Reduced baroreceptor sensitivity in patients with chronic obstructive pulmonary disease

Baroreceptor sensitivity, reflected by the slope of the linear regression of the electrocardiographic R-R interval on the rise of systolic blood pressure after injection of phenylephrine, was significantly lower in 27 patients with chronic obstructive pulmonary disease (4.67 +/- 2.67) than in 10 normal subjects (12.07 +/- 3.3) of comparable age (p less than 0.001). In 20 patients in whom right heart catheterisation was performed, pulmonary artery pressure was inversely related to baroreflex sensitivity (r = - 0.603, p less than 0.01). Independent variables such as arterial Po2, Pco2, and mean pulmonary artery pressure were examined in order to assess their ability to predict baroreflex sensitivity. The independent variable that made the most significant contribution was mean pulmonary artery pressure. It seems that the attenuation of baroreflex response in patients with chronic obstructive pulmonary disease is caused mainly by pulmonary hypertension and partly by the central effects of hypoxia and hypercapnia.