Baroreceptor function during exercise: resetting the record

This paper briefly reviews the historical evolution of ideas about how baroreflexes operate and continue to regulate arterial blood pressure during exercise. Observations from studies conducted in conscious humans and animals are emphasized and three main questions are asked. First, do baroreflexes contribute to arterial blood pressure regulation during exercise? Second, if baroreflexes contribute to blood pressure regulation during exercise, how do they do it? Third, are there any pathophysiological conditions in which manipulation of baroreflexes or baroreflex 'dysfunction' might alter exercise responses? In this context, ideas related to baroreflex resetting during exercise are emphasized, and the potential improvement in exercise tolerance in cardiovascular disease that might be achieved by electrical stimulation of the carotid sinus nerve is highlighted. Additionally, the key contributions of John Shepherd and the late David Donald (along with their colleagues) on related issues are noted.