Device-based therapy for resistant hypertension by electrical activation of the carotid baroreflex is currently undergoing active clinical investigation, and initial findings from clinical trials have been published. The purpose of this mini-review is to summarize the experimental studies that have provided a conceptual understanding of the mechanisms that account for the long-term lowering of arterial pressure with baroreflex activation. Because of the well established role of the baroreflex in short-term regulation of arterial pressure by rapidly changing peripheral resistance and cardiac function, the more sluggish actions of the baroreflex on renal excretory function are often not taken into consideration in long-term pressure control. However, since clinical, experimental, and theoretical evidence indicates that the kidneys play a dominant role in long-term control of arterial pressure, this review focuses on the mechanisms that link baroreflex-mediated reductions in central sympathetic outflow with increases in renal excretory function that lead to sustained reductions in arterial pressure.
- blood pressure
- renal function
- sympathetic nervous system
- renin-angiotensin system
- Copyright © 2012, Journal of Applied Physiology