Daily Profile of Baroreflex Sensitivity and the Variability of Blood Pressure in Essential Hypertensive Patients

Ogawa, Jun; Arai, Shirõ; Takata, Shigeo; Ikeda, Takayuki; Takabatake, Toshikazu; Hattori, Nobu; Nomura, Gakuji

doi:10.1042/cs061157s

Cited by 6 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…43 Improvements in baroreflex function after RDN may, therefore, directly improve mortality risk in these patients. This might be related to improvements in BP lability/variability, 44 a known risk for target organ damage, including stroke incidence. 45,46 We measured BP variability over a 10-minute quiet resting period, which was unchanged after RDN at 1 and 6 months.…”

Section: Cardiac and Sympathetic Baroreflex Sensitivitymentioning

confidence: 99%

Translational Examination of Changes in Baroreflex Function After Renal Denervation in Hypertensive Rats and Humans

et al. 2013

View full text Add to dashboard Cite

Abstract-Renal denervation has shown promise in the treatment of resistant hypertension, although the mechanisms underlying the blood pressure (BP) reduction remain unclear. In a translational study of spontaneously hypertensive rats (n=7, surgical denervation) and resistant hypertensive human patients (n=8; 5 men, 33-71 years), we examined the relationship among changes in BP, sympathetic nerve activity, and cardiac and sympathetic baroreflex function after renal denervation. In humans, mean systolic BP (SBP; sphygmomanometry) and muscle sympathetic nerve activity (microneurography) were unchanged at 1 and 6 months after renal denervation (P<0.05). Interestingly, 4 of 8 patients showed a 10% decrease in SBP at 6 months, but sympathetic activity did not necessarily change in parallel with SBP. In contrast, all rats showed significant and immediate decreases in telemetric SBP and lumbar sympathetic activity (P<0.05), 7 days after denervation. Despite no change in SBP, human cardiac and sympathetic baroreflex function (sequence and threshold techniques) showed improvements at 1 and 6 months after denervation, particularly through increased sympathetic baroreflex sensitivity to falling BP. This was mirrored in spontaneously hypertensive rats; cardiac and sympathetic baroreflex sensitivity (spontaneous sequence and the Oxford technique) improved 7 days after denervation. The more consistent results in rats may be because of a more complete (>90% reduction in renal norepinephrine content) denervation. We conclude that (1) renal denervation improves BP in some patients, but sympathetic activity does not always change in parallel, and (2) baroreflex sensitivity is consistently improved in animals and humans, even when SBP has not decreased. Determining procedural success will be crucial in advancing this treatment modality.

show abstract

Section: Cardiac and Sympathetic Baroreflex Sensitivitymentioning

confidence: 99%

Translational Examination of Changes in Baroreflex Function After Renal Denervation in Hypertensive Rats and Humans

et al. 2013

View full text Add to dashboard Cite

show abstract

“…32 ' 33 Differing patient populations or methods may be responsible. We included all cardiac cycles in our analysis of these data, whereas Mancia et al 33 processed their records to provide mean values for each 3-second interval.…”

mentioning

confidence: 99%

Factors influencing blood pressure and heart rate variability in hypertensive humans.

et al. 1988

View full text Add to dashboard Cite

SUMMARY We examined the influence of baroreceptor reflex sensitivity (the increase in pulse interval in response to a phenylephrine-induced increase in blood pressure), age, blood pressure, and /3-adrenergic receptor blockade on the variability of blood pressure and heart rate in essential hypertension. Fifty-six subjects were studied before treatment; intra-arterial blood pressure was recorded outside the hospital for 24 hours. Variability was defined (from all beats occurring while subjects were awake) as the standard deviation about the average waking value for mean arterial pressure (MAP) or pulse interval. The correlation (r) between baroreceptor reflex sensitivity and blood pressure variability was -0.47 (p<0.0002). Baroreceptor reflex sensitivity was the only independent determinant of blood pressure variability on multiple regression analysis. Thirty subjects were restudied after 5 months of /3-adrenergic receptor blockade. Ambulatory blood pressure was lower during treatment, whereas pulse interval, its variability, and baroreceptor reflex sensitivity were higher. Blood pressure variability was unchanged. The variability of MAP was inversely correlated with baroreceptor reflex sensitivity before (r = -0.42, p<0.02) and during ( r = -0.45, p < 0.02) treatment, but it was unrelated to the average ambulatory MAP or to the variability of pulse interval either before or during /3-blockade. Sixteen subjects whose average waking ambulatory blood pressure was 140/90 mm Hg or less were not treated. This group of borderline hypertensive subjects had less variable MAP than did the remaining 40 subjects (12.4 ± 2.3 [SD] vs 14.5 ± 2.5 mm Hg; p<0.01). We conclude that 1) the decline in baroreceptor reflex sensitivity is the principal determinant of increased blood pressure variability in hypertension, 2) MAP and its variability are regulated independently, 3) heart rate variability is not influenced by baroreceptor reflex sensitivity and is unrelated to blood pressure variability, and 4) the blood pressure of subjects with borderline hypertension is not excessively labile. in normal and hypertensive humans, 1 but factors that might influence and regulate this variability remain imperfectly understood. Considerable experimental evidence supports the concept that the arterial baroreceptor reflex is intimately involved in the short-term regulation of arterial blood pressure. Denervation of the sinoaortic baroreceptors in rats and dogs consistently increases the beat-to-beat variation of blood pressure but has less dramatic and disputed effects on its level.2 " 5 Central interruption of the baroreceptor reflex by lesioning nucleus tractus solitarii produces hypertension, tachycardia, and increased blood pressure variability in awake animals. 6 Selective removal of the noradrenergic innervation of this nucleus does not induce hypertension, but it does cause an increase in blood pressure variability that is inversely related to a decrease in the baroreceptor reflex control of heart rate.

show abstract

“…As another possible explanation structural changes of peripheral blood vessels are to be discussed. Such structural changes would explain the relationship between blood pressure variability and reduced baroreflex sensitivity as described in diurnal measurement of blood pressure (22,36).…”

Section: Discussionmentioning

confidence: 99%

Basal blood pressure variability and reactivity of blood pressure to emotional stress in essential hypertension

et al. 1984

View full text Add to dashboard Cite

Blood pressure variability under basal conditions and blood pressure reactivity to emotional stress were studied in 38 hypertensives and 13 normotensives. Systolic basal blood pressure variability correlated with systolic blood pressure reactivity. Variability increased with higher basal blood pressure. Thus in the hypertension group the blood pressure variability was greater than in the normotension group. Besides, the hypertension group showed a greater reactivity of systolic blood pressure to emotional stress, too. An influence of age on basal blood pressure, blood pressure variability, and reactivity could be evaluated; but no influence of sex on these parameters was detected. The results indicate that variability and reactivity of blood pressure can be referred to a common central nervous blood-pressure-regulating mechanism. As both parameters are increased in hypertension, a greater lability of blood pressure must be assumed. This greater lability may be attributed to a stronger neurogenic influence or to structural changes of peripheral blood vessels.

show abstract

Daily Profile of Baroreflex Sensitivity and the Variability of Blood Pressure in Essential Hypertensive Patients

Cited by 6 publications

References 6 publications

Translational Examination of Changes in Baroreflex Function After Renal Denervation in Hypertensive Rats and Humans

Translational Examination of Changes in Baroreflex Function After Renal Denervation in Hypertensive Rats and Humans

Factors influencing blood pressure and heart rate variability in hypertensive humans.

Basal blood pressure variability and reactivity of blood pressure to emotional stress in essential hypertension

Contact Info

Product

Resources

About