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(Hypertension. 2009;53:826.)
© 2009 American Heart Association, Inc.

Original Articles

Arterial Baroreflex Control of Cardiac Vagal Outflow in Older Individuals Can Be Enhanced by Aerobic Exercise Training

From the Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Mass.

Correspondence to J. Andrew Taylor, Cardiovascular Research Laboratory, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Room 556, 125 Nashua St, Boston, MA 02114. E-mail jandrew_taylor{at}hms.harvard.edu

Maintained cardiac vagal function is critical to cardiovascular health in human aging. Aerobic exercise training has been considered an attractive intervention to increase cardiovagal baroreflex function; however, the data are equivocal. Moreover, if regular exercise does reverse the age-related decline in cardiovagal baroreflex function, it is unknown how this might be achieved. Therefore, we assessed the effects of a 6-month aerobic training program on baroreflex gain and its mechanical and neural components in older individuals (5 women and 7 men, aged 55 to 71 years). We assessed baroreflex function using pharmacological pressure changes (bolus nitroprusside followed by bolus phenylephrine) and estimated the integrated gain (R-R interval/ systolic blood pressure) and mechanical ( diameter/ pressure) and neural (R-R interval/ diameter) components via measurements of carotid artery diameter in previously sedentary older individuals before and after 6 months of aerobic training. There was a significant 26% increase in baroreflex gain that was directly related to the amount of exercise performed and that was derived mainly from an increase in the neural component of the arterial baroreflex (P<0.05). We did find changes in the mechanical component, but unlike integrated gain and the neural component, these were not related to the magnitude of the exercise stimulus. These results suggest that exercise training can have a powerful effect on cardiovagal baroreflex function, but a sufficient stimulus is necessary to produce the effect. Moreover, adaptations in the afferent-efferent baroreflex control of cardiac vagal outflow may be crucial for the improvement in arterial baroreflex function in older humans.

Key Words: baroreflex • aging • exercise • nervous system • autonomic • carotid arteries