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Abstract

The autonomic pattern, including analysis of heart rate variability (HRV) and baroreflex sensitivity (BRS), has been suggested by some authors as an additional factor in the evaluation of cardiovascular risk in hypertensive patients.

The aim of this study is to stratify never treated mild hypertensive patients by their autonomic nervous pattern, assessed by time domain analysis of heart rate variability (HRV) and baroreflex sensitivity (BRS) and to examine if autonomic pattern correlates with some of the known cardiovascular risk factors and with the Framnigham score.

We selected 290 never treated essential hypertensive patients; they underwent ambulatory blood pressure monitoring, 24hr ECG Holter (for the evaluation of HRV), non invasive continuous finger blood pressure monitoring by Portapres device (for the evaluation of BRS) and ecocardiocolordoppler;

HRV variables are strongly correlated to BRS values (p<0.0001); RMSSD and CLV which are vagal tone indices, are associated to: day mean diastolic blood pressure values (b=−0.146; p=0.02), 24hr heart rate (b=−0.638; p<0.0001), age (b=−0.301; p<0.0001) and diastolic compliance (b=0.278; p=0.009). Stratifying patients by BRS tertili, we found that BRS is inversely associated to systolic blood pressure (p=0.03), heart rate (p=0.003), age (p=0.005) and total cholesterol (p=0.05) and directly to diastolic compliance (p=0.012). Both HRV indices and BRS are inversely associated to Framingham score (p<0.04).

Autonomic patter is a useful and powerful tool in the evaluation of total cardiovascular risk in hypertensive patients.

Am J Hypertens (2004) 17, 231A–231A; doi: 10.1016/j.amjhyper.2004.03.617

Autonomic Pattern, Essential Hypertension, Cardiovascular Risk
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© American Journal of Hypertension, Ltd. 2004
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