Efficacy of Electrical Baroreflex Activation Is Independent of Peripheral Chemoreceptor Modulation

Karsten Heusser, Arvo Thöne, Axel Lipp, Jan Menne, Joachim Beige, Hannes Reuter, Fabian Hoffmann, Marcel Halbach, Siegfried Eckert, Manuel Wallbach, Michael Koziolek, Helge Haarmann, Michael J. Joyner, Julian F.R. Paton, André Diedrich, Hermann Haller, Jens Jordan, Jens Tank

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Arterial baroreflex activation through electrical carotid sinus stimulation has been developed for the treatment of resistant hypertension. Previous studies suggested that the peripheral chemoreflex is tonically active in hypertensive patients and may inhibit baroreflex responses. We hypothesized that peripheral chemoreflex activation attenuates baroreflex efficacy evoked by electrical carotid sinus stimulation. We screened 35 patients with an implanted electrical carotid sinus stimulator. Of those, 11 patients with consistent acute depressor response were selected (7 men/4 women, age: 67±8 years, body mass index: 31.6±5.2 kg/m2, 6±2 antihypertensive drug classes). We assessed responses to electrical baroreflex stimulation during normoxia, isocapnic hypoxia (SpO2: 79.0±1.5%), and hyperoxia (40% end-tidal O2 fraction) by measuring heart rate, blood pressure, ventilation, oxygen saturation, end-tidal CO2 and O2 fractions, and muscle sympathetic nerve activity. During normoxia, baroreflex activation reduced systolic blood pressure from 164±27 to 151±25 mm Hg (mean±SD, P<0.001), heart rate from 64±13 to 61±13 bpm (P=0.002), and muscle sympathetic nerve activity from 42±12 to 36±12 bursts/min (P=0.004). Hypoxia increased systolic blood pressure 8±12 mm Hg (P=0.057), heart rate 10±6 bpm (P<0.001), muscle sympathetic nerve activity 7±7 bursts/min (P=0.031), and ventilation 10±7 L/min (P=0.002). However, responses to electrical carotid sinus stimulation did not differ between hypoxic and hyperoxic conditions: systolic blood pressure: -15±7 versus -14±8 mm Hg (P=0.938), heart rate: -2±3 versus -2±2 bpm (P=0.701), and muscle sympathetic nerve activity: -6±4 versus -4±3 bursts/min (P=0.531). We conclude that moderate peripheral chemoreflex activation does not attenuate acute responses to electrical baroreflex activation therapy in patients with resistant hypertension. These patients provided insight into human baroreflex-chemoreflex interactions that could not be gained otherwise.

Original languageEnglish (US)
Pages (from-to)257-264
Number of pages8
JournalHypertension (Dallas, Tex. : 1979)
Volume75
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Baroreflex
Carotid Sinus
Blood Pressure
Heart Rate
Muscles
Ventilation
Hypertension
Hyperoxia
Antihypertensive Agents
Electric Stimulation
Body Mass Index
Oxygen
Therapeutics

Keywords

  • baroreflex
  • blood pressure
  • carotid sinus
  • hyperoxia
  • hypoxia

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Efficacy of Electrical Baroreflex Activation Is Independent of Peripheral Chemoreceptor Modulation. / Heusser, Karsten; Thöne, Arvo; Lipp, Axel; Menne, Jan; Beige, Joachim; Reuter, Hannes; Hoffmann, Fabian; Halbach, Marcel; Eckert, Siegfried; Wallbach, Manuel; Koziolek, Michael; Haarmann, Helge; Joyner, Michael J.; Paton, Julian F.R.; Diedrich, André; Haller, Hermann; Jordan, Jens; Tank, Jens.

In: Hypertension (Dallas, Tex. : 1979), Vol. 75, No. 1, 01.01.2020, p. 257-264.

Research output: Contribution to journalArticle

Heusser, K, Thöne, A, Lipp, A, Menne, J, Beige, J, Reuter, H, Hoffmann, F, Halbach, M, Eckert, S, Wallbach, M, Koziolek, M, Haarmann, H, Joyner, MJ, Paton, JFR, Diedrich, A, Haller, H, Jordan, J & Tank, J 2020, 'Efficacy of Electrical Baroreflex Activation Is Independent of Peripheral Chemoreceptor Modulation', Hypertension (Dallas, Tex. : 1979), vol. 75, no. 1, pp. 257-264. https://doi.org/10.1161/HYPERTENSIONAHA.119.13925
Heusser, Karsten ; Thöne, Arvo ; Lipp, Axel ; Menne, Jan ; Beige, Joachim ; Reuter, Hannes ; Hoffmann, Fabian ; Halbach, Marcel ; Eckert, Siegfried ; Wallbach, Manuel ; Koziolek, Michael ; Haarmann, Helge ; Joyner, Michael J. ; Paton, Julian F.R. ; Diedrich, André ; Haller, Hermann ; Jordan, Jens ; Tank, Jens. / Efficacy of Electrical Baroreflex Activation Is Independent of Peripheral Chemoreceptor Modulation. In: Hypertension (Dallas, Tex. : 1979). 2020 ; Vol. 75, No. 1. pp. 257-264.
@article{209d00917a5f4d9c94b8d199463e8c41,
title = "Efficacy of Electrical Baroreflex Activation Is Independent of Peripheral Chemoreceptor Modulation",
abstract = "Arterial baroreflex activation through electrical carotid sinus stimulation has been developed for the treatment of resistant hypertension. Previous studies suggested that the peripheral chemoreflex is tonically active in hypertensive patients and may inhibit baroreflex responses. We hypothesized that peripheral chemoreflex activation attenuates baroreflex efficacy evoked by electrical carotid sinus stimulation. We screened 35 patients with an implanted electrical carotid sinus stimulator. Of those, 11 patients with consistent acute depressor response were selected (7 men/4 women, age: 67±8 years, body mass index: 31.6±5.2 kg/m2, 6±2 antihypertensive drug classes). We assessed responses to electrical baroreflex stimulation during normoxia, isocapnic hypoxia (SpO2: 79.0±1.5{\%}), and hyperoxia (40{\%} end-tidal O2 fraction) by measuring heart rate, blood pressure, ventilation, oxygen saturation, end-tidal CO2 and O2 fractions, and muscle sympathetic nerve activity. During normoxia, baroreflex activation reduced systolic blood pressure from 164±27 to 151±25 mm Hg (mean±SD, P<0.001), heart rate from 64±13 to 61±13 bpm (P=0.002), and muscle sympathetic nerve activity from 42±12 to 36±12 bursts/min (P=0.004). Hypoxia increased systolic blood pressure 8±12 mm Hg (P=0.057), heart rate 10±6 bpm (P<0.001), muscle sympathetic nerve activity 7±7 bursts/min (P=0.031), and ventilation 10±7 L/min (P=0.002). However, responses to electrical carotid sinus stimulation did not differ between hypoxic and hyperoxic conditions: systolic blood pressure: -15±7 versus -14±8 mm Hg (P=0.938), heart rate: -2±3 versus -2±2 bpm (P=0.701), and muscle sympathetic nerve activity: -6±4 versus -4±3 bursts/min (P=0.531). We conclude that moderate peripheral chemoreflex activation does not attenuate acute responses to electrical baroreflex activation therapy in patients with resistant hypertension. These patients provided insight into human baroreflex-chemoreflex interactions that could not be gained otherwise.",
keywords = "baroreflex, blood pressure, carotid sinus, hyperoxia, hypoxia",
author = "Karsten Heusser and Arvo Th{\"o}ne and Axel Lipp and Jan Menne and Joachim Beige and Hannes Reuter and Fabian Hoffmann and Marcel Halbach and Siegfried Eckert and Manuel Wallbach and Michael Koziolek and Helge Haarmann and Joyner, {Michael J.} and Paton, {Julian F.R.} and Andr{\'e} Diedrich and Hermann Haller and Jens Jordan and Jens Tank",
year = "2020",
month = "1",
day = "1",
doi = "10.1161/HYPERTENSIONAHA.119.13925",
language = "English (US)",
volume = "75",
pages = "257--264",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Efficacy of Electrical Baroreflex Activation Is Independent of Peripheral Chemoreceptor Modulation

AU - Heusser, Karsten

AU - Thöne, Arvo

AU - Lipp, Axel

AU - Menne, Jan

AU - Beige, Joachim

AU - Reuter, Hannes

AU - Hoffmann, Fabian

AU - Halbach, Marcel

AU - Eckert, Siegfried

AU - Wallbach, Manuel

AU - Koziolek, Michael

AU - Haarmann, Helge

AU - Joyner, Michael J.

AU - Paton, Julian F.R.

AU - Diedrich, André

AU - Haller, Hermann

AU - Jordan, Jens

AU - Tank, Jens

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Arterial baroreflex activation through electrical carotid sinus stimulation has been developed for the treatment of resistant hypertension. Previous studies suggested that the peripheral chemoreflex is tonically active in hypertensive patients and may inhibit baroreflex responses. We hypothesized that peripheral chemoreflex activation attenuates baroreflex efficacy evoked by electrical carotid sinus stimulation. We screened 35 patients with an implanted electrical carotid sinus stimulator. Of those, 11 patients with consistent acute depressor response were selected (7 men/4 women, age: 67±8 years, body mass index: 31.6±5.2 kg/m2, 6±2 antihypertensive drug classes). We assessed responses to electrical baroreflex stimulation during normoxia, isocapnic hypoxia (SpO2: 79.0±1.5%), and hyperoxia (40% end-tidal O2 fraction) by measuring heart rate, blood pressure, ventilation, oxygen saturation, end-tidal CO2 and O2 fractions, and muscle sympathetic nerve activity. During normoxia, baroreflex activation reduced systolic blood pressure from 164±27 to 151±25 mm Hg (mean±SD, P<0.001), heart rate from 64±13 to 61±13 bpm (P=0.002), and muscle sympathetic nerve activity from 42±12 to 36±12 bursts/min (P=0.004). Hypoxia increased systolic blood pressure 8±12 mm Hg (P=0.057), heart rate 10±6 bpm (P<0.001), muscle sympathetic nerve activity 7±7 bursts/min (P=0.031), and ventilation 10±7 L/min (P=0.002). However, responses to electrical carotid sinus stimulation did not differ between hypoxic and hyperoxic conditions: systolic blood pressure: -15±7 versus -14±8 mm Hg (P=0.938), heart rate: -2±3 versus -2±2 bpm (P=0.701), and muscle sympathetic nerve activity: -6±4 versus -4±3 bursts/min (P=0.531). We conclude that moderate peripheral chemoreflex activation does not attenuate acute responses to electrical baroreflex activation therapy in patients with resistant hypertension. These patients provided insight into human baroreflex-chemoreflex interactions that could not be gained otherwise.

AB - Arterial baroreflex activation through electrical carotid sinus stimulation has been developed for the treatment of resistant hypertension. Previous studies suggested that the peripheral chemoreflex is tonically active in hypertensive patients and may inhibit baroreflex responses. We hypothesized that peripheral chemoreflex activation attenuates baroreflex efficacy evoked by electrical carotid sinus stimulation. We screened 35 patients with an implanted electrical carotid sinus stimulator. Of those, 11 patients with consistent acute depressor response were selected (7 men/4 women, age: 67±8 years, body mass index: 31.6±5.2 kg/m2, 6±2 antihypertensive drug classes). We assessed responses to electrical baroreflex stimulation during normoxia, isocapnic hypoxia (SpO2: 79.0±1.5%), and hyperoxia (40% end-tidal O2 fraction) by measuring heart rate, blood pressure, ventilation, oxygen saturation, end-tidal CO2 and O2 fractions, and muscle sympathetic nerve activity. During normoxia, baroreflex activation reduced systolic blood pressure from 164±27 to 151±25 mm Hg (mean±SD, P<0.001), heart rate from 64±13 to 61±13 bpm (P=0.002), and muscle sympathetic nerve activity from 42±12 to 36±12 bursts/min (P=0.004). Hypoxia increased systolic blood pressure 8±12 mm Hg (P=0.057), heart rate 10±6 bpm (P<0.001), muscle sympathetic nerve activity 7±7 bursts/min (P=0.031), and ventilation 10±7 L/min (P=0.002). However, responses to electrical carotid sinus stimulation did not differ between hypoxic and hyperoxic conditions: systolic blood pressure: -15±7 versus -14±8 mm Hg (P=0.938), heart rate: -2±3 versus -2±2 bpm (P=0.701), and muscle sympathetic nerve activity: -6±4 versus -4±3 bursts/min (P=0.531). We conclude that moderate peripheral chemoreflex activation does not attenuate acute responses to electrical baroreflex activation therapy in patients with resistant hypertension. These patients provided insight into human baroreflex-chemoreflex interactions that could not be gained otherwise.

KW - baroreflex

KW - blood pressure

KW - carotid sinus

KW - hyperoxia

KW - hypoxia

UR - http://www.scopus.com/inward/record.url?scp=85076449393&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076449393&partnerID=8YFLogxK

U2 - 10.1161/HYPERTENSIONAHA.119.13925

DO - 10.1161/HYPERTENSIONAHA.119.13925

M3 - Article

C2 - 31786986

AN - SCOPUS:85076449393

VL - 75

SP - 257

EP - 264

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 1

ER -