Baroreflex buffering and susceptibility to vasoactive drugs

Circulation
Jens JordanFriedrich C Luft

Abstract

The overall effect of vasoactive drugs on blood pressure is determined by a combination of the direct effect on vascular tone and an indirect baroreflex-mediated effect, a baroreflex buffering of blood pressure. Differences in baroreflex function affect the responsiveness to vasoactive medications, particularly baroreflex buffering of blood pressure; however, the magnitude is not known. We characterized baroreflex function and responses to vasoactive drugs in patients with idiopathic orthostatic intolerance, patients with essential hypertension, patients with monogenic hypertension and brachydactyly, patients with multiple system atrophy, and control subjects. We used phenylephrine sensitivity during ganglionic blockade as a measure of baroreflex buffering. Phenylephrine (25 microg) increased systolic blood pressure 6+/-1.6 mm Hg in control subjects, 6+/-1.1 mm Hg in orthostatic intolerance patients, 18+/-3.9 mm Hg in patients with essential hypertension, 31+/-3.4 mm Hg in patients with monogenic hypertension, and 25+/-3.4 mm Hg in patients with multiple system atrophy. Similar differences in sensitivities between groups were observed with nitroprusside. The sensitivity to vasoactive drugs was highly correlated with baroreflex ...Continue Reading

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Citations

Mar 2, 2011·European Journal of Applied Physiology·Matjaž Klemenc, Petra Golja
Nov 18, 2008·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Christoph SchroederJens Jordan
Oct 21, 2003·The Journal of Thoracic and Cardiovascular Surgery·Niv AdJames L Cox
Feb 25, 2011·Journal of Cardiovascular Pharmacology·Kenneth M MaddenGraydon S Meneilly
Sep 6, 2012·Cardiology·Patrícia RodriguesLuís Sousa-Pereira
Mar 17, 2006·Medicine and Science in Sports and Exercise·Joseph I EsformesKaren M Birch
Oct 8, 2013·Journal of Hypertension·Jens Jordan
Jan 26, 2012·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Silas W SmithJeffrey K Aronson
Nov 22, 2012·Autonomic Neuroscience : Basic & Clinical·Jens Jordan, Italo Biaggioni
Jun 4, 2010·The Journal of Physiology·Christiane HesseJohn H Eisenach
Dec 15, 2010·Psychophysiology·Evgeny G VaschilloMarsha E Bates
Jan 17, 2014·Journal of Clinical Pharmacology·C Michael White
May 6, 2005·Journal of Vascular Surgery·S A Reza NouraeiMichael E Gaunt
Mar 12, 2015·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Jens JordanItalo Biaggioni
Feb 28, 2016·Journal of Cardiovascular Electrophysiology·Yufan YangShenghua Zhou
Feb 14, 2003·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Gozewijn D LavermanGerjan Navis
Oct 11, 2011·Vascular and Endovascular Surgery·Ageliki PandaziGeorgia Kostopanagiotou
Jun 5, 2004·American Journal of Physiology. Heart and Circulatory Physiology·Demetra D ChristouDouglas R Seals
Apr 1, 2003·Circulation·Pamela Parker JonesDouglas R Seals
Apr 7, 2004·Circulation·Jens JordanItalo Biaggioni
Jul 24, 2002·Circulation·Jens JordanFriedrich C Luft
Sep 19, 2007·Hypertension·Jens TankJens Jordan
Nov 30, 2006·Hypertension·Alfredo GamboaItalo Biaggioni
Mar 24, 2004·Hypertension·Jens TankJens Jordan
May 7, 2003·Hypertension·Demetra D ChristouDouglas R Seals
May 14, 2003·Hypertension·Gianfranco PiccirilloVincenzo Marigliano
May 3, 2005·American Journal of Physiology. Heart and Circulatory Physiology·N Muenter SwiftP A Low
Jan 4, 2018·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Rasna SabharwalMark W Chapleau

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