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Baroreflex sensitivity modulates vasodepressor response to nitroprusside.

A M Shepherd, M S Lin, J L McNay

    Hypertension (Dallas, Tex. : 1979)
    |January 1, 1983
    PubMed
    Summary
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    The baroreflex response to blood pressure changes in hypertensive patients depends on initial blood pressure and sympathetic nervous system activity. Higher baseline blood pressure and lower sympathetic response correlate with a reduced vasodepressor effect from sodium nitroprusside.

    Area of Science:

    • Cardiovascular Physiology
    • Hypertension Research
    • Autonomic Nervous System Function

    Background:

    • Baroreflex activity is crucial for maintaining blood pressure homeostasis.
    • Essential hypertension is characterized by altered cardiovascular regulation.
    • Understanding baroreflex modulation is key to managing hypertensive states.

    Purpose of the Study:

    • To investigate factors influencing the vasodepressor response to sodium nitroprusside in hypertensive patients.
    • To determine the relationship between baseline blood pressure, sympathetic activity, and baroreflex sensitivity.
    • To elucidate the mechanisms underlying variable responses to antihypertensive agents.

    Main Methods:

    • Sequential incremental intravenous infusions of sodium nitroprusside (0.05 to 6.4 micrograms/kg/min) in eight male patients with essential hypertension.

    Related Experiment Videos

  • Measurement of changes in mean arterial pressure (delta MAP), heart rate (delta HR), and plasma norepinephrine (delta NE) at each infusion level.
  • Analysis of correlations between drug dosage, hemodynamic parameters, and neurochemical markers.

    • Main Results:

    • Significant correlations were observed between delta MAP and log dose NP, delta HR and delta MAP, and delta NE and delta MAP.
    • Individual patient responses (slopes) varied significantly and correlated with control blood pressure.
    • Sympathetic responsiveness (delta NE vs. delta MAP) was inversely correlated with the vasodepressor response magnitude.

    Conclusions:

    • The magnitude of the vasodepressor response to sodium nitroprusside is influenced by predrug blood pressure, potentially due to vascular geometry changes in hypertension.
    • Sympathetic nervous system responsiveness plays a significant role, likely through reflex alpha-adrenergic vasoconstriction.
    • These findings highlight the complex interplay of factors determining baroreflex effectiveness in essential hypertension.