Leung JH, Bayomy OF, Bonyhay I, et al. - Hypoglycemia induced attenuation of cardiovascular homeostatic autonomic control is known as the cardiovascular component of hypoglycemia associated autonomic failure (HAAF), which is characterized most notably by reduced baroreflex sensitivity (BRS) that initiates during hypoglycemia and persists until at least the next day, despite return to euglycemia. Researchers here sought the role of the adrenocorticotropin hormone (ACTH)-adrenal axis in reducing BRS. They examined if acute suppression of BRS could be attained with infusion of ACTH 1-24 (cosyntropin), as compared with placebo, and if this reduction in BRS persists until the next day. In this double-blind, placebo-controlled, random-order, cross-over study, healthy men and women were administered intravenous infusion of cosyntropin (70 mcg/hour for 2.5 hours in the morning and again in the early afternoon) or normal saline placebo. Outcomes revealed BRS attenuation in correlation with receiving ACTH. This suggests the possible contribution of hypoglycemia-induced increases in ACTH in the cardiovascular component of HAAF.