Clinical Significance of Baroreflex Sensitivity in Hypertensive Patients After Acute Ischemic Stroke

Celovska, Denisa; Staško, Ján; Gonsorčík, J; Dukát, Andrej

doi:10.1097/00004872-201106001-00296

Cited by 3 publications

(16 citation statements)

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“…24–26 Baroreceptors at the carotid bulb help regulate blood pressure by means of a vagal component that decreases the heart rate or alternatively by a sympathetic (adrenergic) component increasing peripheral resistance and the heart rate. 27 Baroreceptors have been shown to “reset” their baseline blood pressure level after a 48-hour period of sustained increase or decrease in mean arterial pressure (resetting phenomenon).…”

Section: Discussionmentioning

confidence: 99%

Beta-blocker use is associated with lower stroke and death after carotid artery stenting

Obeid

Arhuidese

Gaidry

et al. 2016

Journal of Vascular Surgery

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Background Proper selection of patients for carotid artery stenting (CAS) remains controversial despite multiple controlled trials. This relates in part to differences in interpretation of the relative importance of myocardial vs stroke complications after the procedure by different specialties and a lack of granular clinical data to analyze outcomes outside the large clinical trials. The objective of this study was to assess the effect of preoperative medications, procedure parameters, and patient characteristics on outcomes of CAS performed in a multispecialty national database. Methods We analyzed all patients who underwent CAS between 2005 and2014in the Vascular Quality Initiative. A multivariate logistic regression model was built to assess the effects of age, gender, comorbidities, smoking, preprocedure medications, procedure details, and hypotension or hypertension that required intravenous medication on 30-day death or stroke rates. Results A total of 5263patients underwent CAS (mean age, 70years;63%male). The 30-day stroke/death rate was 3.4%(1.5% minor stroke, 0.9% major stroke, and 1.2% death; 40% of patients who had major strokes died within 30 days), and the myocardial infarction rate was 0.8%. Postprocedural hypertension requiring treatment occurred in 519 cases (9.9%), and it was associated with a 3.4-fold increase in stroke/death (odds ratio, 3.39; 95% confidence interval, 2.30–5.00; P < .0001). Preprocedural beta-blocker use for >30 days was associated with a 34% reduction in the stroke/death risk (odds ratio, 0.66; 95% confidence interval, 0.46–0.95; P = .025) compared with nonuse. Beta-blocker use was not associated with postprocedural hypotension. Other predictors of postoperative stroke and death included age, symptomatic status, diabetes (type 1 or type 2), and postprocedural hypotension, whereas prior carotid endarterectomy and distal embolic protection use were protective. Conclusions Postprocedural hypertension and hypotension that require treatment are both strongly associated with periprocedural stroke/death after CAS. Beta blockers significantly reduce the stroke/death risk associated with carotid stenting and should be investigated prospectively for potential use during CAS.

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Section: Discussionmentioning

confidence: 99%

Beta-blocker use is associated with lower stroke and death after carotid artery stenting

Obeid

Arhuidese

Gaidry

et al. 2016

Journal of Vascular Surgery

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“…Table 2 summarizes the characteristics of selected studies. Two of the 19 studies are longitudinal studies [ 40 , 42 ], 11 are case–control studies [ 20 , 35 , 37 , 39 , 43 , 44 , 46 – 48 , 50 , 51 ], while the remaining are cohort studies which only involve the hypertension group [ 34 , 36 , 38 , 41 , 45 , 49 ]. 15 studies involved participants with a mean age ranging from 40 to 65 years [ 20 , 34 – 37 , 39 – 44 , 46 , 48 – 50 ], while three studies recruited older individuals aged above 65 years [ 45 , 47 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two of the 19 studies are longitudinal studies [ 40 , 42 ], 11 are case–control studies [ 20 , 35 , 37 , 39 , 43 , 44 , 46 – 48 , 50 , 51 ], while the remaining are cohort studies which only involve the hypertension group [ 34 , 36 , 38 , 41 , 45 , 49 ]. 15 studies involved participants with a mean age ranging from 40 to 65 years [ 20 , 34 – 37 , 39 – 44 , 46 , 48 – 50 ], while three studies recruited older individuals aged above 65 years [ 45 , 47 , 51 ]. Of all included studies, 12 included both normotensive control and essential hypertensive subjects [ 43 ], with both mixed genders involved [ 20 , 35 , 37 , 39 , 40 , 44 , 46 – 48 , 50 , 51 ], whereas one study investigated the association between autonomic control and vascular condition in men with essential hypertension only [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Non-invasive parameters of autonomic function using beat-to-beat cardiovascular variations and arterial stiffness in hypertensive individuals: a systematic review

Ooi,

Lim,

Seng

et al. 2024

BioMed Eng OnLine

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Purpose Non-invasive, beat-to-beat variations in physiological indices provide an opportunity for more accessible assessment of autonomic dysfunction. The potential association between the changes in these parameters and arterial stiffness in hypertension remains poorly understood. This systematic review aims to investigate the association between non-invasive indicators of autonomic function based on beat-to-beat cardiovascular signals with arterial stiffness in individuals with hypertension. Methods Four electronic databases were searched from inception to June 2022. Studies that investigated non-invasive parameters of arterial stiffness and autonomic function using beat-to-beat cardiovascular signals over a period of > 5min were included. Study quality was assessed using the STROBE criteria. Two authors screened the titles, abstracts, and full texts independently. Results Nineteen studies met the inclusion criteria. A comprehensive overview of experimental design for assessing autonomic function in terms of baroreflex sensitivity and beat-to-beat cardiovascular variabilities, as well as arterial stiffness, was presented. Alterations in non-invasive indicators of autonomic function, which included baroreflex sensitivity, beat-to-beat cardiovascular variabilities and hemodynamic changes in response to autonomic challenges, as well as arterial stiffness, were identified in individuals with hypertension. A mixed result was found in terms of the association between non-invasive quantitative autonomic indices and arterial stiffness in hypertensive individuals. Nine out of 12 studies which quantified baroreflex sensitivity revealed a significant association with arterial stiffness parameters. Three studies estimated beat-to-beat heart rate variability and only one study reported a significant relationship with arterial stiffness indices. Three out of five studies which studied beat-to-beat blood pressure variability showed a significant association with arterial structural changes. One study revealed that hemodynamic changes in response to autonomic challenges were significantly correlated with arterial stiffness parameters. Conclusions The current review demonstrated alteration in autonomic function, which encompasses both the sympathetic and parasympathetic modulation of sinus node function and vasomotor tone (derived from beat-to-beat cardiovascular signals) in hypertension, and a significant association between some of these parameters with arterial stiffness. By employing non-invasive measurements to monitor changes in autonomic function and arterial remodeling in individuals with hypertension, we would be able to enhance our ability to identify individuals at high risk of cardiovascular disease. Understanding the intricate relationships among these cardiovascular variability measures and arterial stiffness could contribute toward better individualized treatment for hypertension in the future. Systematic review registration: PROSPERO ID: CRD42022336703. Date of registration: 12/06/2022.

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“…The arterial barorefl ex is defi ned as one of the most important physiological mechanisms involves in homeostasis of blood pressure (BP) (1). Barorefl ex sensitivity (BRS) damage is a marker of autonomic dysfunction and plays a major role in the long-term development of arterial hypertension and related complications (2).…”

mentioning

confidence: 99%

“…Which further incorporate to a vicious cycle of hypertension and related complications. The baroreceptor refl ex serves blood pressure buffer system for damping short-term variations of arterial pressure (1). Due to their complex rest in any new MAP baroreceptors have minor importance on chronic (6).…”

mentioning

confidence: 99%

Morphine and nicotine addiction and withdrawal influence baroreflex sensitivity and blood pressure in two-kidney one clip hypertensive (2K1C) rats

Zeinivand¹,

Shamsizadeh²,

Pourshanazari³

et al. 2014

BLL

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Abstract:Objective: This study aimed to investigate the effects of addiction to morphine and nicotine as well as their withdrawal on both barorefl ex sensitivity and blood pressure in hypertensive rats. Methods: In this experimental study 40 male rats were divided into two main groups as follows: in group I, hypertensive rats received saline for 8 weeks; in group II, hypertensive rats were treated with morphine and nicotine for 8 weeks. At the end of 8 weeks group II rats were divided into four sub-groups including, 3 sub-groups of those were put on drug withdrawal protocol. At the end of experiment, blood pressure, heart rate, plasma renin activity (PRA), serum NO concentration and barorefl ex sensitivity (BRS) were measured. Results: Results demonstrated that BP and BRS were signifi cantly lower in addicted to morphine and nicotine hypertensive rats compared to control (p < 0.05). Addiction withdrawal (in morphine and nicotine withdrawal rats) completely reversed BP and BRS to the pre-addiction levels (p < 0.05). Withdrawal in the only nicotine treated group lowered BP and BRS compared to group that had received morphine and nicotine together (p < 0.05). Conclusion: Results of current study may propose simultaneous morphine and nicotine withdrawal can prevent cardiovascular complications raised due to withdrawal (Fig. 5, Ref. 58). Text in PDF www.elis.sk.

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Clinical Significance of Baroreflex Sensitivity in Hypertensive Patients After Acute Ischemic Stroke

Cited by 3 publications

References 0 publications

Beta-blocker use is associated with lower stroke and death after carotid artery stenting

Beta-blocker use is associated with lower stroke and death after carotid artery stenting

Non-invasive parameters of autonomic function using beat-to-beat cardiovascular variations and arterial stiffness in hypertensive individuals: a systematic review

Morphine and nicotine addiction and withdrawal influence baroreflex sensitivity and blood pressure in two-kidney one clip hypertensive (2K1C) rats

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