Document Detail


Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients.
MedLine Citation:
PMID:  20101001     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 > or =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 > or =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.
Authors:
Karsten Heusser; Jens Tank; Stefan Engeli; Andr? Diedrich; Jan Menne; Siegfried Eckert; Tim Peters; Fred C G J Sweep; Hermann Haller; Andreas M Pichlmaier; Friedrich C Luft; Jens Jordan
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study     Date:  2010-01-25
Journal Detail:
Title:  Hypertension     Volume:  55     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-19     Completed Date:  2010-03-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  619-26     Citation Subset:  IM    
Affiliation:
Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / therapeutic use
Baroreflex / physiology
Blood Pressure / physiology*
Carotid Sinus / innervation*
Drug Resistance / physiology
Electric Stimulation Therapy / methods*
Feasibility Studies
Female
Heart Rate / physiology
Humans
Hypertension / drug therapy,  physiopathology*,  therapy*
Male
Middle Aged
Neural Inhibition / physiology
Pressoreceptors / physiology*
Prospective Studies
Renin / blood
Stroke Volume / physiology
Sympathetic Nervous System / physiology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; EC 3.4.23.15/Renin
Comments/Corrections
Comment In:
Hypertension. 2010 Mar;55(3):607-9   [PMID:  20100993 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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