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Seth W. Holwerda, Ph.D.

Seth Holwerda portrait
Assistant Professor, Anesthesiology, Pain and Perioperative Medicine

Professional Background

My lab at KUMC is currently R01 funded and focused on 1) determining the direction of causality between obesity/insulin resistance and the development hypertension and effective pharmacological and non-pharmacological interventions, and 2) direction of causality between chronic pain and hypertension and how the baroreceptors modulate pain perception. I have expertise in assessments of cardiac and sympathetic baroreflex sensitivity in humans, in addition to central and peripheral vascular measurements to assess arterial blood flow and end-organ responsiveness to sympathetic vasoconstriction.

Education and Training
  • PhD, Neural cardiovascular control, University of Missouri
  • Post Doctoral Fellowship, Vascular Physiology, University of Iowa

Research

Overview

My primary focus of research is in neural cardiovascular control in humans with emphasis on the sympathetic nervous system.

Two current research tracks The first is focused on chronic pain-related hypertension. Chronic pain, such as low back pain, is the greatest contributor to disability worldwide and is associated with impaired autonomic function. We are performing studies to further understand the vital interactions between pain and autonomic regulatory systems that may be working in a feed-forward fashion to promote chronic pain and hypertension in a vicious cycle. Studies include examining the contribution of baroreceptors to pain perception in patients with chronic pain. We are also studying patients receiving epidural spinal cord stimulator devices, which block pain signals from reaching the brain. The hypothesis is that epidural spinal cord stimulation may be favorably influencing the autonomic nervous system in addition to reducing chronic pain symptoms. The goal is to determine the extent to which hypertension and impaired autonomic function predict improvements in chronic pain symptoms following the implant of a spinal cord stimulator device. Results may improve the ability to predict which patients will respond most favorably to pain therapy and reduce the prevalence of hypertension in patients with chronic pain.

The second research track is focused on obesity-related hypertension. Nearly 75% of cases of hypertension can be attributed to obesity. Hallmarks of obesity-related hypertension are oxidative stress, chronic inflammation, and vascular dysfunction. To further understanding the vascular mechanisms underlying the development of hypertension in obesity, we use an innovative method to assess the influence of sympathetic nerve activity, which plays a significant role in hypertension, on vascular function with high resolution. We are launching studies that will examine the influence of elevated blood glucose and lipids on vascular sensitivity to sympathetic nerve activity and the role of oxidative stress that is created by elevated glucose and lipids. Sympathetic nerve activity also plays a role in inflammation, and we are performing studies to examine the extent to which anti-hypertensive drugs that block sympathetic nerve activity reduce the inflammatory profile often observed in obesity and insulin resistance.