Abstract-The role of baroreflexes in long-term control of arterial pressure is unresolved. To determine whether chronic activation of the baroreflex produces sustained hypotension, we developed a method for prolonged activation of the carotid baroreflex in conscious dogs. This was achieved by chronically implanting electrodes around both carotid sinuses and using an externally adjustable pulse generator to electrically activate the carotid baroreflex. Control values for mean arterial pressure (MAP) and heart rate were 93Ϯ3 mm Hg and 64Ϯ4 bpm, respectively. After control measurements, the carotid baroreflex was activated bilaterally for 7 days at a level that produced a prompt and substantial reduction in MAP, and for day 1 MAP was reduced to 75Ϯ4 mm Hg. Moreover, this hypotensive response was sustained throughout the entire 7 days of baroreflex activation (day 7, MAPϭ72Ϯ5 mm Hg). During prolonged baroreflex activation, heart rate decreased in parallel with MAP, although the changes were not as pronounced (day 7, heart rateϭ51Ϯ3 bpm). Prolonged baroreflex activation was also associated with Ϸ35% reduction in plasma norepinephrine concentration (controlϭ87Ϯ15 pg/mL). After baroreflex activation, hemodynamic measures and plasma levels of norepinephrine returned to control levels. Interestingly, despite the pronounced fall in MAP, plasma renin activity did not increase during prolonged baroreflex activation. These data indicate that prolonged baroreflex activation can lead to substantial reductions in MAP by suppressing the sympathetic nervous system. Furthermore, sustained sympathoinhibitory effects on renin secretion may play an important role in mediating the long-term hypotensive response. Key Words: baroreflex Ⅲ arterial pressure Ⅲ sympathetic nervous system Ⅲ renin-angiotensin system Ⅲ sodium S ince McCubbin et al 1 demonstrated a marked resetting of the arterial baroreflex in chronic hypertension, there has been considerable skepticism that baroreflexes participate in long-term control of arterial pressure. 2-5 Nonetheless, because of the importance of this neural feedback mechanism in the acute regulation of sympathetic activity and arterial pressure, there has been continued interest in the possibility that baroreflexes may play a role in the pathogenesis of hypertension. Indeed, a recurrent hypothesis to account for excessive sympathetic activation in hypertension is baroreflex dysfunction, an associated finding in some forms of experimental and clinical hypertension. 2,3,6,7 However, whether impaired baroreflex suppression of sympathetic activity plays a role in the hypertensive process would appear to depend on whether baroreflexes completely reset when exposed to chronic changes in arterial pressure. If, in fact, resetting is complete and baroreflexes do not chronically alter sympathetic activity, then they could not produce functional changes that influence the severity of hypertension.The fundamental question of whether baroreflexes completely reset and have the capacity to chronically alter sympathet...

Chronic pressure-mediated baroreflex activation suppresses renal sympathetic nerve activity. Recent observations indicate that chronic electrical activation of the carotid baroreflex produces sustained reductions in global sympathetic activity and arterial pressure. Thus, we investigated the effects of global and renal specific suppression of sympathetic activity in dogs with sympathetically-mediated, obesity-induced hypertension by comparing the cardiovascular, renal, and neurohormonal responses to chronic baroreflex activation and bilateral surgical renal denervation. After control measurements, the diet was supplemented with beef fat while sodium intake was held constant. After 4 weeks on the high-fat, when body weight had increased ~a 50%, fat intake was reduced to a level that maintained this body weight. This weight increase was associated with an increase in mean arterial pressure from 100±2 to 117±3 mm Hg and heart rate from 86±3 to 130±4 bpm. The hypertension was associated with a marked increase in cumulative sodium balance despite ~ a 35% increase in GFR. The importance of increased tubular reabsorption to sodium retention was further reflected by ~ a 35% decrease in fractional sodium excretion. Subsequently, both chronic baroreflex activation (7 days) and renal denervation decreased plasma renin activity and abolished the hypertension. However, baroreflex activation also suppressed systemic sympathetic activity and tachycardia and reduced glomerular hyperfiltration while increasing fractional sodium excretion. In contrast, GFR increased further after renal denervation. Thus, by improving autonomic control of cardiac function and diminishing glomerular hyperfiltration, suppression of global sympathetic activity by baroreflex activation may have beneficial effects in obesity beyond simply attenuating hypertension.

Abstract-Despite recent evidence indicating sustained activation of the baroreflex during chronic infusion of angiotensin II (Ang II), sinoaortic denervation does not exacerbate the severity of the hypertension. Therefore, to determine whether Ang II hypertension is relatively resistant to the blood pressure-lowering effects of the baroreflex, the carotid baroreflex was electrically activated bilaterally for 7 days in 5 dogs both in the presence and absence of a continuous infusion of Ang II (5 ng/kg per minute) producing high physiological plasma levels of the peptide. Under control conditions, basal values for mean arterial pressure (MAP) and plasma norepinephrine concentration (NE) were 93Ϯ1 mm Hg and 99Ϯ25 pg/mL, respectively. By day 7 of baroreflex activation, MAP and NE were reduced to 72Ϯ4 mm Hg (Ϫ21Ϯ3 mm Hg) and 56Ϯ15 pg/mL, respectively, but PRA was unchanged (controlϭ0.41Ϯ0.06 ng ANG I/mL per hour). All values returned to basal levels by the end of a 7-day recovery period. After 7 days of Ang II infusion, MAP increased from 93Ϯ3 to 129Ϯ3 mm Hg, whereas NE fell from 117Ϯ15 to 86Ϯ23 pg/mL. During the next 7 days of baroreflex activation/Ang II infusion, further reductions in NE were not statistically significant, and on the final day of baroreflex activation, the reduction in MAP was only 5Ϯ1 mm Hg, compared with 21Ϯ3 mm Hg in the control normotensive state.