Cardiopulmonary receptor reflex in hypertension.
Several studies have described the modifications of the arterial baroreceptor reflex in hypertension. Whether this condition alters the other major cardiovascular reflex (ie, that originating from receptors in the cardiopulmonary region) is less well known, however. Herein we describe the importance of the inhibitory control of sympathetic vasomotor and renin influences exerted by the cardiopulmonary reflex in normotensive humans as assessed by deactivating and stimulating heart and lung receptors through reductions and increases in central venous pressure respectively obtained via lower-body negative pressure and passive leg raising. Observations on this reflex obtained in experimental animal models are summarized. Finally, we report recent evidence showing that the cardiopulmonary reflex is only slightly affected by mild or moderate essential hypertension but impaired in hypertension with left ventricular hypertrophy in a fashion positively related to the degree of this cardiac structural alteration. This may further worsen the severity of hypertension. However, the impairment of the cardiopulmonary reflex is reversible with regression of hypertrophy obtained by antihypertensive treatment which is thus beneficial for cardiovascular homeostasis.
Mancia
G
G
Cattedra di Semeiotica Medica, Università di Milano, Italy.
Grassi
G
G
Giannattasio
C
C
D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008465:Mechanoreceptors / Q000503:physiopathology*; D011311:Pressoreceptors / Q000503:physiopathology*; D011661:Pulmonary Stretch Receptors / Q000503:physiopathology*; D012018:Reflex / Q000502:physiology*