The baroreflex is the fastest mechanism to regulate acute blood pressure changes via

controlling heart rate, contractility, and peripheral resistance. The baroreflex or baroreceptor
sensitivity (BRS) index is a measurement to quantify how much control the baroreflex has on
the heart rate. BRS can be valuable in assessing the development and progression of
cardiovascular diseases.
Reduced BRS can indicate:

Neurological Disorders

Cardiovascular Disease
o Hypertension
o Coronary artery disease
o Myocardial infarction
o Heart failure

End-organ damage

Progression of underlying disease

Increased cardiovascular risk in post MI and heart failure patients

Physiology of Baroreceptors
Baroreceptors are mechanoreceptors located in the carotid sinus and in the aortic arch. Their
function is to sense pressure changes by responding to change in the tension of the arterial
wall. The baroreflex mechanism is a fast response to changes in blood pressure. Impulses
sent from the mechanoreceptors are relayed to the nucleus of the tractus solitarius and
ultimately to the vasomotor center of the brain. A sudden increase in blood pressure stretches
the baroreceptors and the increased firing results in the vasomotor center inhibiting
sympathetic drive and increasing vagal tone on the SA node of the heart. The SA node is
slowed by the acetylcholine and heart rate slows to correct the increase in pressure. When a
person has a sudden drop in blood pressure, for example standing up, the decreased blood
pressure is sensed by the baroreceptor as a decrease in tension therefore will decrease in the
firing of impulses. This causes the vasomotor center to uninhibit sympathetic activity in the
heart and blood vessels and decrease vagal tone (parasympathetic influence on the cardiac SA
node) causing an increase in heart rate. The baroreflex responds to acute changes in blood
pressure. If the hypertension/hypotension is still present after approximately one day, the
baroreceptors will reset to the new blood pressure levels.
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