Interpreting the impact of water drinking on arterial baroreflex function: When physiology speaks for itself
Abstract
We are happy that our study (Vianna et al., 2018) has received the attention of others and pleased to have the opportunity to respond and debate the merits of our approach. In their Letter to the Editor, Papaioannou et al. (2019) raise some interesting points regarding the methods of our study and how they relate to the estimation of cardiac baroreflex sensitivity, which we would like to address and provide further clarification. We are aware and in agreement with the statement by Dr Papaioannou and colleagues that body posture is a critical factor when assessing neural cardiovascular function at rest and during perturbational conditions. In this regard, our group has recently demonstrated that both cardiac and peripheral sympathetic outflow to postexercise ischemia (i.e. muscle metaboreflex activation) can be modulated by mobilization of central blood volume (Katayama et al., 2018; Teixeira et al., 2018). Whether the arterial baroreflex responses to water drinking are dependent on the body posture is unknown. However, this was not part of our study question. As we have clearly stated in the Methods section, subjects were studied in a supine position, which is a standard position for human neural cardiovascular control studies and the majority of studies on water drinking. It is important to clarify further that subjects ingested the 500ml of water or saline in this position using a flexible straw; therefore, there was no positional change. This approach also minimizes limb…
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