The Role of the Autonomic Nervous System in the Regulation of Aortic Stiffness

Hypertension. 2016 Nov;68(5):1290-1297. doi: 10.1161/HYPERTENSIONAHA.116.08035. Epub 2016 Sep 26.


The autonomic nervous system is important in regulating blood pressure, but whether it regulates aortic stiffness is more contentious. We conducted 3 studies in young, healthy individuals to address this important question. Study 1 was a cross-sectional study of 347 subjects with detailed measurements of hemodynamics and heart rate variability. In study 2, 9 subjects were given a bolus of intravenous nicotinic ganglion blocker, pentolinium, or saline in a random order and hemodynamics and heart rate variability were assessed before and after. In study 3, changes in hemodynamics and heart rate variability were assessed during stimulation of the sympathetic nervous system with the use of isometric handgrip exercise in 12 subjects. Study 1: aortic pulse wave velocity (P=0.003) was lowest in the subjects with the highest parasympathetic activity, but after adjusting for mean arterial pressure, the effect was abolished (P=0.3). Study 2: after pentolinium, sympathetic and parasympathetic activity fell (P=0.001 for both), mean arterial pressure, and heart rate increased (P=0.004 and P=0.04, respectively), but there was no change in pulse wave velocity in comparison to placebo (P=0.1). Study 3: during handgrip exercise, sympathetic activity (P=0.003), mean arterial pressure (P<0.0001), and aortic pulse wave velocity increased (P=0.013). However, pulse wave velocity adjusted for mean arterial pressure did not change (P=0.1). The main finding of these studies is that in young healthy subjects, the autonomic nervous system does not have a pressure-independent role in the regulation of aortic stiffness. However, these findings may not apply to patients with increased sympathetic tone or hypertension.

Keywords: aortic stiffness; autonomic nervous system; blood pressure; healthy volunteers; heart rate; hemodynamics.

Publication types

  • Comparative Study
  • Observational Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arterial Pressure / physiology*
  • Autonomic Nervous System / physiopathology*
  • Cross-Over Studies
  • Cross-Sectional Studies
  • Double-Blind Method
  • Female
  • Hand Strength / physiology
  • Healthy Volunteers
  • Heart Rate / drug effects
  • Heart Rate / physiology*
  • Hemodynamics / physiology*
  • Humans
  • Hypertension / physiopathology*
  • Male
  • Pentolinium Tartrate / administration & dosage
  • Prognosis
  • Pulse Wave Analysis
  • Role
  • Vascular Stiffness / drug effects*
  • Vascular Stiffness / physiology
  • Young Adult


  • Pentolinium Tartrate