Valsalva Vasoconstrictor Reflex in Human Hypertension and after β-Adrenoreceptor Blockade in Conscious Rabbits

Pi, Korner; Blombery, Peter; Bobik, Alex; Tonkin, A.; Uther, John B.

doi:10.1042/cs051365s

Cited by 9 publications

(6 citation statements)

References 6 publications

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“…This is another demonstration that the intensity of straining, translated into stroke volume reductions, conditions the vascular sympathetic activation [32]. A pharmacological approach also demonstrated the crucial role of the reflex vascular sympathetic activation during phase II, showing that a Valsalva maneuver determined profound hypotension, reaching 40 mmHg, in control subjects after alpha-adrenoceptor blockade [20,27].…”

Section: Discussionmentioning

confidence: 96%

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Tuba players reproduce a Valsalva maneuver while playing high notes

Elghozi

Girard

Fritsch³

et al. 2008

Clin Auton Res

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Playing wind instruments requires expiratory efforts. Blowing low notes on a tuba means a low resistance to expiration while playing high notes requires a strenuous expiratory strain. The resulting high intrathoracic pressure may reproduce a Valsalva maneuver. Ten tuba players were asked to blow medium loud long (15 seconds) notes at three different pitches (low, middle, and high) and to perform Valsalva maneuvers at 10, 40, and 60 mmHg. Blood pressure (BP) was measured continuously with a Finapres monitor. The four classic phases of the Valsalva maneuver were reproduced with the notes. The expiratory effort produced systolic BP and pulse pressure falls reaching about 24 mmHg with the high note or the Valsalva 60. BP and pulse pressure falls were linearly related to stroke volume reductions. Reflex heart rate (HR) changes were inversely related to BP falls, with maximal increases for the high notes (24 beats/minute) and Valsalva 60 (33 beats/minute). High baroreflex sensitivity was associated with a high HR response. Total peripheral resistance was reflexly elevated to counteract cardiac output reductions. During rebreathing, BP overshoots reached 30 mmHg for the high note and 53 mmHg for the Valsalva 60. Altogether, these findings indicate that blowing notes on a tuba reproduces the cardiovascular changes seen with a Valsalva maneuver with the effects of blowing high notes being close to a classic (40 mmHg) Valsalva maneuver. In addition, the baroreflex sensitivity might be a predictor of the ability to surmount the BP intolerance that could occur during wind instrument playing.

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Section: Discussionmentioning

confidence: 96%

“…Many factors such as preexisting hypertension or age may affect the vascular and HR responses to the Valsalva maneuver [8,20,31]. It is evident that an autonomic neuropathy or drugs affecting the autonomic nervous system function may alter the responses to a Valsalva maneuver and supposedly to blowing notes on a wind instrument.…”

Section: Discussionmentioning

confidence: 99%

Tuba players reproduce a Valsalva maneuver while playing high notes

Elghozi

Girard

Fritsch³

et al. 2008

Clin Auton Res

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“…The three groups were studied to see if any of the changes were only seen in the hypertensive subjects, or if they were related to the rise of blood pressure right through the population. Some of the results have been briefly presented previously (Korner et al, 1976a).…”

Section: Introductionmentioning

confidence: 99%

Valsalva constrictor and heart rate reflexes in subjects with essential hypertension and with normal blood pressure

Pi¹,

Tonkin²,

Uther³

1979

Clin Exp Pharmacol Physiol

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1.The haemodynamic and heart rate responses to graded expiratory pressures were studied during Valsalva manoeuvres of standard 30 s duration in two groups of normotensives in the upper (n = 10) and lower (n = 9) halves of the 'normal' blood pressure range, and in a group of essential hypertensive subjects with minimal complications (n = 10). Haemodynamic variables were arterial, atrial and peripheral vein pressures, cardiac output and total peripheral resistance.2. Reflex and mechanical effects of the manoeuvre were assessed in each subject from changes in the relationship between the expiratory pressure and circulatory responses before autonomic blockade, after cardiac effector block and after 'total' blockade.3. The relationships between expiratory pressure and central and peripheral vein pressures were not changed by autonomic blockade, indicating that they depended on mechanical factors. In hypertensives the rise in venous pressures per unit expiratory pressure was significantly smaller than in normotensive subjects.4. The expiratory pressure-related rise in total peripheral resistance was reflex and was similar in magnitude in all groups before autonomic blockade. However, after cardiac effector blockade the rise was greatest in the hypertensive subjects. The sensitivity of the constrictor response was related t o the subjects' resting total peripheral resistance index when measurements from all subjects were included. 5.The reflex heart rate responses of the hypertensives showed: (i) accentuation of the bradycardia at the start of forced expiration; (ii) an increased threshold for eliciting tachycardia during the latter part of the manoeuvre; and (iii) attenuation of the 'overshoot' bradycardia following release of expiratory pressure.6. The differences between the responses of hypertensives and normotensives were relatively small and probably depended at least partly on differences in venous filling, structural differences of resistance vessels and different afferent inputs through arterial and cardiopulmonary baroreceptors.

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“…1969) suggests that any effect from this action is not important. The rise in blood pressure during the effort phase of Valsalva's manoeuvre is not inhibited by (3-receptor-blocking drugs Prichard et al, 1970b), and more direct measure ments have not found any evidence of inhibition of vasoconstriction (Korner et al, 1976). No depression of the cold pressor test was seen after 3 weeks of oral propranolol in male hypertensive patients, again suggesting that the innervation of the a-receptor was not impeded (Guazzi et al, 1976).…”

Section: Adrenergic Neurone-blocking Effects O F (3-receptor-blockingmentioning

confidence: 87%

<i>β</i>-Adrenoceptor-Blocking Agents in the Management of Hypertension

Prichard

1979

Cardiology

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Valsalva Vasoconstrictor Reflex in Human Hypertension and after β-Adrenoreceptor Blockade in Conscious Rabbits

Cited by 9 publications

References 6 publications

Tuba players reproduce a Valsalva maneuver while playing high notes

Tuba players reproduce a Valsalva maneuver while playing high notes

Valsalva constrictor and heart rate reflexes in subjects with essential hypertension and with normal blood pressure

<i>β</i>-Adrenoceptor-Blocking Agents in the Management of Hypertension

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Valsalva Vasoconstrictor Reflex in Human Hypertension and after β-Adrenoreceptor Blockade in Conscious Rabbits

Cited by 9 publications

References 6 publications

Tuba players reproduce a Valsalva maneuver while playing high notes

Tuba players reproduce a Valsalva maneuver while playing high notes

Valsalva constrictor and heart rate reflexes in subjects with essential hypertension and with normal blood pressure

<i>&beta;</i>-Adrenoceptor-Blocking Agents in the Management of Hypertension

Contact Info

Product

Resources

About

<i>β</i>-Adrenoceptor-Blocking Agents in the Management of Hypertension