Aims: The prognostic value of baroreflex sensitivity in hypertensive patients has not much been studied.
Method: A cohort of 451 hypertensive patients without cardiovascular history was studied for an average of 6.2 +/- 2.8 years follow-up. Each patient had a baroreflex sensitivity measurement by the sequence method, which is represented by the slope of up-sequences (systolic blood pressure+/pulse interval+) and down-sequences (systolic blood pressure-/pulse interval-) of spontaneous fluctuations in systolic blood pressure and pulse interval.
Results: During the follow-up, there were 20 deaths from any cause and 30 patients presented a major adverse cardiovascular event. Deaths and major adverse cardiovascular events were associated with a reduction in baroreflex sensitivity (systolic blood pressure+/pulse interval+ and systolic blood pressure-/pulse interval-). In multivariate analysis, the reduction in baroreflex sensitivity systolic blood pressure+/pulse interval+ was associated with an increased risk of deaths from any cause (Odds ratio 1.23; 95% confidence interval 1.02-1.67, P = 0.04). A baroreflex sensitivity systolic blood pressure+/pulse interval+ under 4.5 ms/mmHg was associated with a 2.5-increased relative risk of major adverse cardiovascular event (95% confidence interval 1.11-5.93, P = 0.03). However, multivariate analysis showed that baroreflex sensitivity systolic blood pressure-/pulse interval- was not associated either with death or major adverse cardiovascular events.
Conclusions: Reduction in baroreflex sensitivity marked by a reduction in vagal reflexes is an independent marker of the risk of mortality and major adverse cardiovascular events in hypertensive patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/HJH.0b013e3283015e5a | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Meeting international self-report muscle strengthening guidelines is associated with better cardiovagal baroreflex sensitivity in adults.
Front Sports Act Living
December 2024
Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada.
Engaging in muscle strengthening activities (e.g., resistance training) at least twice/week is promoted by (Inter)national movement guidelines.
View Article and Find Full Text PDFComputational modelling of cardiac control following myocardial infarction using an in silico patient cohort.
J Physiol
December 2024
Daniel Baugh Institute for Functional Genomics and Computational Biology, Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Loss of cardiac physiological function following myocardial infarction (MI) is accompanied by neural adaptations in the baroreflex that are compensatory in the short term, but then become associated with long-term disease progression. One marker of these adaptations is decreased baroreflex sensitivity, a strong predictor of post-MI mortality. The relative contributions of cardiac remodelling and neural adaptation in the sensory, central brainstem and peripheral ganglionic loci to baroreflex sensitivity changes remain underexplored.
View Article and Find Full Text PDFSensitivity analysis of closed-loop one-chamber and four-chamber models with baroreflex.
PLoS Comput Biol
December 2024
Sano Centre for Computational Medicine, Cracow, Poland.
The baroreflex is one of the most important control mechanisms in the human cardiovascular system. This work utilises a closed-loop in silico model of baroreflex regulation, coupled to pulsatile mechanical models with (i) one heart chamber and 36-parameters and (ii) four chambers and 51 parameters. We perform the first global sensitivity analysis of these closed-loop systems which considers both cardiovascular and baroreflex parameters, and compare the models with their respective unregulated equivalents.
View Article and Find Full Text PDFExploration of simultaneous transients between cerebral hemodynamics and the autonomic nervous system using windowed time-lagged cross-correlation matrices: a CENTER-TBI study.
Acta Neurochir (Wien)
December 2024
Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke Hospital, University of Cambridge, Cambridge, UK.
Background: Traumatic brain injury (TBI) can significantly disrupt autonomic nervous system (ANS) regulation, increasing the risk for secondary complications, hemodynamic instability, and adverse outcome. This retrospective study evaluated windowed time-lagged cross-correlation (WTLCC) matrices for describing cerebral hemodynamics-ANS interactions to predict outcome, enabling identifying high-risk patients who may benefit from enhanced monitoring to prevent complications.
Methods: The first experiment aimed to predict short-term outcome using WTLCC-based convolution neural network models on the Wroclaw University Hospital (WUH) database (P = 31 with 1,079 matrices, P = 16 with 573 matrices).
Neurocardiology: Major mechanisms and effects.
J Electrocardiol
November 2024
Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America.
Neurocardiology is a broad interdisciplinary specialty investigating how the cardiovascular and nervous systems interact. In this brief introductory review, we describe several key aspects of this interaction with specific attention to cardiovascular effects. The review introduces basic anatomy and discusses physiological mechanisms and effects that play crucial roles in the interaction of the cardiovascular and nervous systems, namely: the cardiac neuraxis, the taxonomy of the nervous system, integration of sensory input in the brainstem, influences of the autonomic nervous system (ANS) on heart and vasculature, the neural pathways and functioning of the arterial baroreflex, receptors and ANS effects in the walls of blood vessels, receptors and ANS effects in excitable cells in the heart, ANS effects on heart rate and sympathovagal balance, endo-epicardial inhomogeneity, ANS effects with a balanced vagal and sympathetic stimulation, sympathovagal interaction, arterial baroreflex, baroreflex sensitivity and heart rate variability, arrhythmias and the arterial baroreflex, the cardiopulmonary baroreflex, the exercise pressor reflex, exercise-recovery hysteresis, mental stress, cardiac-cardiac reflexes, the cardiac sympathetic afferent reflex (CSAR), and neuromodulation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!