Pathophysiological contribution of vascular function to baroreflex regulation in hypertension

Circ J. 2014;78(6):1414-9. doi: 10.1253/circj.cj-14-0064. Epub 2014 Apr 3.

Abstract

Background: We examined which pathophysiological abnormalities of vascular function might be closely associated with abnormal baroreflex regulation in subjects with hypertension.

Methods and results: In the cross-sectional assessment, 280 subjects with hypertension were enrolled for measurement of brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), flow-mediated vasodilatation (FMD) of the brachial artery and baroreceptor sensitivity (BRS). These parameters were measured again as prospective assessment in some of these subjects. In the cross-sectional assessment, after adjustment for confounding variables including anti-hypertensive medication, the baPWV, but not the rAI or FMD, was found to have a significant independent relationship with BRS (standardization coefficient, -0.149, P<0.043). In the subjects who were newly started on anti-hypertensive medication (n=40), regression of baPWV before and 1 year after the start of medication was significantly associated with change in BRS during the same period. In subjects already on anti-hypertensive medication (n=92) also, the evolutional change of baPWV over a follow-up period >1.5 years was significantly associated with change in BRS during the same period.

Conclusions: Increased stiffness of the large- to middle-sized arteries, rather than abnormal central hemodynamics or endothelial dysfunction, appears to contribute to abnormal baroreflex regulation in patients with hypertension.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Baroreflex*
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Vascular Stiffness*