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Cited by 96Heart Rate Variability and Autonomic ControlCardiovascular Syncope and Autonomic DisordersBlood Pressure and Hypertension Studies

Baroreflex control of muscle sympathetic nerve activity in borderline hypertension.

Rea, R F, Hamdan, M·1990·Circulation
DOI 10.1161/01.cir.82.3.856
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Abstract

Patients with borderline hypertension have exaggerated vascular responses to orthostatic stress produced by tilt or lower body negative pressure (LBNP). It has been suggested that 1) in the supine position, these patients have augmented activity of cardiopulmonary baroreceptors that exerts an increased restraint on sympathetic vasoconstrictor tone; 2) withdrawal of this augmented inhibitory baroreceptor activity during orthostatic stress elicits augmented reflex sympathetic vasoconstrictor outflow; and 3) augmented cardiopulmonary baroreceptor activity may be secondary to impaired arterial baroreflex mechanisms. To test these hypotheses, we recorded muscle sympathetic nerve activity from the peroneal nerve in seven borderline hypertensive subjects and seven age-, sex-, and weight-matched normotensive subjects during three levels of nonhypotensive LBNP and infusions of phenylephrine and nitroprusside. During LBNP, reductions of central venous pressure were similar in borderline hypertensive and normotensive subjects, and arterial pressure and heart rate values were unchanged. Increases of sympathetic nerve activity, however, were significantly greater in borderline hypertensive than in normotensive subjects at each level of LBNP, indicating an augmented gain of the cardiopulmonary baroreflex. To determine whether this augmentation is related to impairment of arterial baroreflexes, we measured changes of sympathetic nerve activity during increases and decreases of arterial pressure produced with infusions of intravenous phenylephrine and nitroprusside. Central venous pressure was held at control levels by LBNP during phenylephrine and saline infusion during nitroprusside. Changes of sympathetic nerve activity during alterations of arterial pressure were similar in borderline hypertensive and normotensive subjects. These data show that cardiopulmonary baroreflex control of SNA is augmented in borderline hypertensive subjects and that this augmentation does not result from an attenuation of the arterial baroreflex.

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  • Although there are exceptions, the weight of evidence suggests that in the early stages of hypertension, particularly in young patients, there is marked adrenergic overdrive.

    “Although there are several exception34,35, the weight of evidence suggest that in the early stages of hypertension, particularly in young patients, there is marked adrenergic overdrive, a finding that supports the hypothesis that sympathetic overactivity occurs in the clinical phases of essential hypertension.”

    From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [34]

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Authors
Rea, R. F., & Hamdan, M.
Affiliations
University of Iowa (US)
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1990-09
Volume
82
Issue
3
Pages
856-862
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.82.3.856
OpenAlex
W2164012016
Cited by
96
References
18
Citations by year
2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 3 · 2012: 1
FWCI
3.39
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
borderline hypertension, muscle sympathetic nerve activity, cardiopulmonary baroreflex, arterial baroreflex, orthostatic stress, lower body negative pressure, phenylephrine, sodium nitroprusside, central venous pressure, peroneal nerve
MeSH terms
Blood Pressure, Central Venous Pressure, Humans, Hypertension, Lower Body Negative Pressure, Male, Muscles, Nitroprusside, Phenylephrine, Pressoreceptors, Reference Values, Sympathetic Nervous System

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