Baroreceptor sensitivity Dotaz Zobrazit nápovědu
Observačné prieskumy ukazujú nízke percento kontrolovaného krvného tlaku. Zlá kontrola tlaku krvi sa pripisuje trom hlavným dôvodom: 1. veľká časť pacientov nie je identifikovaná alebo liečená, najmä v nízko alebo stredne príjmových krajinách, 2. mnoho liečených pacientov nie je adekvátne alebo trvalo kontrolovaných svojimi lekármi alebo neužívajú predpísanú liečbu, 3. malá, ale podstatná časť hypertonikov sa ťažko lieči kvôli rezistentnej hypertenzii, ktorá zahŕňa aj liekmi indukovanú hypertenziu a sekundárnu hypertenziu. Kľúčové slová: baroreceptorová stimulácia, rezistentná hypertenzia, baroreflexná senzitivita
Observational surveys show low rates of blood pressure control. Poor control of blood pressure is attributed to three major reasons: 1. very large proportion of the patients is not identified or not treated, especially in low or low middle income countries, 2. many treated patients are not adequately or persistently managed by their physicians or the patients are not compliant with the prescribed treatment, 3. smaller but substantial proportion of hypertensive patients are difficult to be controlled due to resistant hypertension including drug induced hypertension and secondary hypertension. Key words: baroreceptor stimulation, resistant hypertension, baroreflex sensitivity
STR/N is an inbred strain of mice which is known to exhibit extreme polydipsia and polyuria. We previously found central administration of angiotensin II enhanced cardiovascular responses in STR/N mice than normal mice, suggesting that STR/N mice might exhibit different cardiovascular responses. Therefore, in this study, we investigated daily mean arterial blood pressure and heart rate, and changes in the baroreceptor-heart rate reflex in conscious STR/N mice and control (ICR) mice. We found that variability in daily mean arterial blood pressure and heart rate was significantly larger in STR/N mice than in ICR mice (p<0.05). There was a stronger response to phenylephrine (PE) in STR/N mice than in ICR mice. For baroreceptor reflex sensitivity, in the rapid response period, the slopes of PE and sodium nitroprusside (SNP) were more negative in STR/N mice than in ICR mice. In the later period, the slopes of PE and SNP were negatively correlated between heart rate and blood pressure in ICR mice, but their slopes were positively correlated in STR/N mice. These results indicated that STR/N mice exhibited the different cardiovascular responses than ICR mice, suggesting that the dysfunction of baroreceptor reflex happened in conscious STR/N mice.
- MeSH
- baroreflex účinky léků MeSH
- fenylefrin farmakologie MeSH
- krevní tlak MeSH
- myši inbrední ICR MeSH
- myši MeSH
- nitroprusid farmakologie MeSH
- polydipsie genetika patofyziologie MeSH
- presoreceptory patofyziologie MeSH
- srdeční frekvence * účinky léků MeSH
- vazodilatancia farmakologie MeSH
- vazokonstriktory farmakologie MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- antracykliny aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- baroreflex MeSH
- dítě MeSH
- dospělí MeSH
- finanční podpora výzkumu jako téma MeSH
- leukemie farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- nádory farmakoterapie MeSH
- tělesná námaha MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- přehledy MeSH
- srovnávací studie MeSH
- MeSH
- baroreflex MeSH
- dospělí MeSH
- infarkt myokardu terapie MeSH
- krevní tlak MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhlá srdeční smrt prevence a kontrola MeSH
- rizikové faktory MeSH
- spektrální analýza MeSH
- trombolytická terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- srovnávací studie MeSH
- MeSH
- baroreflex fyziologie genetika MeSH
- financování organizované MeSH
- krevní tlak genetika MeSH
- lidé MeSH
- srdeční frekvence genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
It has been known for many years that baroreflex sensitivity is lowered in hypertensive patients. There are several known factors implicating this association, e.g. high blood pressure leads to remodeling of the carotid arterial wall, to its stiffness and to a diminished activation of baroreceptors; leptin released from a fatty tissue activates the sympathetic nervous system etc. On the other hand, low baroreflex sensitivity (BRS, usually quantified in ms/mmHg) can be inborn. Studies on primary hypertension in children and adolescents have brought new information about the role of baroreflex in the development of an early stage of primary hypertension. BRS lower than 3.9 ms/mmHg was found in 5 % of healthy subjects. This value approaches the critical value for the risk of sudden cardiac death in patients after myocardial infarction and corresponds to the value present in hypertensive patients. A decreased BRS and BRSf (baroreflex sensitivity expressed in mHz/mmHg, index independent of the mean cardiac interval), was found not only in children with hypertension, but also in those with white-coat hypertension. This is in accordance with a single interpretation. The decrease of BRS/BRSf precedes a pathological blood pressure increase. The contribution of obesity and BRS/BRSf to the development of hypertension in adolescents was also compared. Both factors reach a sensitivity and a specificity between 60 % and 65 %, but there is no correlation between the values of the body mass index and BRS either in the group of hypertensive patients or in healthy controls. If a receiver operating curve (sensitivity versus specificity) is plotted for both values together using logistic regression analysis, a sensitivity higher than 70 % and a specificity over 80 % are reached. This means that low baroreflex sensitivity is an independent risk factor for the development of primary hypertension. Studies demonstrate that adolescents with increased blood pressure and with BRS under 7 ms/mmHg should be given care and intensively motivated to change their lifestyle including a change in diet and increase in physical activity.
- MeSH
- ambulantní monitorování krevního tlaku MeSH
- baroreflex MeSH
- financování organizované MeSH
- hypertenze genetika patofyziologie MeSH
- lidé MeSH
- mladiství MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- antropometrie MeSH
- baroreflex * fyziologie MeSH
- dospělí MeSH
- index tělesné hmotnosti MeSH
- lidé středního věku MeSH
- lidé MeSH
- presoreceptory fyziologie MeSH
- roztroušená skleróza * diagnóza patofyziologie MeSH
- srdeční frekvence fyziologie MeSH
- statistika jako téma MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
