Raising lipids acutely reduces baroreflex sensitivity

Impaired baroreflex sensitivity (BRS) is associated with hypertension and cardiovascular risk. Lipid abnormalities accompanying insulin resistance may impair BRS. To test this, nine obese, dyslipidemic hypertensive and seven healthy normotensive individuals were studied. The BRS was measured during a phenylephrine infusion before and after nonesterified fatty acids (NEFAs) and triglycerides were raised for 1 h with an Intralipid and heparin infusion, ie, acute dyslipidemia. The obese group had higher values than lean controls for several components of the insulin resistance syndrome including blood pressure (BP) and heart rate, as well as fasting insulin, triglycerides, and NEFA. The BRS was lower in obese hypertensive subjects than healthy controls at baseline (P < .0001); BRS declined from 8.3 +/- 0.4 to 5.2 +/- 0.3 (P < .001) in obese hypertensive subjects and from 15.9 +/- 2.2 to 7.5 +/- 0.7 msec/mm Hg (P = .04) in controls with acute dyslipidemia. The reduction in BRS correlated with the rise in NEFAs (r = -0.59, P = .02) but not triglycerides (r = -0.07, P = NS). These observations indicate that elevating NEFAs acutely impairs BRS. The findings suggest that lipid abnormalities in obese hypertensives may contribute to elevated BP and increased cardiovascular events by impairing BRS.