Alterations in heart rate variability and its circadian rhythm in hypertensive patients with left ventricular hypertrophy free of coronary artery disease

Chakko, Simon; Mulingtapang, Reynaldo; Huikuri, Heikki V.; Kessler, Kenneth M.; Materson, Barry J.; Myerburg, Robert J.

doi:10.1016/0002-8703(93)90535-h

Cited by 104 publications

(46 citation statements)

References 27 publications

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“…15 Several studies have reported alterations in the circadian pattern of HRV, analysed in the time and frequency domain, in hypertensive patients compared to normotensive subjects. [16][17][18][19][20][21] In particular, we have previously observed that mild hypertensives were characterised by a reduced day-night oscillation of the low frequency spectral component (LF) of HRV compared with controls. 16 The aim of the present study was to investigate the cardiac sym-Journal of Human Hypertension patho-vagal balance, during the entire 24 h, in black and white hypertensives using heart rate variability.…”

Section: Introductionmentioning

confidence: 99%

Absence of sympathetic overactivity in Afro-Caribbean hypertensive subjects studied by heart rate variability

Guzzetti¹,

Mayet

Shahi

et al. 2000

J Hum Hypertens

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Black hypertensives present a greater prevalence of left ventricular hypertrophy and an increased mortality compared to white hypertensives. Differences in sympathetic activity might contribute to explain these racial differences in hypertension. Nevertheless, previous laboratory studies did not show any increase of sympathetic activity direct to the heart in black subjects. The aim of the present study was to investigate the cardiac sympatho-vagal balance in black and white hypertensives analysing heart rate variability, during the entire 24 h. We analysed Holter recordings of 52 essential hypertensive patients, who had never received antihypertensive treatment, 26 of whom were black and 26 were white. Consecutive series of 300 beats, with 150 beats overlapped (approximately 600 series/day), were considered for the analysis in time and frequency domain. The mean 24-h value of the power of the low frequency spec-

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Section: Introductionmentioning

confidence: 99%

Absence of sympathetic overactivity in Afro-Caribbean hypertensive subjects studied by heart rate variability

Guzzetti¹,

Mayet

Shahi

et al. 2000

J Hum Hypertens

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“…In addition, the improvement of HRV indexes is presumed as advantageous for prognosis because the decreased HRV indexes are generally considered as being associated with adverse prognosis in cardiovascular disorders. [11][12][13][14] Earlier reports have shown that impaired HRV indexes in patients with hypertension reflect the presence of either left ventricular hypertrophy 9 or coronary artery disease, 10 and that impaired HRV indexes are associated with a poor prognosis in patients with cardiovascular disease. [20][21][22] Further prospective studies would be of benefit to determine whether improvements in HRV secondary to the autonomic nervous effect of betaxolol treatment result in more favorable patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13][14] It is likely that the combined treatment of calcium channel blockers and -blockers might have a beneficial effect on cardiac autonomic nervous activity (CANA) assessed by HRV. However, there are no studies to directly compare the dose-up effect of amlodipine with the adding effect of betaxolol on CANA in patients with low dose amlodipine therapy.…”

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confidence: 99%

Comparative Effects of Amlodipine Monotherapy and Combination Therapy With Betaxolol on Cardiac Autonomic Nervous Activity and Health-Related Quality of Life in Patients With Poorly Controlled Hypertension

Takase

Takeishi

Hirai

et al. 2008

Circ J

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ong-acting calcium channel blockers are being frequently used for the treatment of hypertension in clinical practice. In particular, amlodipine is one of the most prescribed drugs of long-acting calcium channel blockers. [1][2][3] According to the guidelines for the management of hypertension (JSH 2004), the combined treatment of long-acting calcium channel blockers and -blockers is recommended. 4 Betaxolol, a third generation -blocker, is characterized as being long-acting, 1-adrenoceptor selective antagonist with a mild vasodilator effect and has few effects on metabolism of carbohydrates and lipids. [5][6][7][8] It is assumed that calcium channel blockers and -blockers, could have synergistic effects on blood pressure (BP) decrease and prevent a reflex tachycardia caused by the calcium channel blockers.Heart rate variability (HRV) indexes are well known prognostic markers for the various cardiovascular disorders, including hypertensive patients. [9][10][11][12][13][14] It is likely that the combined treatment of calcium channel blockers and -blockers might have a beneficial effect on cardiac autonomic nervous activity (CANA) assessed by HRV. However, there are no studies to directly compare the dose-up effect of amlodipine with the adding effect of betaxolol on CANA in patients with low dose amlodipine therapy.Antihypertensive drug therapy might elicit adverse drug reactions and compromise the patient's health-related quality of life (HRQL). 15,16 Particularly, -blockers might be associated with symptoms such as fatigability and inactivity.Thus, the purpose of the present study was to evaluate whether betaxolol adding therapy could have better outcomes of CANA assessed by HRV and HRQL evaluated by the questionnaire sheets than amlodipine dose-up therapy in patients with a poor BP control with low dose amlodipine therapy. Methods Study PopulationThe study population consisted of 65 hypertensive patients (66±9 years, 36 men and 29 women) who were Circ J 2008; 72: 764 -769

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“…11,15) Autonomic function was measured in the present study using power spectra obtained by frequency analysis using FFT. HF decreases in ischemic heart dis-ease, 16) congestive heart failure, 17) physical inactivity, 18) respiratory distress, 19) left ventricular hypertrophy, 20) and aging, 21) and it has been reported that HF increases due to β-blocker and angiotensin-converting enzyme inhibitor administration, and the administration of some calcium antagonists. 22,23) Pitzalis, et al 24) suggested that in the very early phase of myocardial infarction, heart rate variability in anterior and inferior sites was different and that during the first hours of myocardial infarction, patients with an inferior site showed greater vagal activity than patients with an anterior site, and that the recovery of heart rate variability is an early phenomenon in both sites of infarction, being already evident by the second week after the infarction.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between the Mismatch of 123I-BMIPP and 201Tl Myocardial Single-Photon Emission Computed Tomography and Autonomic Nervous System Activity in Patients With Acute Myocardial Infarction

et al. 2006

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SUMMARYThe purpose of this study was to elucidate the relationship between the mismatch of thallium-201(Tl) and iodine-123-beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial single-photon emission computed tomography (SPECT) and autonomic nervous system activity in myocardial infarction (MI) patients. The subjects were 40 patients (34 males, 6 females) who underwent examinations by 123 I-BMIPP and 201 Tl myocardial SPECT imaging and 24-hour Holter monitoring within a 3-day period 3 weeks after the onset of their first MI. R-R intervals were analyzed every hour over a period of 24 hours by fast Fourier transformation (FFT). High frequency (HF) and low frequency (LF) were defined as markers of cardiac vagal activity in the former and the LF/HF ratio as sympathetic activity. Greater or more extensive decreases in the BMIPP image than that in the Tl image were defined as a positive mismatch. Patients were divided into positive and negative mismatch groups of 20 patients each.There were no significant differences between the 2 groups in age, sex, site of infarction, max CK (creatine kinase), max CK-MB, or left ventricular ejection fraction. The incidences of clinical signs suggesting residual myocardial ischemia were significantly greater in the positive than in the negative mismatch group (P < 0.05). The mean values for HF over the entire 24-hour period and over the 5-hour nocturnal period (0-5 AM) in the positive mismatch group were both significantly lower than those in the negative mismatch group (P < 0.001 in both groups). The 24-hour mean HF and mean nighttime HF in patients with signs of residual ischemia were both significantly lower than in those without signs of residual ischemia in the positive mismatch group (P < 0.05 in both groups).The mean LF/HF ratio for both the entire 24-hour and the nocturnal period in the positive mismatch group were significantly higher than those in the negative mismatch group (P < 0.001, P < 0.05, respectively). The daily profile of hourly HF measurements was significantly lower in the positive mismatch group than in the negative mismatch group (P < 0.02). The mean values of HF for 24-hour and 5-hour periods were significantly lower in patients with signs of residual ischemia in the positive mismatch group than in those with signs of residual ischemia in the negative mismatch group (P < 0.01, P < 0.02, respectively). There were no significant differences between the patients with From the

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Alterations in heart rate variability and its circadian rhythm in hypertensive patients with left ventricular hypertrophy free of coronary artery disease

Cited by 104 publications

References 27 publications

Absence of sympathetic overactivity in Afro-Caribbean hypertensive subjects studied by heart rate variability

Absence of sympathetic overactivity in Afro-Caribbean hypertensive subjects studied by heart rate variability

Comparative Effects of Amlodipine Monotherapy and Combination Therapy With Betaxolol on Cardiac Autonomic Nervous Activity and Health-Related Quality of Life in Patients With Poorly Controlled Hypertension

Relationship Between the Mismatch of 123I-BMIPP and 201Tl Myocardial Single-Photon Emission Computed Tomography and Autonomic Nervous System Activity in Patients With Acute Myocardial Infarction

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