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Cardiovascular reflexes and hypertension.

A Zanchetti1, G Mancia

  • 1Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.

Hypertension (Dallas, Tex. : 1979)
|November 1, 1991
PubMed
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Hypertension blunts arterial baroreceptor and cardiopulmonary reflexes, impairing blood pressure and volume regulation. These reflex changes are consequences, not causes, of hypertension, often linked to left ventricular hypertrophy.

Area of Science:

  • Cardiovascular Physiology
  • Hypertension Pathophysiology
  • Autonomic Nervous System Regulation

Background:

  • Arterial baroreceptor and cardiopulmonary reflexes are crucial for blood pressure and volume homeostasis.
  • These reflexes are known to be altered in human hypertension.

Purpose of the Study:

  • To investigate the modifications in arterial baroreceptor and cardiopulmonary reflexes in hypertension.
  • To determine if these reflex alterations are a cause or consequence of hypertension.

Main Methods:

  • Vasoactive drug injection and neck chamber technique for arterial baroreceptor reflex assessment.
  • Passive leg raising and lower body negative pressure for cardiopulmonary reflex assessment.
  • Echocardiography to evaluate left ventricular hypertrophy.

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Main Results:

  • Arterial baroreceptor reflexes are reset and blunted, affecting heart rate and blood pressure regulation.
  • Cardiopulmonary reflexes are blunted, impacting peripheral vasoconstriction and renin release.
  • Left ventricular hypertrophy, more than hypertension itself, induces cardiopulmonary reflex blunting.

Conclusions:

  • Modified arterial and cardiopulmonary reflexes in hypertension reduce the effectiveness of buffering blood pressure and volume changes.
  • These reflex alterations appear to be a consequence, not a cause, of hypertension.
  • Left ventricular hypertrophy plays a significant role in the blunting of cardiopulmonary reflexes, which can improve with antihypertensive therapy.