FIGURE 2.
Beat-to-beat heart rate and blood pressure responses to the Valsalva maneuver (12-second duration, 30 mm Hg) in July 2001 and November 2005. In the latter recording, note progressive decline in blood pressure during Phase II, smaller pressure overshoot, and delayed return of pressure toward baseline in Phase IV, consistent with worsening baroreflex-sympathoneural function. Heart rate responses during and after the maneuver were also smaller in 2005 than in 2001, despite larger changes in blood pressure, consistent with worsening baroreflex-cardiovagal function.