From the Guidelines
Stimulation does not cause a reduction in Systemic Vascular Resistance (SVR), but rather, certain medications and interventions can decrease SVR, such as vasodilating drugs, including ACE inhibitors or ARBs, which can reduce systolic blood pressure without a substantial reduction in diastolic blood pressure in patients with chronic conditions 1.
Key Points
- Systemic vascular resistance (SVR) is largely determined by arteriolar caliber and number, and is an important determinant of normal cardiovascular function as well as a key pathophysiologic factor in various cardiac and vascular disease states 1.
- Certain medications, such as ACE inhibitors or ARBs, can reduce SVR by decreasing arteriolar resistance, which can lead to a reduction in systolic blood pressure without a substantial reduction in diastolic blood pressure in patients with chronic conditions 1.
- Non-pharmacological interventions, such as aerobic exercise training, dietary changes, and weight loss, can also reduce arterial stiffness and wave reflections, which can lead to a reduction in SVR and improve cardiovascular function 1.
- The effects of exercise on arterial stiffness and wave reflections can vary depending on the type, intensity, and duration of exercise, and can have different effects on central aortic pressure and SVR 1.
Mechanisms
- The mechanism of reduced SVR involves decreased arteriolar resistance, which can be achieved through the use of vasodilating drugs, such as ACE inhibitors or ARBs, or through non-pharmacological interventions, such as aerobic exercise training and dietary changes 1.
- The reduction in SVR can lead to a decrease in systolic blood pressure and an improvement in cardiovascular function, which can reduce the risk of cardiovascular events and improve quality of life 1.
Clinical Implications
- The reduction in SVR can have important clinical implications, particularly in patients with hypertension or cardiovascular disease, as it can lead to a reduction in blood pressure and an improvement in cardiovascular function 1.
- The use of vasodilating drugs, such as ACE inhibitors or ARBs, and non-pharmacological interventions, such as aerobic exercise training and dietary changes, can be an effective strategy for reducing SVR and improving cardiovascular function in patients with chronic conditions 1.
From the FDA Drug Label
Elevated central venous and pulmonary capillary wedge pressures, and pulmonary and systemic vascular resistance are also reduced by nitroglycerin therapy
- Stimulation of nitroglycerin causes a reduction in Systemic Vascular Resistance (SVR).
- The reduction in SVR is due to the vasodilatory effect of nitroglycerin, which leads to arteriolar relaxation and a decrease in peripheral vascular resistance 2.
From the Research
Stimulation and Systemic Vascular Resistance (SVR)
- The effect of stimulation on SVR is not directly addressed in the provided studies, which primarily focus on the treatment of pulmonary arterial hypertension (PAH) and the effects of various medications on hemodynamics.
- However, some studies mention the impact of certain medications on systemic vascular resistance:
- A study on the combination of Bosentan and Sildenafil found that it significantly lowered pulmonary vascular resistance (PVR), but did not provide information on the effect on SVR 3.
- A study on the clinical efficacy of endothelin receptor antagonists in patients with PAH found that these medications improved hemodynamics, including a decrease in pulmonary vascular resistance, but did not discuss SVR 4.
- A study on the effects of phosphodiesterase 5 inhibition on hemodynamics in advanced heart failure and pulmonary hypertension found that sildenafil reduced pulmonary vascular resistance and increased cardiac output, but did not affect systemic vascular resistance 5.
- A study on pharmacological manipulation of peripheral vascular resistance in special clinical situations after pediatric cardiac surgery discussed the complexity of managing SVR in certain patient populations, but did not provide information on the effect of stimulation on SVR 6.
- A study on the treatment with phosphodiesterase inhibitors type III and V found that milrinone decreased systemic vascular resistance, while sildenafil preserved it 7.