Document Detail

Implications of sino-aortic baroreceptor reflex dysfunction in severe preeclampsia.
MedLine Citation:
PMID:  2733938     Owner:  NLM     Status:  MEDLINE    
Loss of sino-aortic baroreceptor reflex sensitivity has been associated with various forms of hypertension. Baroreflexive dysfunction antedates elevation of blood pressure (BP) in some forms of hypertension, and may play a role in their pathogenesis. We studied baroreflex function in seven women with severe preeclampsia being treated with intravenous hydralazine. As indices of baroreflex sensitivity and hemodynamic competence, we measured the reflexive elevations in heart rate (HR) (delta HR/delta BP) and cardiac index (CI) (delta CI/delta BP) in response to hydralazine-induced falls in blood pressure. The change in cardiac index per unit change in systemic vascular resistance index (SVRI) (delta CI/delta SVRI) served as an additional measure of hemodynamic competence. The results indicated that a higher baseline blood pressure was associated with a dramatic reduction in baroreflex sensitivity (delta HR/delta BP) and baroreflex control of blood pressure (delta CI/delta BP and delta CI/delta SVRI). In patients with higher baseline blood pressures, the severe impairment of baroreflex function eliminated the normal circulatory buffer against vasodilator-induced hypotension. Abrupt and profound reductions in blood pressure and the development of fetal distress in response to hydralazine occurred in the patients with higher initial blood pressures. In addition, the present results suggest that phenomena such as the blood pressure lability and increased responsiveness to angiotensin that characterize preeclampsia are, at least in part, reflections of baroreflex dysfunction.
N Wasserstrum; B Kirshon; I K Rossavik; R S Willis; K J Moise; D B Cotton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  74     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-07-21     Completed Date:  1989-07-21     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  34-9     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
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MeSH Terms
Blood Pressure / drug effects
Cardiac Output
Heart Rate
Hydralazine / pharmacology
Pre-Eclampsia / physiopathology*
Pressoreceptors / physiopathology*
Reg. No./Substance:

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