Verapamil buffering effect on the abrupt elevation in blood pressure, linkage with microcirculatory blood flow

1 We studied the effects of verapamil on sudden elevation in blood pressure, microcirculation and arterial baroreflex sensitivity (BRS). 2 Thirty experiments (10 controls and 20 with verapamil) were performed in rabbits sedated using pentobarbital infusion (5 mg kg(-1) h(-1)). 3 BRS, mean femoral artery blood pressure (MAP), heart rate (HR) and ear lobe skin microcirculatory blood flow, estimated using microphotoelectric plethysmography (MPPG), were simultaneously measured during 30 min of verapamil infusion (20 mug kg(-1) min(-1)). BRS was assessed from HR and MAP responses to intravenous phenylephrine (Ph) and by power spectral analysis using transfer function (TF) from MAP to the HR (BRS(Ph,TF)). 4 Verapamil significantly increased microcirculatory blood flow, and decreased BRS(Ph,TF) and phenylephrine-induced abrupt elevation in MAP (MAP(AE)). 5 A significant inverse correlation was found between verapamil-induced changes in MAP(AE), BRS and in microcirculatory blood flow, measured before phenylephrine blood pressure ramps (DeltaMAP(AE) with DeltaBRS(TF), r = -0.47, P < 0.036; DeltaMAP(AE) with DeltaMPPG, r = -0.49, P < 0.025). 6 These results suggest involvement of the arterial baroreflex and vascular blood pressure-buffering mechanisms, their enhancement by verapamil, and thus a potential benefit of verapamil in cardiovascular conditions where patients present with abrupt high elevations in blood pressure.