Is Low Baroreflex Sensitivity only a Consequence of Essential Hypertension or also a Factor Conditioning Its Development?
|Název česky||Je nízká citlivost baroreflexu důsledkem esenciální hypertenze nebo také faktor podmiňující její vznik?|
|Druh||Kapitola v knize|
|Fakulta / Pracoviště MU|
|Popis||Baroreflex sensitivity (BRS) is an individually characteristic index. It fluctuates spontaneously even at rest and therefore a particular value measured represents an approximate estimate of its size. Bearing in mind the fact that essential hypertension (EH) is a disease of higher age, the majority of studies done in previous years were naturally focused on BRS in older population. The increased arterial stiffness, increased IMT, and sympathetic activation in obesity represent indubitable factors which lead to hypertension and, consequently, result in a decrease of BRS. The hypothesis ensuing from these studies, which states that the drop in BRS accompanies the development of hypertension as a secondary manifestation of the disease, is proved by these studies. On the other hand, measurements of BRS in children and adolescents and the first genetic studies on the inborn conditionality of BRS have provided enough evidence that some individuals possess congenitally low BRS. Without a targeted study, we cannot even speculate on how this assumption will manifest itself in advanced age in terms of increased risk of sudden cardiac death, since in the meantime the long-term pathological influence of other mechanisms lowering BRS will have presented itself in the other risky patients. Low BRS will manifest itself as blood pressure hyperreactivity. It may lead to white coat hypertension in adolescents as a step in the development of EH. Therefore, congenitally low BRS may be considered as another risk factor for the development of EH. This is the reason why in the young population increased emphasis should be put on the prevention of obesity and sufficient physical activity as on easily influence able stimuli which additively increase blood pressure.|