Document Detail


Hemodynamic and autonomic correlates of postexercise hypotension in patients with mild hypertension.
MedLine Citation:
PMID:  11893607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated the interplay of neural and hemodynamic mechanisms in postexercise hypotension (PEH) in hypertension. In 15 middle-aged patients with mild essential hypertension, we evaluated blood pressure (BP), cardiac output (CO), total peripheral resistance (TPR), forearm (FVR) and calf vascular resistance (CVR), and autonomic function [by spectral analysis of R-R interval and BP variabilities and spontaneous baroreflex sensitivity (BRS)] before and after maximal exercise. Systolic and diastolic BP, TPR, and CVR were significantly reduced from baseline 60-90 min after exercise. CO, FVR, and HR were unchanged. The low-frequency (LF) component of BP variability increased significantly after exercise, whereas the LF component of R-R interval variability was unchanged. The overall change in BRS was not significant after exercise vs. baseline, although a significant, albeit small, BRS increase occurred in response to hypotensive stimuli. These findings indicate that in hypertensive patients, PEH is mediated mainly by a peripheral vasodilation, which may involve metabolic factors linked to postexercise hyperemia in the active limbs. The vasodilator effect appears to override a concomitant, reflex sympathetic activation selectively directed to the vasculature, possibly aimed to counter excessive BP decreases. The cardiac component of arterial baroreflex is reset during PEH, although the baroreflex mechanisms controlling heart period appear to retain the potential for greater opposition to hypotensive stimuli.
Authors:
Jacopo M Legramante; Alberto Galante; Michele Massaro; Antonio Attanasio; Gianfranco Raimondi; Fabio Pigozzi; Ferdinando Iellamo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of physiology. Regulatory, integrative and comparative physiology     Volume:  282     ISSN:  0363-6119     ISO Abbreviation:  Am. J. Physiol. Regul. Integr. Comp. Physiol.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-03-14     Completed Date:  2002-04-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100901230     Medline TA:  Am J Physiol Regul Integr Comp Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  R1037-43     Citation Subset:  IM    
Affiliation:
Dipartimento di Medicina Interna, Centro di Riabilitazione Cardiologica San Raffaele and Università di Roma Tor Vergata, 00173 Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Autonomic Nervous System / physiology
Baroreflex / physiology
Blood Pressure / physiology
Cardiac Output / physiology
Exercise / physiology*
Female
Heart Rate / physiology
Humans
Hypertension / physiopathology*
Hypotension / physiopathology*
Male
Middle Aged
Vascular Resistance / physiology

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


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