Assessment of baroreflex sensitivity from spontaneous oscillations of blood pressure and heart rate: Proven clinical value?

The baroreceptor-heart rate reflex (baroreflex sensitivity, BRS) is a key mechanisms contributing to the neural regulation of the cardiovascular system. Therefore, the measurement of this reflex is a source of valuable information in the management of a variety of cardiovascular disorders. Several methods have been proposed so far to assess BRS by analyzing the spontaneous beat-to-beat fluctuations of arterial pressure and heart rate. These methods are inherently simple, non-invasive and low-cost. This article briefly reviews most representative clinical studies using these techniques in the attempt to assess their impact in the clinical management of patients with cardiovascular disease. These studies were based on three major algorithms for analyzing spontaneous oscillations of blood pressure and heart rate: the sequence method, the transfer function method and the more recent phase-rectified signal averaging method. We show that these methods have been successfully used both in prognostic evaluation and in the assessment of treatment effect.