Reduced cerebral and cardiovascular hemodynamics during sustained affective stimulation in young women with chronic low blood pressure

Cellini, Nicola; Zambotti, Massimiliano de; Covassin, Naima; Gallicchio, Germano; Stegagno, Luciano; Sarlo, Michela

doi:10.1016/j.physbeh.2015.02.047

Cited by 6 publications

(2 citation statements)

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“…Reduced blood pressure reactivity may also be involved in deficient cerebral blood flow regulation in hypotension. Various studies using transcranial Doppler sonography have documented blunted hemodynamic adjustment, in terms of smaller phasic blood flow increases during cognitive and emotional processing (Cellini et al, 2015; Duschek & Schandry, 2004; Sarlo, de Zambotti, Gallicchio, Devigili, & Stegagno, 2013). Moreover, recent research indicated that the amplitudes of cerebral blood flow responses depend, to a certain degree, on the magnitude of blood pressure reactions (Duschek, Heiss, Schmidt, Werner, & Schuepbach, 2010; Duschek & Schandry, 2006; Duschek, Werner, Kapan, & Reyes del Paso, 2008).…”

Section: Discussionmentioning

confidence: 99%

Autonomic Cardiovascular Dysregulation at Rest and During Stress in Chronically Low Blood Pressure

Duschek

Hoffmann

Montoro

et al. 2019

Journal of Psychophysiology

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Abstract. Chronic low blood pressure (hypotension) is accompanied by symptoms such as fatigue, reduced drive, faintness, dizziness, cold limbs, and concentration difficulties. The study explored the involvement of aberrances in autonomic cardiovascular control in the origin of this condition. In 40 hypotensive and 40 normotensive subjects, impedance cardiography, electrocardiography, and continuous blood pressure recordings were performed at rest and during stress induced by mental calculation. Parameters of cardiac sympathetic control (i.e., stroke volume, cardiac output, pre-ejection period, total peripheral resistance), parasympathetic control (i.e., heart rate variability), and baroreflex function (i.e., baroreflex sensitivity) were obtained. The hypotensive group exhibited markedly lower stroke volume, heart rate, and cardiac output, as well as higher pre-ejection period and baroreflex sensitivity than the control group. Hypotension was furthermore associated with a smaller blood pressure response during stress. No group differences arose in total peripheral resistance and heart rate variability. While reduced beta-adrenergic myocardial drive seems to constitute the principal feature of the autonomic impairment that characterizes chronic hypotension, baroreflex-related mechanisms may also contribute to this state. Insufficient organ perfusion due to reduced cardiac output and deficient cardiovascular adjustment to situational requirements may be involved in the manifestation of bodily and mental symptoms.

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Section: Discussionmentioning

confidence: 99%

Autonomic Cardiovascular Dysregulation at Rest and During Stress in Chronically Low Blood Pressure

Duschek

Hoffmann

Montoro

et al. 2019

Journal of Psychophysiology

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“…Research shows that sustained reductions in systemic blood pressure is correlated with a higher use of vasopressors and an independent, significantly higher risk of death of 45% at 5 years [1]. Another study identified a close association between reduced processing of pleasant stimuli and chronic low blood pressure in young adulthood [2].…”

Section: Letter To the Editormentioning

confidence: 99%

Minimum Systolic Brain Perfusion in the Control of Systemic Hypertension

Godoy¹

2015

J Neurol Neurosci

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The recommended goal of a systolic pressure under 130 mmHg in hypertensive diabetic patients results in a significant drop in blood pressure that often causes neurological symptoms, a condition not always considered in the clinical practice. A controlled reduction in blood pressure should be achieved by using antihypertensive drugs to reach the minimum pressure without symptoms. Although in this evaluation the main variable must be the systolic pressure, the diastolic pressure should not be ignored.

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The cardiac, vasomotor and myocardial branches of the baroreflex in hypotension: indications of reduced venous return to the heart

Reyes del Paso,

Montoro,

Daydov

et al. 2024

Clin Auton Res

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Purpose Alterations of autonomic cardiovascular control are implicated in the origin of chronic low blood pressure (BP) (hypotension), but comprehensive analysis of baroreflex function is still lacking. This study explored baroreflex function in its cardiac, vascular and myocardial branches Methods Continuous BP was recorded at rest and during a mental arithmetic task in 40 hypotensive and 40 normotensive participants. Assessed cardiovascular variables included stroke volume (SV) (calculated by the Modelflow method), heart rate (HR), cardiac output (CO), total peripheral resistance (TPR) and heart rate variability (HRV). Baroreflex sensitivity (BRS) was calculated using the spontaneous sequence method. Results Hypotensive participants exhibited greater BRS in the three baroreflex branches, in addition to lower SV, HR and CO and higher HRV and TPR. Reactivity for BP, HRV and CO during the stress task was reduced in hypotensive individuals. The greater cardiac BRS can explain the lower HR and higher HRV observed in hypotension, suggestive of increased vagal cardiac influences. The higher vasomotor BRS may contribute to the greater TPR observed in the hypotensive participants. Abnormal associations between myocardial BRS and SV arose, suggesting aberrant autonomic control of myocardial contractility in hypotension. Conclusion The results indicate that hemodynamic deficits in hypotension are related to preload factors, probably triggered by hypovolemia and reduced unstressed blood reserves, resulting in lower venous return, ventricular preload and SV. In contrast, afterload mechanisms seem to work appropriately.

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Reduced cerebral and cardiovascular hemodynamics during sustained affective stimulation in young women with chronic low blood pressure

Cited by 6 publications

References 64 publications

Autonomic Cardiovascular Dysregulation at Rest and During Stress in Chronically Low Blood Pressure

Autonomic Cardiovascular Dysregulation at Rest and During Stress in Chronically Low Blood Pressure

Minimum Systolic Brain Perfusion in the Control of Systemic Hypertension

The cardiac, vasomotor and myocardial branches of the baroreflex in hypotension: indications of reduced venous return to the heart

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