Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea

Krzysztof Narkiewicz, Catherine A. Pesek, Masahiko Kato, Bradley G. Phillips, Diane E. Davison, Virend Somers

Research output: Contribution to journalArticle

162 Citations (Scopus)

Abstract

Patients with obstructive sleep apnea are at increased risk for hypertension. The mechanisms underlying this increased risk are not known. We tested the hypothesis that obstructive sleep apnea, independent of factors such as hypertension, obesity, and age, is characterized by impairment of baroreflex sensitivity. We measured muscle sympathetic nerve activity (MSNA) and heart rate responses to activation and deactivation of baroreceptors in newly diagnosed, never treated, normotensive patients with obstructive sleep apnea. These responses were compared with those obtained in healthy control subjects closely matched for age, body mass index, and blood pressure. Heart rate and MSNA changes during infusion of phenylephrine (baroreceptor activation) were similar in the control subjects and patients with sleep apnea. Infusion of nitroprusside (baroreceptor deactivation) elicited similar decreases in mean arterial pressure (MAP) but lesser MSNA increases in patients with sleep apnea than in control subjects. Calculation of AMSNA/AMAP ratio revealed that baroreflex regulation of sympathetic activity for similar blood pressure changes was diminished in patients with sleep apnea in comparison to normal control subjects (P=0.01). However, increases in heart rate during nitroprusside infusion were comparable in both groups. Sympathetic, blood pressure and heart rate responses to the cold pressor test were also similar in the 2 groups. Our results indicate that normotensive patients with sleep apnea have a selective impairment of the sympathetic response to baroreceptor deactivation but not to baroreceptor activation or to the cold pressor test. The impairment of baroreflex sympathetic modulation in patients with sleep apnea is not accompanied by any impairment of baroreflex control of heart rate.

Original languageEnglish (US)
Pages (from-to)1039-1043
Number of pages5
JournalHypertension
Volume32
Issue number6
StatePublished - Dec 1998
Externally publishedYes

Fingerprint

Baroreflex
Obstructive Sleep Apnea
Pressoreceptors
Sleep Apnea Syndromes
Heart Rate
Nitroprusside
Blood Pressure
Hypertension
Muscles
Phenylephrine
Myocardium
Healthy Volunteers
Arterial Pressure
Body Mass Index
Obesity

Keywords

  • Autonomic nervous system
  • Baroreceptors
  • Blood pressure
  • Heart rate
  • Sleep apnea
  • Sympathetic nervous system

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Narkiewicz, K., Pesek, C. A., Kato, M., Phillips, B. G., Davison, D. E., & Somers, V. (1998). Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea. Hypertension, 32(6), 1039-1043.

Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea. / Narkiewicz, Krzysztof; Pesek, Catherine A.; Kato, Masahiko; Phillips, Bradley G.; Davison, Diane E.; Somers, Virend.

In: Hypertension, Vol. 32, No. 6, 12.1998, p. 1039-1043.

Research output: Contribution to journalArticle

Narkiewicz, K, Pesek, CA, Kato, M, Phillips, BG, Davison, DE & Somers, V 1998, 'Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea', Hypertension, vol. 32, no. 6, pp. 1039-1043.
Narkiewicz K, Pesek CA, Kato M, Phillips BG, Davison DE, Somers V. Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea. Hypertension. 1998 Dec;32(6):1039-1043.
Narkiewicz, Krzysztof ; Pesek, Catherine A. ; Kato, Masahiko ; Phillips, Bradley G. ; Davison, Diane E. ; Somers, Virend. / Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea. In: Hypertension. 1998 ; Vol. 32, No. 6. pp. 1039-1043.
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