YI 2.4 Neural Baroreflex Sensitivity and Long-Term Effect of Antihypertensive Agents—A Pharmacological Substudy of the Paris Prospective Study III
- 10.2991/artres.k.201209.012How to use a DOI?
- Antihypertensive; baroreflex; arterial stiffness
Background/Objectives: The baroreflex is a crucial mechanism acutely modulating vascular tone and heart rate response to maintain blood pressure (BP) in an optimal range. A decrease in baroreflex sensitivity (BRS) is associated with ageing, and pathological conditions such as hypertension and diabetes. Antihypertensive agents are generally known to have beneficial effect on the BRS, however it is still uncertain if the effect is mediated through a more compliant arterial wall or a sympathoinhibitory action.
Methods: In the Paris Prospective Study III , spontaneous baroreflex, carotid stiffness and pharmacological drugs intake were available in 7967 adults (aged 55–75 years). The neural component of the baroreflex sensitivity (nBRS) was obtained with a cross-spectral analysis of variations in carotid distention rate and R-R intervals. Pharmacological classes were analysed according to the Anatomical Therapeutic Chemical (ATC) classification. Individuals with a BP lowering medication (BP-treated) were paired to non-BP treated individuals with a similar cardiovascular risk (controls) using a propensity score matching procedure (n = 1182 pairs).
Results: Amongst pharmacological classes of BP lowering agents, only agents acting on the renin-angiotensin system (ACEi-ARB) were associated with nBRS (β = –0.08, p = 0.045). Compared to their matched controls, ACEi-ARB users had lower nBRS (2.79 ± 0.66 vs. 2.90 ± 0.62, p = 0.03). In multivariate analysis, ACEi-ARB remained significant (stdβ = –0.09, p = 0.025) after adjustment for carotid stiffness (stdβ = 0.25, p < 0.001) and systolic pressure (stdβ = –0.20, p < 0.001).
Conclusion: In this epidemiological study, ACEi-ARB were negatively associated with nBRS. This effect is independent of BP and stiffness, which may suggest an inhibition of sympathetic activity by ACEi-ARB.
- © 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
- Open Access
- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
Cite this article
TY - JOUR AU - Nicolas Danchin AU - Catherine Guibout AU - Xavier Jouven AU - Marie-Cécile Perier AU - Frederique Thomas AU - Catherine Fortier AU - Jean-Philippe Empana AU - Hakim Khettab AU - Rosa-Maria Bruno AU - Pierre Boutouyrie PY - 2020 DA - 2020/12/31 TI - YI 2.4 Neural Baroreflex Sensitivity and Long-Term Effect of Antihypertensive Agents—A Pharmacological Substudy of the Paris Prospective Study III JO - Artery Research SP - S17 EP - S17 VL - 26 IS - Supplement 1 SN - 1876-4401 UR - https://doi.org/10.2991/artres.k.201209.012 DO - 10.2991/artres.k.201209.012 ID - Danchin2020 ER -