Non-invasive methods of determination of baroreflex sensitivity
(BRS, ms/mmHg) are based on beat-to-beat systolic blood
pressure and inter-beat interval recording. Sequential methods
and spectral methods at spontaneous breathing include transient
superposition of breathing and 0.1 Hz rhythms. Previously, a
cross-spectral method of analysis was used, at constant
breathing rate using a metronome set at 0.33 Hz, enabling
separate determination of BRS at 0.1 Hz (BRS0.1Hz) and
respiratory rhythms (BRS0.33Hz). The aim of the present study was
to evaluate the role of breathing in the spectral method of BRS
determination with respect to age and hypertension. Such
information would be important in evaluation of BRS at
pathological conditions associated with extremely low BRS levels.
Blood pressure was recorded by Finapres (5 minutes, controlled
breathing at 0.33 Hz) in 118 healthy young subjects (YS: mean
age 21.0±1.3 years), 26 hypertensive patients (HT: mean age
48.6±10.3 years) with 26 age-matched controls (CHT: mean age
46.3±8.6 years). A comparison of BRS0.1Hz and BRS0.33Hz was
made. Statistically significant correlations were found between
BRS0.1Hz and BRS0.33Hz in all groups: YS: r=0.52, p<0.01, HT:
r=0.47, p<0.05, and CHT: r=0.70, p<0.01. The regression
equations indicated the existence of a breathing-dependent
component unrelated to BRS (YS: BRS0.33Hz=2.63+1.14*BRS0.1Hz;
HT: BRS0.33Hz=3.19+0.91*BRS0.1Hz; and CHT: BRS0.33Hz=1.88+
+1.01*BRS0.1Hz; differences between the slopes and the slope of
identity line were insignificant). The ratios of BRS0.1Hz to BRS0.33Hz
were significantly lower than 1 (p<0.01) in all groups (YS:
0.876±0.419, HT: 0.628±0.278, and CHT: 0.782±0.260). Thus,
BRS evaluated at the breathing rate overestimates the real
baroreflex sensitivity. This is more pronounced at low values of
BRS, which is more important in patients with pathologic low
BRS. For diagnostic purposes we recommend the evaluation of
BRS at the frequency of 0.1 Hz using metronome-controlled
breathing at a frequency that is substantially higher than 0.1 Hz
and is not a multiple of 0.1 Hz to eliminate respiratory baroreflexnon-related influence and resonance effect on heart rate
fluctuations.