Carotid Baroreceptor Stimulation, Sympathetic Activity, Baroreflex Function, and Blood Pressure in Hypertensive Patients
Abstract
In animals, electric field stimulation of carotid baroreceptors elicits a depressor response through sympathetic inhibition. We tested the hypothesis that the stimulation acutely reduces sympathetic vasomotor tone and blood pressure in patients with drug treatment–resistant arterial hypertension. Furthermore, we tested whether the stimulation impairs the physiological baroreflex regulation. We studied 7 men and 5 women (ages 43 to 69 years) with treatment-resistant arterial hypertension. A bilateral electric baroreflex stimulator at the level of the carotid sinus (Rheos) was implanted ≥1 month before the study. We measured intra-arterial blood pressure, heart rate, muscle sympathetic nerve activity (microneurography), cardiac baroreflex sensitivity (cross-spectral analysis and sequence method), sympathetic baroreflex sensitivity (threshold technique), plasma renin, and norepinephrine concentrations. Measurements were performed under resting conditions, with and without electric baroreflex stimulation, for ≥6 minutes during the same experiment. Intra-arterial blood pressure was 193±9/94±5 mm Hg on medications. Acute electric baroreflex stimulation decreased systolic blood pressure by 32±10 mm Hg (range: +7 to −108 mm Hg; P =0.01). The depressor response was correlated with a muscle sympathetic nerve activity reduction ( r 2 =0.42; P <0.05). In responders, muscle sympathetic nerve activity decreased sharply when electric stimulation started. Then, muscle sympathetic nerve activity increased but remained below the baseline level throughout the stimulation period. Heart rate decreased 4.5±1.5 bpm with stimulation ( P <0.05). Plasma renin concentration decreased 20±8% ( P <0.05). Electric field stimulation of carotid sinus baroreflex afferents acutely decreased arterial blood pressure in hypertensive patients, without negative effects on physiological baroreflex regulation. The depressor response was mediated through sympathetic inhibition.
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An implantable device for bilateral electric baroreceptor stimulation that decreases sympathetic tone alleviates obesity-associated hypertension in experimental and clinical settings.
“An implantable device for bilateral electric baroreceptor stimulation that decreases sympathetic tone alleviates obesity-associated hypertension in experimental and clinical settings (22–24).”
From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [23]
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- Authors
- Heusser, K., Tank, J., Engeli, S., Diedrich, A., Menne, J., Eckert, S., Peters, T., Sweep, F. C. G. J., Haller, H., Pichlmaier, A. M., Luft, F. C., & Jordan, J.
- Affiliations
- Vanderbilt University (US)
- From the Institute of Clinical Pharmacology (K.H., J.T., S.En., J.J.), Department of Internal Medicine (J.M., H.H.), and Division of Cardiothoracic, Transplantation, and Vascular Surgery (A.M.P.), Hannover Medical School, Hannover, Germany; Autonomic Dysfunction Service (A.D.), Vanderbilt University, Nashville, Tenn; Department of Cardiology (S.Ec.), Ruhr University of Bochum, Bad Oeyenhausen, Germany; R&D Consulting (T.P.), Riehen, Switzerland; Department of Chemical Endocrinology (F.C.G.J.S.),...
- ORCID
- Venue
- Hypertension
- Published
- 2010-03
- Volume
- 55
- Issue
- 3
- Pages
- 619-626
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2162619801
- Cited by
- 433
- References
- 45
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 25 · 2023: 16 · 2022: 15 · 2021: 11 · 2020: 16 · 2019: 22 · 2018: 20 · 2017: 34 · 2016: 30 · 2015: 46 · 2014: 39 · 2013: 47 · 2012: 39
- FWCI
- 29.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (P01HL056693)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- carotid sinus, treatment-resistant hypertension, hypertension, muscle sympathetic nerve activity, baroreflex sensitivity, sympathetic vasomotor tone, blood pressure reduction, plasma renin, norepinephrine, heart rate, electrical field stimulation
- MeSH terms
- Adult, Aged, Antihypertensive Agents, Blood Pressure, Carotid Sinus, Drug Resistance, Electric Stimulation Therapy, Feasibility Studies, Female, Heart Rate, Humans, Hypertension, Male, Middle Aged, Neural Inhibition, Pressoreceptors, Prospective Studies, Renin, Stroke Volume, Sympathetic Nervous System, Baroreflex
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