Circulatory effects of carotid sinus stimulation and changes in blood volume distribution in hypertensive man

Lindblad, Lars Erik; Bevegård, Sture; Castenfors, Jan; Tranesjö, Jussi

doi:10.1111/j.1748-1716.1981.tb06740.x

Cited by 7 publications

(2 citation statements)

References 25 publications

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“…This intervention has been shown to cause less venous pooling in the legs of hypertensive subjects 20 and to be associated with a smaller fall in right atrial pressure. 20 Our study, using a different method of venous pooling in a substantially larger group of patients, confirms these initial observations.…”

Section: Central Hemodynamic Effects Of Reduced Venous Distensibilitysupporting

confidence: 85%

Decreased venous distensibility and reduced renin responsiveness in hypertension.

Fitzpatrick¹,

Hinderliter²,

Egan³

et al. 1986

Hypertension

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Abnormalities of renin release and of venous distensibility have been described in essential hypertension. We have postulated that decreased venous distensibility could contribute to the blunted renin response to upright posture in hypertension. Stiffer veins might prevent venous pooling in the lower extremities, which in turn might affect the stretch on cardiopulmonary mechanoreceptors, thereby influencing the reflex release of renin. We investigated this hypothesis in the present study of 47 patients with mild hypertension and 26 (male) healthy volunteers of similar age and race. To induce isolated changes in the stretch of cardiopulmonary mechanoreceptors, systemic hemodynamics were measured before and after thigh cuff inflation at 60 mm Hg for 30 minutes. Cardiac output was determined by dye dilution. Before the intervention, variable thigh cuff pressures were used to measure venous pressure volume with mercury-in-Silastic strain gauge plethysmography. Venous distensibility was diminished in hypertension, as evidenced by a shift in the calf venous volume/pressure curve toward the pressure axis. During the 30-minute experiment, the hypertensive subjects had less blood pooling in their legs in response to thigh cuff inflation, as compared with the control subjects. The hemodynamic and renin responses reflected this diminished effect of thigh cuff inflation on venous return. The smal ler increase of renin in the hypertensive group was associated with a smaller fall in the stroke index and right atrial pressure; the reflex rise in the heart rate was also decreased. By pooling blood in the lower extremities, thigh cuff inflation simulates upright posture. It is customary to classify the renin status of hypertensive patients according to the renin response to upright posture. Our study suggests that abnormal venous distensibility, through its effect on cardiopulmonary receptors, may be partly responsible for the low renin values frequently observed in hypertension. (Hypertension 8 [Suppl II]: II-36-II-43, 1986) KEY WORDS • renin • venous distensibility • essential hypertension • hemodynamics • cardiopulmonary mechanoreceptors M OST investigations 1 " 4 have demonstrated that venous distensibility is reduced in borderline and established hypertension, although some studies, 56 using small numbers of subjects, have been inconclusive. The functional importance of less compliant veins in hypertension remains uncertain. Ulrych et al. 7 postulated that the exaggerated natriuresis observed in hypertensive subjects during an intravenous volume load was due to reduced peripheral vascular compliance. Several investigators 8 "" have demonstrated redistribution

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Section: Central Hemodynamic Effects Of Reduced Venous Distensibilitysupporting

confidence: 85%

Decreased venous distensibility and reduced renin responsiveness in hypertension.

Fitzpatrick¹,

Hinderliter²,

Egan³

et al. 1986

Hypertension

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“…However, this is probably not of major concern as long as one is studying the effect of a single, well-defined type of stimulus. Further discussions of this technique are presented elsewhere (16,17).…”

Section: Baroreceptor Stimulationmentioning

confidence: 99%

Effect of Mental Stress on Baroreceptor-Mediated Changes in Blood Pressure and Heart Rate and on Plasma Catecholamines and Subjective Responses in Healthy Men and Women

Forsman¹,

Lindblad²

1983

Psychosomatic Medicine

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The aim of this study was to determine whether carotid sinus baroreceptor reflexes are impaired by moderate mental stress. In 12 healthy subjects (6 men, 6 women) baroreceptors were stimulated by static neck suction (at -40 mm Hg) for repeated 2-minute periods during mental stress and control conditions. Heart rate, arterial blood pressure, and levels of plasma catecholamines were measured, and self-reports of effort and distress were obtained. Mental stress, which was induced by a color-word conflict task, increased mean levels of heart rate (+12.4 beats/min; p less than 0.001) and systolic blood pressure (+11.8 mm Hg; p; less than 0.001). The onset of mental stress induced increases in plasma adrenaline and noradrenaline concentrations of 45.8% (p less than 0.08) and 17.6% (p less than 0.05), respectively. The increase in systolic blood pressure was significantly greater in men than in women (p less than 0.01). During mental stress, men had significantly higher levels of plasma adrenaline (p less than 0.05). In both sexes neck suction induced a significant decrease in heart rate and systolic blood pressure; these effects were essentially the same during mental stress and control. The results suggest that nonspecific mental stress does not substantially influence the ability of carotid sinus baroreceptors to decrease heart rate or blood pressure in response to sustained changes in baroreceptor input. The possibility that transient changes influence reflex activity is discussed.

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General Anesthesia is Preferable for Patients Undergoing Carotid Endarterectomy

Lake¹

1988

Controversies in Cardiovascular Anesthesia

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Circulatory effects of carotid sinus stimulation and changes in blood volume distribution in hypertensive man

Cited by 7 publications

References 25 publications

Decreased venous distensibility and reduced renin responsiveness in hypertension.

Decreased venous distensibility and reduced renin responsiveness in hypertension.

Effect of Mental Stress on Baroreceptor-Mediated Changes in Blood Pressure and Heart Rate and on Plasma Catecholamines and Subjective Responses in Healthy Men and Women

General Anesthesia is Preferable for Patients Undergoing Carotid Endarterectomy

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