title: Reduced baroreflex effectiveness index in hypertensive patients with chronic renal failure.
abstract: BACKGROUND
  Impaired arterial baroreflex function has been associated with an increased risk of ventricular arrhythmia and sudden death. This has also been suggested for patients with chronic renal failure (CRF) who are at high risk for cardiovascular morbidity. The aim of this study was to investigate the arterial baroreflex function in CRF patients with emphasis on analyzing the time during which the arterial baroreflex is active, the baroreflex effectiveness index (BEI).
  
  
  METHODS
  Beat-to-beat blood pressure (measured with Portapres) and electrocardiography were continuously registered during 30 min rest in 216 hypertensive CRF patients on hemodialysis (n=95), continuous ambulatory peritoneal dialysis (n=59), or conservative treatment (n=59). The spontaneous sequence method was used to calculate BRS and BEI. Age-matched healthy subjects (n=43) were examined for comparison.
  
  
  RESULTS
  The BRS was reduced by 51% and the BEI by 49% in CRF patients compared with healthy subjects (P<.001 for both). In addition, CRF patients with diabetes showed further reductions compared with patients without diabetes (15% reduction of BRS and 44% of BEI, P<.01 for both). The treatment modality for renal failure had no effect on BRS or BEI. In a multivariate linear regression analysis, age, body mass index, and systolic blood pressure were independent predictors of BRS, whereas age and diabetes were independent predictors of BEI in patients with CRF.
  
  
  CONCLUSIONS
  We conclude that BEI, which is markedly reduced in hypertensive patients with CRF, may convey information on arterial baroreflex function that is complementary to BRS.
authors.affiliation: Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden. m.johansson@medfak.gu.se
authors.forename: Mats
authors.initials: M
authors.lastname: Johansson
authors.forename: Sinsia A
authors.initials: SA
authors.lastname: Gao
authors.forename: Peter
authors.initials: P
authors.lastname: Friberg
authors.forename: Marita
authors.initials: M
authors.lastname: Annerstedt
authors.forename: Göran
authors.initials: G
authors.lastname: Bergström
authors.forename: Jan
authors.initials: J
authors.lastname: Carlström
authors.forename: Ted
authors.initials: T
authors.lastname: Ivarsson
authors.forename: Gert
authors.initials: G
authors.lastname: Jensen
authors.forename: Susanne
authors.initials: S
authors.lastname: Ljungman
authors.forename: Oivind
authors.initials: O
authors.lastname: Mathillas
authors.forename: Finn-David
authors.initials: FD
authors.lastname: Nielsen
authors.forename: Ulf
authors.initials: U
authors.lastname: Strömbom
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive; D006435:Renal Dialysis
chemical_list: D000959:Antihypertensive Agents