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Baroreflex function and centrally acting antihypertensive drugs

  • Gordon P. GuthrieJr.

Abstract

The baroreflex is a neural circuit that has powerful effects on blood pressure and heart rate. First recognized in the 1920s (Koch and Mies 1929), it is now known to involve sensory endings (arterial baroreceptors) in both the carotid sinus and the aortic arch. These produce afferent impulses which are transmitted via the glossopharyngeal (carotid) and vagus (aortic) nerves to synapses within the nucleus tractus solitarius of the medulla. Ultimately, blood pressure and heart rate are affected by parallel sympathetic and parasympathetic modulation. Following the initial description of the baroreflex, it was speculated that a primary disturbance of its function might lead to hypertension in man. This speculation remains active today, supported by observations that impairment of the baroreflex function can produce hypertension in animals and in man. The development of centrally acting antihypertensive drugs, including Clonidine hydrochloride, has provided further information about the neurophysiology of the baroreflex, including evidence that baroreflex modulation may be a component action of such drugs.

Keywords

Carotid Sinus Nucleus Tractus Solitarius Baroreflex Sensitivity Baroreflex Function Sustained Hypertension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Aars H (1972) Effects of Clonidine on aortic diameter and aortic baroreceptor activity. Eur J Pharmacol 20:52–59.PubMedCrossRefGoogle Scholar
  2. 2.
    Bauernfeind R, Hall C, Denes P, Rosen KM (1978) Carotid sinus hypersensitivity with alpha methyldopa. Ann Int Med 88:214–215.PubMedGoogle Scholar
  3. 3.
    Brown AM (1980) Receptors under pressure: an update on baroreceptors. Circ Res 46:1–10.PubMedGoogle Scholar
  4. 4.
    Carretta R, Fabris B, Bellini G, Tonutti L, Battilana G, Bianchetti A, Campanacci L (1983) Baroreflex function after therapy withdrawal in patients with essential hypertension. Clin Sci 64:259–263.PubMedGoogle Scholar
  5. 5.
    Cowley AW Jr., Liard JF, Guyton AC (1973) Role of the baroreceptor reflex in daily control of arterial blood pressure and other variables in dogs. Circ Res 32:564–576.PubMedGoogle Scholar
  6. 6.
    Eckberg DL (1979) Carotid baroreflex function in young men with borderline blood pressure elevation. Circulation 59:623–636.Google Scholar
  7. 7.
    Gribbin B, Pickering TG, Sleight P, Peto R (1971) Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res 29:424–431.PubMedGoogle Scholar
  8. 8.
    Guthrie GP Jr., Kotchen TA (1983) Effects of oral Clonidine on baroreflex function in patients with essential hypertension. Chest 83 (Suppl): 327–328.PubMedGoogle Scholar
  9. 9.
    Haeusler G (1977) Neuronal mechanisms influencing transmission in the baroreceptor reflex arc. In: De Jong W, Provoost SP, Shapiro AP (eds), Hypertension and Brain Mechanisms, Prog Brain Res 47:95–109.CrossRefGoogle Scholar
  10. 10.
    Kobinger W, Walland A (1972) Evidence for a central activation of a vagalcardiodepressor reflex by Clonidine. Eur J Pharmacol 19:203–209.PubMedCrossRefGoogle Scholar
  11. 11.
    Koch E, Mies A (1929) Chronischer arterieller Hochdruck durch experimentelle Dauerausschaltung der Blutdruckzügler. Krankheitsforsch 7:241–256.Google Scholar
  12. 12.
    Korner PI, West MJ, Shaw J, Uther JB (1974) Steady state properties of the baroreceptor-heart rate reflex in essential hypertension in man. Clin Exp Pharmacol Physiol 1:65–76.PubMedCrossRefGoogle Scholar
  13. 13.
    Korner PI, Oliver JR, Sleight P, Robinson JS, Chalmers JP (1975) Assessment of cardiac autonomic excitability in renal hypertensive rabbits using clonidine-induced resetting of the baroreceptor-heart rate reflex. Eur J Pharmacol 33:353–362.PubMedCrossRefGoogle Scholar
  14. 14.
    Kotchen TA, Guthrie GP Jr., McKean H, Kotchen JM (1982) Adrenergic responsiveness in prehypertensive subjects. Circulation 65:285–290.PubMedCrossRefGoogle Scholar
  15. 15.
    Mancia G, Ferrari A, Gregorini L, Zanchetti A (1979). Clonidine and carotid baroreflex in essential hypertension. Hypertension 1:362–370.PubMedGoogle Scholar
  16. 16.
    Mancia G, Ferrari A, Gregorini L, Ferrari C, Bianchini C, Terzoli L, Leonetti G, Zanchetti A (1980) Effect of prazosin on autonomic control of circulation in essential hypertension. Hypertension 2:700–707.PubMedGoogle Scholar
  17. 17.
    Nowak SJG (1940) Chronic hypertension produced by carotid sinus and aortic-depressor nerve section. Ann Surg 111:102–111.PubMedCrossRefGoogle Scholar
  18. 18.
    Ripley RC, Hollifield JW, Nies AS (1977) Sustained hypertension after section of the glossopharyngeal nerve. Am J Med 62:297–302PubMedCrossRefGoogle Scholar
  19. 19.
    Sasso EH, O’Connor DT (1982) Prazosin depression of baroreflex function in hypertensive man. Eur J Clin Pharmacol 22:7–14.PubMedCrossRefGoogle Scholar
  20. 20.
    Simon AC, Safar ME, Weiss YA, London GM, Milliez PL (1977a) Baroreflex sensitivity and cardiopulmonary blood volume in normotensive and hypertensive patients. Br Heart J 39:799–805.PubMedCrossRefGoogle Scholar
  21. 21.
    Simon G, Kiowski W, Julius S (1977b) Effect of beta-adrenoceptor antagonists on baroreceptor reflex sensitivity in hypertension. Clin Pharmacol Ther 22:293–298.PubMedGoogle Scholar
  22. 22.
    Sleight P, West MJ (1975) The effects of Clonidine on the baroreflex arc in man. In: Davies DS, Reid JL (eds), Central action of drugs in blood pressure regulation. Pitman Medical, Tunbridge, Wells 291–299.Google Scholar
  23. 23.
    Sleight P (1979) Reflex control of the heart. AM J Cardio 44:889–894.CrossRefGoogle Scholar
  24. 24.
    Sleight P, Gribbin B, Pickering TG (1979) Baroreflex sensitivity in normal and hypertensive man: the effect of beta adrenergic blockade on reflex sensitivity. Post Grad Med J 47:79–81.Google Scholar
  25. 25.
    Smyth HS, Sleight P, Pickering GW (1969) Reflex regulation of arterial pressure during sleep in man: a quantitative method of assessing baroreflex sensitivity. Circ Res 24:109–112.PubMedGoogle Scholar
  26. 26.
    Takeshita et al. (1975) Circulation 51:739.Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1984

Authors and Affiliations

  • Gordon P. GuthrieJr.
    • 1
  1. 1.Division of Endocrinology, Department of MedicineUniversity of Kentucky College of MedicineLexingtonUSA

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