PHYSIOLOGICAL EFFECTS OF ANTIHYPERTENSIVE DRUGS ON BARORECEPTOR SENSITIVITY: A SYSTEMATIC REVIEW AND META-ANALYSIS
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Keywords
Baroreceptor sensitivity; Baroreflex; Antihypertensive drugs; Autonomic regulation; Hypertension; Systematic review; Meta-analy
Abstract
Baroreceptor sensitivity is a fundamental component of short-term blood pressure regulation and autonomic cardiovascular control, and its impairment is commonly observed in hypertension and other cardiovascular disorders. Antihypertensive drugs lower blood pressure through diverse pharmacological mechanisms that may differentially influence baroreflex function, yet the physiological impact of these agents on baroreceptor sensitivity has not been comprehensively synthesized. This systematic review and meta-analysis evaluated the effects of major classes of antihypertensive drugs on baroreceptor sensitivity in adult humans. A comprehensive literature search was conducted in major electronic databases following PRISMA guidelines. Randomized controlled trials, crossover studies, and observational studies assessing baroreceptor sensitivity using pharmacological, sequence, or spectral methods were included. Overall, antihypertensive therapy was associated with improvement in baroreceptor sensitivity, with marked class-dependent differences. Agents targeting the renin–angiotensin system and central sympathetic pathways consistently enhanced baroreflex function, likely through improvements in arterial compliance and attenuation of sympathetic overactivity. Beta-blockers and calcium-channel blockers demonstrated variable or modest effects influenced by drug-specific physiological actions and methodological differences in baroreflex assessment, while diuretics showed minimal impact. These findings highlight the importance of autonomic modulation as a complementary therapeutic target in hypertension and support a physiology-driven approach to antihypertensive drug selection. Further studies using standardized baroreceptor sensitivity assessment and long-term clinical endpoints are warranted to clarify the prognostic significance of baroreflex improvement.
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Tripti Tripathi
Associate Professor, Department of Physiology, Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, India
Muzammil Husain
Assistant Professor, Department of Physiology, Autonomous State Medical College, Gonda, Uttar Pradesh, India.
Ekta Maurya
Assistant Professor, Department of Physiology, Integral Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
