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The balance between neural and hemodynamic factors is abolished in hypertensive men
Author(s) -
Hart Emma,
Burchell Amy,
Ratcliffe Laura,
Baumbach Andreas,
Nightingale Angus,
Paton Julian FR
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.1108.5
Subject(s) - microneurography , medicine , blood pressure , supine position , sympathetic nervous system , stroke volume , heart rate , cardiology , hemodynamics , balance (ability) , baroreflex , physical therapy , anesthesia
Bristol, Bristol, United Kingdom In normotensive men there is a balance among sympathetic nerve activity (SNA), peripheral resistance (TPR) and cardiac output (Q). Thus, the net effect that high resting levels of SNA has on blood pressure (BP) is minimal. SNA is elevated in resistant hypertensive men, despite treatment with three or more medications. We hypothesised that there would be an imbalance between SNA, TPR and Q in resistant hypertensive men. In 10 (age; 53 ± 4) resistant hypertensive men, we measured muscle SNA (peroneal microneurography), BP (cuff and Finapres) and heart rate (HR, ECG) during 10 minutes of supine rest. Stroke volume was calculated using Modelflow analysis on the Finapres BP waveform. Q was calculated as stroke volume × HR. MSNA was positively associated to TPR (r = 0.59, P<0.05), but not Q (r = 0.13). Thus mean BP was directly related to MSNA (r = 0.56, P<0.05). In summary, despite treatment with more than 3 anti‐hypertensive medications, high MSNA was related to high TPR, which was not balanced by lower Q (as it is in normotensive men). Consequently, sympathetic activity may continue to play a role in resistant hypertension despite treatments targeting the sympathetic nervous system. British Heart Foundation funded.