Diminished Baroreflex Sensitivity in High Blood Pressure

Bristow, James; Honour, A. J.; Pickering, George; Sleight, Peter; Smyth, Harley S.

doi:10.1161/01.cir.39.1.48

Cited by 550 publications

(293 citation statements)

References 25 publications

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“…Importantly, evidence now accumulating suggests that impaired BRS may precede development of hypertension [40][41][42]. We have previously demonstrated that even in the absence of diabetic kidney disease, type 1 diabetes is associated with isolated systolic hypertension and a prematurely increasing pulse pressure, suggestive of accelerated arterial stiffening [43].…”

Section: Discussionmentioning

confidence: 91%

Early autonomic dysfunction in type 1 diabetes: a reversible disorder?

et al. 2009

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Aims/hypothesis Cardiac autonomic neuropathy is associated with increased morbidity and mortality rates in patients with type 1 diabetes. The prevalence of early autonomic abnormalities is relatively high compared with the frequency of manifest clinical abnormalities. Thus, early autonomic dysfunction could to some extent be functional and might lead to an organic disease in a subgroup of patients only. If this is true, manoeuvres such as slow deep-breathing, which can improve baroreflex sensitivity (BRS) in normal but not in denervated hearts, could also modify autonomic modulation in patients with type 1 diabetes, despite autonomic dysfunction.Methods We compared 116 type 1 diabetic patients with 36 matched healthy control participants and 12 hearttransplanted participants with surgically denervated hearts. Autonomic function tests and spectral analysis of heart rate and blood pressure variability were performed. BRS was estimated by four methods during controlled (15 breaths per minute) and slow deep-breathing (six breaths per minute), and in supine and standing positions. Results Conventional autonomic function tests were normal, but resting spectral variables and BRS were reduced during normal controlled breathing in patients with type 1 diabetes. However, slow deep-breathing improved BRS in patients with type 1 diabetes, but not in patients with surgically denervated hearts. Standing induced similar reductions in BRS in diabetic and control participants. Conclusions/interpretation Although we found signs of increased sympathetic activity in patients with type 1 diabetes, we also observed a near normalisation of BRS with a simple functional test, indicating that early autonomic derangements are to a large extent functional and potentially correctable by appropriate interventions.

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Section: Discussionmentioning

confidence: 91%

Early autonomic dysfunction in type 1 diabetes: a reversible disorder?

et al. 2009

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“…Recent evidence suggests that changes in arterial baroreflex control and the autonomous nervous system are involved in the development and maintenance of hypertension. [29][30][31] In a classic study carried out in the 1960's, Bristow et al 32 reported for the first time that the baroreflex control of HR in patients with hypertension was significantly lower than that of normotensive individuals. Herein, we have observed that baroreflex sensitivity in normotensive rats is much higher than in SHRs, which supports the previous study.…”

Section: Discussionmentioning

confidence: 99%

Brain nitric oxide production by a proline-rich decapeptide from Bothrops jararaca venom improves baroreflex sensitivity of spontaneously hypertensive rats

Lameu

Pontieri

Guerreiro³

et al. 2010

Hypertens Res

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Baroreflex sensitivity is disturbed in many people with cardiovascular diseases such as hypertension. Brain deficiency of nitric oxide (NO), which is synthesized by NO synthase (NOS) in the citrulline-NO cycle (with argininosuccinate synthase (ASS) activity being the rate-limiting step), contributes to impaired baroreflex. We recently showed that a decapeptide isolated from Bothrops jararaca snake venom, denoted Bj-PRO-10c, exerts powerful and sustained antihypertensive activity. Bj-PRO-10c promoted vasodilatation dependent on the positive modulation of ASS activity and NO production in the endothelium, and also acted on the central nervous system, inducing the release of GABA and glutamate, two important neurotransmitters in the regulation of autonomic systems. We evaluated baroreflex function using the regression line obtained by the best-fit points of measured heart rate (HR) and mean arterial pressure (MAP) data from spontaneously hypertensive rats (SHRs) treated with Bj-PRO-10c. We also investigated molecular mechanisms involved in this effect, both in vitro and in vivo. Bj-PRO-10c mediated an increase in baroreflex sensitivity and a decrease in MAP and HR. The effects exerted by the peptide include an increase in the gene expression of endothelial NOS and ASS. Bj-PRO-10c-induced NO production depended on intracellular calcium fluxes and the activation of a G i/o -protein-coupled metabotropic receptor. Bj-PRO-10c induced NO production and the gene expression of ASS and endothelial NOS in the brains of SHRs, thereby improving baroreflex sensitivity. Bj-PRO-10c may reveal novel approaches for treating diseases with impaired baroreflex function. Hypertension Research (2010Research ( ) 33, 1283Research ( -1288 doi:10.1038/hr.2010 Keywords: argininosuccinate synthase; baroreflex sensitivity; Bothrops jararaca venom; nitric oxide; proline-rich oligopeptide INTRODUCTIONThe gaseous messenger NO is involved mainly in the regulation of local and systemic vascular resistance, sodium balance and, consequently, blood pressure control, 1 but it is also a signaling molecule and modulator of brain function. 2 Recent studies relate NO with central cardiovascular control through the regulation of the cardiac and vascular autonomic system via the modulation of the central sites of cardiovascular autonomic neural integration. 3,4 NO is generated in the citrulline-NO cycle by NO synthase (NOS) using L-arginine as a substrate. Three isoforms of NOS have been described: calcium-dependent endothelial (eNOS) and neuronal (nNOS) isoforms and inducible NOS. The expression and activity

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“…Systolic BP instead of MAP was used in the calculation because of the ease and accuracy of this measurement. 25 …”

Section: Carotid Baroreceptor Sensitivitymentioning

confidence: 99%

The effect of 4 weeks of aerobic exercise on vascular and baroreflex function of young men with a family history of hypertension

Goldberg

Boutcher

2011

J Hum Hypertens

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The effect of short-term aerobic exercise on vascular function of young individuals with a family history of hypertension was investigated. Thirty young men with a family history of hypertension were randomly assigned to either an exercise (n ¼ 15) or control (n ¼ 15) group. Exercise subjects performed 30 min of supervised cycle training at 65% of their maximal oxygen uptake ( . VO 2max ), three times per week for 4 weeks. Control subjects were asked to maintain their normal levels of physical activity. Peak leg and forearm blood flow were assessed using plethysmography and was determined as the highest blood flow following 5 min of reactive hyperemia. Cardiopulmonary baroreceptor (CPBR) sensitivity was measured using lower body negative pressure (LBNP) for 5 min at À20 mm Hg. CPBR was determined by calculating change of stroke volume and forearm vascular resistance at baseline and during LBNP. Carotid baroreceptor (CBR) sensitivity was assessed using neck suction at À20, À40, À60 and À80 mm Hg pressures, and was determined from RR interval divided by systolic blood pressure. Augmentation index (AIx), a measure of arterial stiffness, was assessed using applanation tonometry and was calculated as the ratio of augmented pressure and pulse pressure. The major findings were that the exercise group showed increase in leg vasodilation, reduction in AIx and increase in .VO 2max compared with the control group (Po0.05). However, there was no significant change for CPBR and CBR. A short-term moderate-intensity aerobic exercise intervention in young men with a family history of hypertension significantly reduced arterial stiffness and increased aerobic fitness.

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Diminished Baroreflex Sensitivity in High Blood Pressure

Cited by 550 publications

References 25 publications

Early autonomic dysfunction in type 1 diabetes: a reversible disorder?

Early autonomic dysfunction in type 1 diabetes: a reversible disorder?

Brain nitric oxide production by a proline-rich decapeptide from Bothrops jararaca venom improves baroreflex sensitivity of spontaneously hypertensive rats

The effect of 4 weeks of aerobic exercise on vascular and baroreflex function of young men with a family history of hypertension

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