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Abstract

Aim

Several studies demonstrated that essential hypertension (EH) is associated to sympathetic activation. Consequently, one of the major aims of antihypertensive therapy should be to attenuate the sympathetic tone. Time Domain (TD) analysis of HRV is a simple and practical method for the assessment of autonomic function.: to assess the effects of an ACEI (fosinopril) and an AIIA (irbesartan) on cardiac autonomic tone by usingTD) analysis of HRV. Methods: 45 mild-moderate untreated EH patients were randomly assigned to fosinopril (F) 20 mg, or irbesartan (I) 150 mg, or atenolol(A) 100 mg o.d treatment. The βblocker A was included as a control drug because its marked effects on HRV. Combined 24-h ecg Holter and ABPM recordings were performed after 2 weeks placebo and after 12 weeks treatment. The TD parameters measured (calculated as 24-h, daytime and nighttime) were the following: PNN50 and RMSSD, short term parameters and indexes of parasympathetic activity. SD and SDANN: long term parameters and related to diurnal and secular trends in HRV. Results: the three groups of patients were comparable for clinical features. All three drugs significantly and similarly decreased office and ABP values vs placebo. Mean RR was significantly increased after A. and unmodified after F and I. 24-h and daytime PNN50 and RMSSD were significantly increased by A (+ 69% PNN50, and +39%RMSSD p<0,05). A significant decrease of these parameters was found during nighttime after I (- 47%PNN50 and -25%RMSSD p<0,05). No changes were found after F. 24-h, daytime and nighttime SD and SDANN parameters were not modified by the three drugs. Conclusion: In comparison to βblocker, I and F produce relative scarce modifications on short term HRV. Moreover, the two drugs do not influence long term HRV in EH. Our data confirm the relative neutral effects of ACEI on cardiac autonomic tone in EH and suggest a similiar behaviour for AIIA

Heart rate variability, antihypertensive drugs, sympathetic nervous system
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© American Journal of Hypertension, Ltd. 2001
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