Afferent blockade with lumbar intrathecal fentanyl reduced mean arterial pressure during exercise more in hypertensive (≈11 mm Hg) than normotensive (≈6 mm Hg) individuals.
Does lumbar intrathecal fentanyl alter circulatory responses to exercise in hypertensive patients compared to normotensive individuals?
Exercise pressor reflex abnormalities largely account for the exaggerated MAP response and impaired peripheral hemodynamics during exercise in hypertension.
We investigated the impact of hypertension on circulatory responses to exercise and the role of the exercise pressor reflex in determining the cardiovascular abnormalities characterizing patients with hypertension. After a 7-day drug washout, 8 hypertensive (mean arterial pressure MAP 130±4 mm Hg; 65±3 years) and 8 normotensive (MAP 117±2 mm Hg; 65±2 years) individuals performed single-leg knee-extensor exercise (7 W, 15 W, 50%, 80%-W peak ) under control conditions and with lumbar intrathecal fentanyl impairing feedback from µ-opioid receptor-sensitive leg muscle afferents. Femoral artery blood flow (Q L ), MAP (femoral artery), leg vascular conductance, and changes in cardiac output were continuously measured. While the increase in MAP from rest to control exercise was significantly greater in hypertension compared with normotension, the exercise-induced increase in cardiac output was comparable between groups, and Q L and leg vascular conductance responses were ≈18% and ≈32% lower in the hypertensive patients ( P 0.2). These findings suggest that exercise pressor reflex abnormalities largely account for the exaggerated MAP response and the impaired peripheral hemodynamics during exercise in hypertension.
Sidhu et al. (Mon,) conducted a other in Hypertension (n=16). Lumbar intrathecal fentanyl vs. Control conditions was evaluated on Decrease in mean arterial pressure (MAP) during exercise. Afferent blockade with lumbar intrathecal fentanyl reduced mean arterial pressure during exercise more in hypertensive (≈11 mm Hg) than normotensive (≈6 mm Hg) individuals.