title: Variations of perioperative baroreflex sensitivity in hypertensive and normotensive patients.
abstract: BACKGROUND
  Impaired baroreflex sensitivity (BRS) is a marker of autonomous dysfunction, which may play an important role in the long-term development of hypertension. Perioperative patients with hypertension are rapidly increasing in all populations worldwide.
  
  
  OBJECTIVE
  To estimate the value of BRS for hypertension in a surgery cohort.
  
  
  METHODS
  An observational and cross-sectional study was performed, involving 96 patients who underwent video-assisted thoracoscopic pulmonary lobectomy or segmentectomy. Invasive blood pressure and heart rate before and after giving nitroglycerin were measured in 48 normotensive patients and 48 hypertensive patients (25 and 23 undergoing regular treatment hypertensive [HR] and irregular treatment hypertensive [HI], respectively) while entering the operation room, 30 minutes after skin incision, and 10 minutes after skin suture.
  
  
  RESULTS
  BRSpreoperativeof hypertensive group (Group H) was lower than normotensive group (Group N) (3.49 ± 1.55 vs. 5.75 ± 4.15 ms/mmHg; P < 0.05). BRSintraoperativeof Group H was lower than Group N (1.70 ± 1.18 vs. 2.84 ± 1.11 ms/mmHg; P < 0.05). BRSpreoperativeof patients in irregular-treated group (Group HI) was lower than regular-treated group (Group HR) (2.92 ± 1.36 vs. 4.31 ± 1.87 ms/mmHg; P < 0.05). BRSintraoperativeof Group HI was lower than Group HR (1.45 ± 0.90 vs. 2.08 ± 1.82 ms/mmHg; P < 0.05). BRSintraoperativeand BRSpostoperativewere lower than BRSpreoperativein each group (P < 0.01).
  
  
  CONCLUSIONS
  The perioperative autonomic nerve function was significantly impaired in hypertensive patients. This effect was less pronounced for those who were on regular antihypertensive treatment. Attention should be paid to maintain the stability of cardiovascular function, to ensure patients can go through perioperative period safely.
authors.affiliation: a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China.
authors.forename: Dan
authors.initials: D
authors.lastname: Huang
authors.affiliation: a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhou
authors.affiliation: a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China.
authors.forename: Diansan
authors.initials: D
authors.lastname: Su
authors.affiliation: a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China.
authors.forename: Weifeng
authors.initials: W
authors.lastname: Yu
authors.affiliation: a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
mesh_terms: D062186:Arterial Pressure; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000187:drug effects / Q000502:physiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D059035:Perioperative Period; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin
keywords: Anesthesia; baroreflex sensitivity; hypertension; nitroglycerin; perioperative