Role of the heart in blood pressure lowering during chronic baroreflex activation: insight from an in silico analysis

American Journal of Physiology. Heart and Circulatory Physiology
John S ClemmerThomas E Lohmeier

Abstract

Electrical stimulation of the baroreflex chronically suppresses sympathetic activity and arterial pressure and is currently being evaluated for the treatment of resistant hypertension. The antihypertensive effects of baroreflex activation are often attributed to renal sympathoinhibition. However, baroreflex activation also decreases heart rate, and robust blood pressure lowering occurs even after renal denervation. Because controlling renal sympathetic nerve activity (RSNA) and cardiac autonomic activity cannot be achieved experimentally, we used an established mathematical model of human physiology (HumMod) to provide mechanistic insights into their relative and combined contributions to the cardiovascular responses during baroreflex activation. Three-week responses to baroreflex activation closely mimicked experimental observations in dogs including decreases in blood pressure, heart rate, and plasma norepinephrine and increases in plasma atrial natriuretic peptide (ANP), providing validation of the model. Simulations showed that baroreflex-induced alterations in cardiac sympathetic and parasympathetic activity lead to a sustained depression of cardiac function and increased secretion of ANP. Increased ANP and suppression of ...Continue Reading

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Citations

Mar 29, 2019·Circulation Research·Thomas E Lohmeier, John E Hall
Aug 31, 2019·American Journal of Physiology. Heart and Circulatory Physiology·John S ClemmerThomas E Lohmeier
Jun 6, 2020·Annual Review of Biomedical Engineering·W Andrew PruettRobert L Hester
Sep 30, 2019·Morphologie : Bulletin De L'Association Des Anatomistes·R L HesterA Ruckdeschel
Apr 23, 2021·Acta Physiologica·Gisele L CavalcanteJoão Paulo J Sabino

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Software Mentioned

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HumMod

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