of life was assessed using the standard fibromyalgia impact questionnaire (FIQ), and pain was assessed using the visual analog scale for pain (VAS pain).
Researchers found that fibromyalgia patients suffering from a poor quality of life and higher pain in the resting position had a lower degree of cardiac baroreflex (a mechanism in the body that tries to regulate blood pressure) involvement while standing — a measure of the body’s ability to maintain blood pressure while standing.
Previous studies had established a link between impaired baroreflex control while standing and fibromyalgia, but did not report on the patients’ quality of life. The authors comment that the reduced ability to control blood pressure as a result of cardiac baroreflex dysfunction affects the ability of fibromyalgia patients to deal with daily activities and results in a lower quality of life as measured by the FIQ.
The quality of life and pain were not significantly affected by other cardiovascular control parameters derived from HP and SAP. Among the limitations of this study is the small sample size. The authors suggest that future studies should also asses the effect of the use of drugs on the parameters tested.
“The study suggests that the lower the degree of cardiac baroreflex involvement during STAND in women with [fibromyalgia], the higher the impact of [fibromyalgia] on the quality of life,” the researchers wrote.
“This result stresses the clinical relevance of computing directionality of the interactions along with cardiac baroreflex from spontaneous fluctuations of SAP and HP to provide a quantitative assessment of the state of the [fibromyalgia] patient.”