Baroreflex Sensitivity Assessment – Latest Advances and Strategies

The baroreflex mechanism has been recognised as a key part of cardiovascular regulation. Alterations in the baroreceptor-heart rate reflex (baroreflex sensitivity [BRS]) contribute to sympathetic–parasympathetic imbalance, playing a major role in the development and progression of many cardiovascular disorders. Therefore, the measurement of the baroreflex is a source of valuable information in the clinical management of cardiac disease patients. This article reviews the most relevant advances for the measurement of BRS and their clinical and prognostic implications. Novel therapeutic strategies, exploring the use of electrical stimulation of the carotid sinus, have been evaluated recently in experimental and preliminary clinical studies to lower blood pressure and to reduce the level of baroreflex-mediated sympathoexcitation in heart failure. A recent study has also shown that the implementation of an artificial baroreflex system to regulate sympathetic vasomotor tone automatically is feasible.