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(Stroke. 2009;40:e678.)
© 2009 American Heart Association, Inc.

Comments, Opinions, and Reviews

Baroreflex: A New Therapeutic Target in Human Stroke?

Marek Sykora, MD; Jennifer Diedler, MD; Peter Turcani, MD; Werner Hacke, MD Thorsten Steiner, MD

From the Department of Neurology (M.S., J.D., W.H., T.S.), University of Heidelberg, Heidelberg, Germany, and Department of Neurology (M.S., P.T.), Comenius University, Bratislava, Slovakia.

Correspondence to Marek Sykora, MD, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. E-mail marek.sykora{at}med.uni-heidelberg.de

Background and Purpose— Autonomic dysfunction, including increased sympathetic drive and blunted baroreflex, has repeatedly been observed in acute stroke. Of clinical importance is that the stroke-related autonomic imbalance seems to be linked to worse outcome after stroke. Here, we discuss the role of baroreflex impairment in acute stroke and its possible pathophysiological and therapeutic relevance.

Summary of Review— Possible mechanisms linking baroreflex impairment with unfavorable outcome in stroke may include increased cardiovascular morbidity and mortality, promotion of secondary brain injury due to local inflammation, hyperglycemia, or altered cerebral perfusion.

Conclusions— We suggest therefore that the modifying of autonomic functions may have important therapeutic implications in acute ischemic as well as in hemorrhagic stroke.

Key Words: baroreflex sensitivity • acute stroke • heart-brain relations • outcome • therapy

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