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Vanderbilt Autonomic Dysfunction Center

Baroreflex Failure

Introduction

Baroreflex Failure is a rare disorder characterized by change of blood pressure with episodes of severe hypertension (high blood pressure).  There can be increased heart rate during stress and hypotension (low blood pressure) with normal or reduced heart rate during rest.

Symptoms may include:

  • Headache
  • Excessive sweating
  • Extremely high or volatile blood pressure and heart rate with spikes in blood pressure in response to stress, with periods of normal or even low blood pressure during rest.
  • Heart rate that does not respond to medications intended to improve it.

Causes of Baroreflex

Possible causes may include:

  • Surgery and radiation for cancer of the throat
  • Injury to the glossopharyngeal and vagus nerves (nerves involved in sensing blood pressure)
  • Cell loss onboth sides in the nuclei of the solitary tract (NTS, a column of cells located in the medulla) in the setting of a degenerative neurologic disease of the brain.
  • For many patients, the cause is unknown.

What is the treatment?

Treatment for Baroreflex Failure invloves medication to control blood pressure and heart rate and to reduce stress. 

A complete history and physical is necessary because Baroreflex Failure may resemble another rare disorder called Pheochromocytoma.

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