DAILY BLOOD PRESSURE PROFILE AND HEART RATE VARIABILITY IN PATIENTS WITH ESSENTIAL HYPERTENSION

Authors:

Abstract:

This article presents the results of a study investigating changes in the daily blood pressure profile and heart rate variability in patients with stage II hypertension. The daily blood pressure profile was studied utilizing data acquired from daily blood pressure monitoring. Furthermore, heart rate variability, as an indicator of autonomic nervous system status, was investigated through the analysis of 5-minute cardiogram recordings. The study revealed that, in most patients with stage II hypertension, a disturbance exists in the daily blood pressure profile, characterized by either insufficient or excessive nocturnal reduction in blood pressure or, conversely, an elevation in nocturnal blood pressure. There was a tendency toward more frequent detection of nocturnal elevation of systolic blood pressure and excessive reduction of diastolic blood pressure in the subgroup of patients with stage 3 hypertension. In the presence of concomitant ischemic heart disease, daytime and nighttime diastolic blood pressure levels exceeded the corresponding indicators in patients with isolated hypertension. When assessing autonomic nervous regulation in patients with stage II hypertension, significant changes in its indicators were found relative to the control group, without a significant difference depending on the degree of hypertension, with the exception of a decrease in the standard deviation of the R-R interval and an increase in the LF/HF ratio in patients with stage III hypertension, which indicated an increase in the influence of the sympathetic branch of autonomic regulation. Thus, patients with stage II hypertension show an increase in the tone of the sympathetic branch of the autonomic nervous system, as evidenced by an increase in the proportion of pathological blood pressure profiles and changes in heart rate variability indicators.

Keywords:

hypertension blood pressure variability daily blood pressure profile heart rate variability autonomic nervous system status sympathovagal index sympatho-parasympathetic ratio

References:

1. Kovalenko VM, Kornatskyy VM, editors. Suchasni problemy okhorony zdorovya ta yikh minimizatsiya v konteksti zbroynoho konfliktu v Ukrayini: posibnyk. Kyiv: State Institution “National Scientific Center “Institute of Cardiology named after Academician M.D. Strazhesko”. 2018: 214. [in Ukrainian]
2. Corrigendum: The impact of systolic and diastolic blood pressure variability on mortality is age dependent: Data from the Dublin Outcome Study. European Journal of Preventive Cardiology. 2020 Mar 31;27(6). doi:10.1177/2047487320916672.
3. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. European heart journal. 1996 Mar;17(3):354-381.
4. Lindstrom M, DeCleene N, Dorsey H, et al. Global Burden of Cardiovascular Diseases and Risks Collaboration, 1990-2021. J Am Coll Cardiol. 2022 Dec, 80 (25) 2372-2425. doi: 10.1016/j.jacc.2022.11.001.
5. Liu X, Xiang L, Tong G. Predictive values of heart rate variability, deceleration and acceleration capacity of heart rate in post‐infarction patients with LVEF ≥35%. Annals of Noninvasive Electrocardiology. 2020 Jul 7;25(6). doi:10.1111/anec.12771.
6. Miakinkova LO, Liulka Ye M, Katerenchuk IP, Teslenko YV, Pysana BO. Rhythm control in patients with bradyasystolic atrial fibrillation. World of Medicine and Biology. 2023. 3(85), 157–161. https://doi.org/10.26724/2079-8334-2023-3-85-157-161.
7. Parizadeh D, Ghahvehchian H, Asgari S, Momenan AA, Azizi F, Hadaegh F. The association between changes in blood pressure components and incident cardiovascular diseases. Blood Pressure. 2017 Jul 14;26(6):341-9. doi:10.1080/08037051.2017.1353882.
8. Saxena T, Ali AO, Saxena M. Pathophysiology of essential hypertension: An update. Expert Review of Cardiovascular Therapy. 2018 Nov 15;16(12):879-87. doi:10.1080/14779072.2018.1540301.
9. Seravalle G, Grassi G. Sympathetic nervous system, hypertension, obesity and metabolic syndrome. High Blood Pressure & Cardiovascular Prevention. 2016 Mar 4;23(3):175-9. doi:10.1007/s40292-016-0137-4.
10. Shibasaki K, Ogawa S, Yamada S, Ouchi Y, Akishita M. Role of autonomic nervous activity, as measured by heart rate variability, on the effect of mortality in disabled older adults with low blood pressure in long‐term care. Geriatrics & Gerontology International. 2018 Apr 11;18(8):1153-8. doi:10.1111/ggi.13328.
11. Stergiou GS, Palatini P, Parati G, O’Brien E, Januszewicz A, Lurbe E, et al. 2021 European Society of Hypertension Practice Guidelines for office and out-of-office blood pressure measurement. Journal of Hypertension. 2021 Mar 12;39(7):1293-302. doi:10.1097/hjh.0000000000002843.
12. Townsend N, Kazakiewicz D, Lucy Wright F, Timmis A, Huculeci R, Torbica A, et al. Epidemiology of Cardiovascular Disease in Europe. Nature Reviews Cardiology. 2021;19(2):133-43. DOI: 10.1038/s41569-021-00607-3.
13. Vallée A, Yannoutsos A, Zhang Y, Henry-Bonniot G, Protogerou A, Topouchian J, et al. Determinants of pulse pressure amplification in hypertensive and diabetic patients. Hypertension Research. 2018 Dec 14;42(3):374-84. doi:10.1038/s41440-018-0161-y.
14. van Es VA, de Lathauwer IL, Kemps HM, Handjaras G, Betta M. Remote monitoring of sympathovagal imbalance during sleep and its implications in cardiovascular risk assessment: A systematic review. Bioengineering. 2024 Oct 19;11(10):1045. doi:10.3390/bioengineering11101045.
15. Yano Y, Rakugi H, Bakris GL, Lloyd-Jones DM, Oparil S, Saruta T, et al. On-treatment blood pressure and cardiovascular outcomes in older adults with isolated systolic hypertension. Hypertension. 2017 Feb;69(2):220-7. doi:10.1161/hypertensionaha.116.08600.

Publication:

«World of Medicine and Biology» Vol. 21 No. 94 (2025) , с. 106-111
УДК 616.1: 616.45-001.1/3

DOI:

https://doi.org/10.26724/2079-8334-2025-4-94-106-111