Baroreceptor reflexes in human hypertension.

We studied the control of arterial pressure by the carotid sinus baroreceptors in 35 hypertensive humans, using a variable pressure neck chamber to alter carotid sinus transmural pressure in a graded fashion. The results were compared with those obtained from 11 normotensives. As in normotensives, reduction in carotid transmural pressure caused a linearly related pressor response and vice versa. However, whereas in normotensives the pressure response was greater than the depressor, the reverse was the case in hypertensives. Furthermore, the pressor response decreased and the depressor response increased progressively with an increase in severity of the hypertension. Thus while in normotensives the carotid baroreflex is more effective in protecting against hypotension, in hypertensives the antihypertensive function of the reflex is favored. Similar differences between hypertensives and normotensives were found with respect to the carotid baroreceptor control of heart rate. In eight hypertensives, reflex changes in heart rate also were studied by injection of phenylephrine and trinitroglycerine to vary not only carotid baroreceptor activity, but also activity of extracarotid baroreceptors. The results were compared with results of similar studies on eight normotensives. These comparisons suggest that, whereas the carotid baroreceptor reflex remains active in hypertension, reflexes stemming from extracarotid baroreceptor areas are much diminished.