HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by WASSERSTRUM, N. Articles by COTTON, D. B. Search for Related Content PubMed PubMed Citation Articles by WASSERSTRUM, N. Articles by COTTON, D. B.

Implications of Sino-Aortic Baroreceptor Reflex Dysfunction in Severe Preeclampsia

From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and the Department of Medicine, Baylor College of Medicine, Houston, Texas

Abstract

Loss of sino-aortic baroreceptor reflex sensitivity has been associated with various forms of hypertension. Baroreflexive dysfunction antedates elevation of blood pressure (BP) in some forms of hypertension, and may play a role in their pathogenesis. We studied baroreflex function in seven women with severe preeclampsia being treated with intravenous hydralazine. As indices of baroreflex sensitivity and hemodynamic competence, we measured the reflexive elevations in heart rate (HR) (HR/BP) and cardiac index (CI) (CI/BP) in response to hydralazine-induced falls in blood pressure. The change in cardiac index per unit change in systemic vascular resistance index (SVRI) (CI/SVRI) served as an additional measure of hemodynamic competence. The results indicated that a higher baseline blood pressure was associated with a dramatic reduction in baroreflex sensitivity (HR/BP) and baroreflex control of blood pressure (CI/BP and CI/SVRI). In patients with higher baseline blood pressures, the severe impairment of baroreflex function eliminated the normal circulatory buffer against vasodilator-induced hypotension. Abrupt and profound reductions in blood pressure and the development of fetal distress in response to hydralazine occurred in the patients with higher initial blood pressures. In addition, the present results suggest that phenomena such as the blood pressure lability and increased responsiveness to angiotensin that characterize preeclampsia are, at least in part, reflections of baroreflex dysfunction.

This article has been cited by other articles:

				C. C. H. Yang, T.-C. Chao, T. B. J. Kuo, C.-S. Yin, and H. I. Chen Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR Am J Physiol Heart Circ Physiol, April 1, 2000; 278(4): H1269 - H1273. [Abstract] [Full Text] [PDF]

				M. M. El-Mas and A. A. Abdel-Rahman Role of Cardiac Output in Ethanol-Evoked Attenuation of Centrally Mediated Hypotension in Conscious Rats Hypertension, August 1, 1997; 30(2): 288 - 294. [Abstract] [Full Text]