Interplay between baroreflex sensitivity, obesity and related cardiometabolic risk factors (Review)

Konstantinidou,Sofia K.; Argyrakopoulou,Georgia; Tentolouris,Nicholas; Karalis,Vangelis; Kokkinos,Alexander

doi:10.3892/etm.2021.10990

Interplay between baroreflex sensitivity, obesity and related cardiometabolic risk factors (Review)

Authors:
- Sofia K. Konstantinidou
- Georgia Argyrakopoulou
- Nicholas Tentolouris
- Vangelis Karalis
- Alexander Kokkinos
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Affiliations: First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece, Diabetes and Obesity Unit, Athens Medical Center, 15125 Athens, Greece, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
Published online on: November 23, 2021 https://doi.org/10.3892/etm.2021.10990
Article Number: 67
Copyright: © Konstantinidou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The baroreflex represents a rapid negative feedback system implicated in blood pressure regulation, which aims to prevent blood pressure variations by regulating peripheral vascular tone and cardiac output. The aim of the present review was to highlight the association between baroreflex sensitivity (BRS) and obesity, including factors associated with obesity, such as metabolic syndrome, hypertension, cardiovascular disease and diabetes. For the present review, a literature search was conducted using the PubMed database until August 21, 2021. The searched terms included ‘baroreflex’, and other terms such as ‘sensitivity’, ‘obesity’, ‘metabolic syndrome’, ‘hypertension’, ‘diabetes’, ‘gender’, ‘aging’, ‘children’, ‘adolescents’, ‘physical activity’, ‘bariatric surgery’, ‘autonomous nervous system’ and ‘cardiometabolic risk factors’. Obesity and its related metabolic disorders can influence baroreflex functionality and decrease BRS, mostly by potentiating sympathetic nervous system activity. Obesity induces inflammation, which can increase sympathetic system activity and lead to a higher incidence of cardiovascular events. Obesity also represents an important risk factor for hypertension through numerous mechanisms; in this setting, dysfunctional baroreceptors are not able to protect against constantly elevated blood pressure. Furthermore, diabetes mellitus and oxidative stress result in deterioration of BRS, whereas aging is also generally related to reduced cardiovagal BRS. Differences in BRS have also been observed between men and women, and overall cardiovagal BRS in healthy women is less intense compared with that in men. BRS appears lower in children with obesity compared with that in children of a healthy weight. Notably, physical exercise can increase BRS in both hypertensive and normotensive subjects, and BRS can also be significantly improved following bariatric surgery and weight loss. In conclusion, obesity and its related metabolic disorders may influence baroreflex functionality and decrease BRS, and baroreceptors cannot protect against the constantly elevated blood pressure in obesity. However, following bariatric surgery and weight loss, BRS can be significantly improved. The present review summarizes the role of obesity and related metabolic risk factors in BRS, providing details on possible mechanisms and shedding light on their interplay leading to autonomic neuropathy.

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