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Baroreflex sensitivity in essential and secondary hypertension
Hanna Mussalo1, Esko Vanninen, Risto Ikäheimo
1Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P. O. Box 1777, 70211 Kuopio, Finland. Hanna.Mussalo@kuh.fi
Summary
Baroreflex sensitivity (BRS) is reduced in severe hypertension, regardless of cause. Mild essential hypertension shows normal BRS, suggesting dysfunction relates to hypertension severity, not etiology.
Area of Science:
- Cardiovascular Physiology
- Hypertension Research
- Autonomic Nervous System Function
Background:
- Baroreceptor reflex regulation adapts to higher blood pressure in hypertension, but its role in hypertension development is unclear.
- Limited data exist on baroreflex sensitivity (BRS) in long-standing, medically treated hypertension of varying etiologies and severities.
Purpose of the Study:
- To investigate baroreflex sensitivity (BRS) in patients with different severities and forms of chronic, medically treated hypertension.
- To compare BRS across renovascular hypertension (RVHT), severe essential hypertension (SEHT), mild essential hypertension (MEHT), and healthy controls.
Main Methods:
- Baroreflex sensitivity (BRS) was assessed using the phenylephrine method.
- Study included patients with RVHT (n=14), SEHT (n=36), MEHT (n=29), and age/sex-matched healthy controls.
Main Results:
- BRS was similarly reduced in RVHT and SEHT groups compared to MEHT and control groups.
- BRS in RVHT and SEHT did not differ significantly after adjusting for age, gender, and left ventricular mass index.
- BRS in the MEHT group was comparable to that of healthy controls.
Conclusions:
- Baroreflex dysfunction in hypertension is linked to clinical severity rather than etiology.
- Impaired BRS is evident in both renovascular and severe essential hypertension.
- Mild essential hypertension, even when long-standing and medically treated, shows preserved baroreflex sensitivity.