Involvement of Carotid Baroreceptor Function in Blood Pressure Control in the Chronic Phase: Effect on 24-Hour Ambulatory Blood Pressure

Ino-Oka, Eiji; Saito, Hiroshi; Kajikawa, Shinya; Inooka, Hikaru; Imai, Yutaka; Hashimoto, Junichiro

doi:10.1080/10641960701815895

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…A corresponding magnitude of MAP change during orthostasis is what one would expect of properly working baroreceptor reflexes 19. In contrast, even a less pronounced orthostatic BP fall might be an early sign of autonomic dysfunction leading in turn to LVH and alterations in left ventricular diastolic filling,23 disorders of circadian BP rhythm (especially non‐dipping),24,25 diurnal BP swings (i.e. supine or sitting vs. standing), and a reflex increase in heart rate during orthostasis, all of which are implicated in HF development 26–28.…”

Section: Discussionmentioning

confidence: 98%

Directionality of blood pressure response to standing may determine development of heart failure: prospective cohort study

Fedorowski

Hedblad

Engström

et al. 2011

European J of Heart Fail

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AimsTo study the prospective relationship of blood pressure response during orthostatic challenge with incidence of heart failure (HF). Methods and resultsIn a Swedish prospective cohort study (the Malmö Preventive Project), we followed up 32 669 individuals (68.2% men; mean age, 46 years) over a period of 24 years. Incidence of first hospitalization due to new-onset HF was related to early (60 -120 s) postural changes in systolic and diastolic blood pressure (DSBP and △DBP), and mean arterial pressure (DMAP), using Cox proportional hazards models. Hazard ratio of incident HF increased across descending quartiles of DSBP from the first (and reference) quartile (+8.5 + 4.9 mmHg), through the second (neutral response), to the third and fourth quartiles (25.0 + 0.1 and 213.7 + 6.1 mmHg, respectively; P for linear trend¼0.009). A pronounced hypotensive SBP response (fourth quartile) conferred the highest risk of new-onset HF [hazard ratio (HR), 1.31; 95% confidence interval (CI), 1.11-1.53]. A similar pattern was observed with regard to DMAP, where the first (and reference) quartile with a marked positive MAP response (+7.7 + 3.1 mmHg) had the lowest, and the fourth quartile with a hypotensive MAP response (25.2 + 3.4 mmHg) had the highest HF risk (HR for fourth vs. first quartile: 1.37; 95% CI, 1.17-1.62). In a continuous model, the risk of incident HF conferred by negative DSBP matched that of resting SBP (HR per 10 mmHg difference: 1.17; 95% CI, 1.11-1.23, and 1.17, 1.14-1.20, respectively), whereas MAP drop was the strongest individual predictor of HF development (HR 1.26, 95% CI, 1.21-1.31). ConclusionEarly increase of blood pressure in response to orthostatic challenge signals reduced the risk of HF development.--

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Section: Discussionmentioning

confidence: 98%

Directionality of blood pressure response to standing may determine development of heart failure: prospective cohort study

Fedorowski

Hedblad

Engström

et al. 2011

European J of Heart Fail

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“…In this conception, baroreflex function acts normally, that is, a transient increase in sympathetic nerve tone by a decrease in Bp will occur to regulate Bp at an adequate level, however, sympathetic nerve tone return to a new lower basic level (16), resulting in the positive relationship. If sympathetic nerve tone is measured instantaneously, this may be shown more directly, however, in the present study we measured the average value of sympathetic nerve tone and Bp every 15 minutes, when Bp could not be maintained at adequate level, in spite of sympathetic nerve stimulated, a further increase in sympathetic nerve tone was required to maintained the Bp, resulting in the inverse relation.…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure and Sympathetic Nerve Tone Relation during Hemodialysis may Reflect Cardiovascular Dysfunction

Ino-Oka¹,

Urae²,

Sekino³

et al. 2011

Intern. Med.

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Background The blood pressure response to the rapid removal of fluid during hemodialysis is complex and the pathophysiological mechanisms underlying intradialytic hypotension are not clear and sometimes these mechanisms render dialysis difficult to continue. Purpose We analyzed the changes in blood pressure and sympathetic nerve tone and attempted to clarify whether the dynamic pattern of this relationship reflects cardiovascular dysfunction. Methods The dynamic pattern of sympathetic nerve activity throughout dialysis was analyzed by frequency analysis of RR intervals recorded by 24 hours Holter electrocardiography in 64 patients and 3 minutes ECG every 15 minutes during dialysis in 121 stable end-stage renal failure patients who underwent maintenance hemodialysis. Blood pressure and fluid volume removed was measured every 15-30 minutes during dialysis and the average value of the ratio of low to high frequency components (LF/HF) was calculated as an index of sympathetic nerve tone. The relationship between removed fluid volume, systolic blood pressure (Bp) and LF/HF was analyzed. Results The patients were classified into 3 groups based on the correlation between the LF/HF and Bp as follows: positive (52 cases), inverse (54 cases), and not significant (NS; 61 cases). Eighteen patients who showed multiple arrhythmias, atrial fibrillation and other artifacts or noises were eliminated as they were inadequate for frequency analysis of RR intervals. The positive group was characterized by a hypotensionresistant response with a low LF/HF, whereas the inverse group was characterized by a hypotension-prone response with high LF/HF. These results suggest that cardiovascular dysfunction is responsible for the inverse correlation. Conclusion Analysis of the relationship between sympathetic nerve tone and Bp is effective in predicting the existing of cardiovascular dysfunction.

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“…During postural change, the blood pressure of each beat and the baroreceptor function were measured along with the change in heart by the frequency method (15). In addition, a plaque score was estimated from the ultrasound tomography of both the carotid arteries as the sum of atheromatous wall thickness at 8 points, using the method of Sakaguchi et al (16).…”

Section: Measurements Of Baroreflex Sensitivity and Plaque Scorementioning

confidence: 99%

Evaluation of Carotid Atherosclerosis from the Perspective of Blood Flow Reflection

Ino-Oka

Saito

Kajikawa

et al. 2009

Clinical and Experimental Hypertension

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Detection and prevention of atherosclerosis at an early stage is important for its prevention. The aim of this study was to propose a valid and highly reliable index for the evaluation of carotid atherosclerosis or carotid function. Images of carotid Doppler wave profiles were processed using an image processing software, and the relative fluctuation in blood flow was calculated from the luminance in one cardiac cycle. Frequency analysis was performed and up to 10 time components of basic frequency (f1) were indicated. The evaluation function alpha was estimated by calculating the ratio of the sum of components f3-f10 against the f1 + f2 components. Blood pressure of the finger was continuously measured using Finapress during passive postural change from the supine to the standing position, the baroreceptor function was evaluated by the frequency method, and the plaque score was measured by ultrasound tomography. The influence of factors such as arterial compliance, blood vessel resistance, and heart rate on this index was studied using electric circuit model simulation. The subjects were 33 patients (18 men, 15 women) who had various types of atherosclerotic disease and hypertension. The average age was 67.3 + 12.2 years. The results showed that index alpha had a strong negative correlation with age and plaque score, and a weak positive correlation with baroreceptor function. Simulation results supported the clinical result. We proposed a new index to evaluate carotid atherosclerosis without blood pressure measurement using the carotid Doppler method. It is a potential index for detecting atherosclerosis of local arteries such as the carotid.

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Involvement of Carotid Baroreceptor Function in Blood Pressure Control in the Chronic Phase: Effect on 24-Hour Ambulatory Blood Pressure

Cited by 3 publications

References 20 publications

Directionality of blood pressure response to standing may determine development of heart failure: prospective cohort study

Directionality of blood pressure response to standing may determine development of heart failure: prospective cohort study

Blood Pressure and Sympathetic Nerve Tone Relation during Hemodialysis may Reflect Cardiovascular Dysfunction

Evaluation of Carotid Atherosclerosis from the Perspective of Blood Flow Reflection

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