Interplay between baroreflex sensitivity, obesity and related cardiometabolic risk factors (Review)

Abstract

The baroreflex represents a rapid negative feedback system implicated in blood pressure regulation, which aims to prevent blood pressure variations by regulating peripheral vascular tone and cardiac output. The aim of the present review was to highlight the association between baroreflex sensitivity (BRS) and obesity, including factors associated with obesity, such as metabolic syndrome, hypertension, cardiovascular disease and diabetes. For the present review, a literature search was conducted using the PubMed database until August 21, 2021. The searched terms included ‘baroreflex’, and other terms such as ‘sensitivity’, ‘obesity’, ‘metabolic syndrome’, ‘hypertension’, ‘diabetes’, ‘gender’, ‘aging’, ‘children’, ‘adolescents’, ‘physical activity’, ‘bariatric surgery’, ‘autonomous nervous system’ and ‘cardiometabolic risk factors’. Obesity and its related metabolic disorders can influence baroreflex functionality and decrease BRS, mostly by potentiating sympathetic nervous system activity. Obesity induces inflammation, which can increase sympathetic system activity and lead to a higher incidence of cardiovascular events. Obesity also represents an important risk factor for hypertension through numerous mechanisms; in this setting, dysfunctional baroreceptors are not able to protect against constantly elevated blood pressure. Furthermore, diabetes mellitus and oxidative stress result in deterioration of BRS, whereas aging is also generally related to reduced cardiovagal BRS. Differences in BRS have also been observed between men and women, and overall cardiovagal BRS in healthy women is less intense compared with that in men. BRS appears lower in children with obesity compared with that in children of a healthy weight. Notably, physical exercise can increase BRS in both hypertensive and normotensive subjects, and BRS can also be significantly improved following bariatric surgery and weight loss. In conclusion, obesity and its related metabolic disorders may influence baroreflex functionality and decrease BRS, and baroreceptors cannot protect against the constantly elevated blood pressure in obesity. However, following bariatric surgery and weight loss, BRS can be significantly improved. The present review summarizes the role of obesity and related metabolic risk factors in BRS, providing details on possible mechanisms and shedding light on their interplay leading to autonomic neuropathy.

Association of Serum Leptin and Adiponectin Concentrations with Type 2 Diabetes Biomarkers and Complications Among Saudi Women

“…BMI is the most important factor related to elevated blood leptin levels in women, according to many investigations. 19 These investigations found a favorable connection between serum leptin and triacylglycerol in women with a high BMI. This supports our findings.…”

Differences in Heart Rate Variability and Baroreflex Sensitivity between Male and Female Athletes

“…Our preliminary, exploratory regression models found that the combination of BMI, age, type of sport, and history of concussion can be potential contributors to the cardiovascular metrics, with BMI being a particularly strong predictor of LF% and BP HF Power, and the type of sport being a strong predictor of BRS parameters. In other research, age has been shown to influence many cardiovascular parameters [ 24 , 27 , 34 ], while BMI has an inverse relationship with HRV [ 35 ] and BRS [ 36 ], and a direct relationship with BPV [ 37 ].…”

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“…A normal HRV confi rms a healthy status, whereas a low HRV may be a predictor of various disease states [49]. Several studies have shown that ANS dysfunction occurs in obesity and imbalance between components of the autonomic nervous system may be one of the most important predictors of cardiovascular death [8,16].…”