Examination of variability in arterial blood pressure at rest using spectral analysis in hypertensive patients

Jp, Siché; Tremel, F; Comparat,; R, de Gaudemaris; Jm, Mallion

doi:10.1097/00004872-199501000-00021

Cited by 8 publications

(12 citation statements)

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“…[32][33][34] Both sequence methods and CSP further showed that BRS was decreased in patients with mild-tomoderate hypertension. 35 In our study, BRS in sequential analysis was found, as in the literature, 36,37 to depend on age, gender, DBP, SBP and HR.…”

Section: Discussionsupporting

confidence: 82%

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Oxidative stress and baroreflex sensitivity in healthy subjects and patients with mild-to-moderate hypertension

Ormezzano

et al. 2004

J Hum Hypertens

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Decreased baroreflex sensitivity (BRS) is a prognostic marker in essential hypertension. Animal experiments suggest that decreased BRS is related to increased oxidative stress. Our study was aimed at testing whether oxidative stress, estimated by isoprostane 15-F 2t -IsoP urinary levels, is correlated to BRS variation in healthy subjects as well as in patients suffering from essential hypertension. Urinary 15-F 2t -IsoP levels and BRS were evaluated in two groups of subjects: healthy volunteers (n ¼ 64) and patients with untreated mild-to-moderate hypertension (n ¼ 33). Data were analysed in 61 and 31 subjects, respectively, BRS analysis being impossible in three and two subjects, respectively. 15-F 2t -IsoP levels were measured using gas chromatography/mass spectrometry. BRS was measured using the sequence method [PS þ /RR þ and PSÀ/RRÀ] and crossspectral analysis (CSP) (MF gain) at rest, lying down. No significant correlation was found between basal urinary 15-F 2t -IsoP levels and BRS (sequence method and CSP) in either healthy controls or hypertensive patients. Our study shows that oxidative stress is not involved in interindividual variations of BRS in healthy subjects and patients suffering from mild-to-moderate hypertension

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Section: Discussionsupporting

confidence: 82%

“…1,2 After a myocardial infarction, a fall in BRS 3 or variability in heart rate (HR), 4 or increased blood pressure (BP) variability 5,6 are linked to a higher cardiovascular morbidity rate. 7 In subjects considered to be healthy, BRS varies greatly from one person to another.…”

Section: Introductionmentioning

confidence: 99%

Oxidative stress and baroreflex sensitivity in healthy subjects and patients with mild-to-moderate hypertension

Ormezzano

et al. 2004

J Hum Hypertens

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“…The modulus of the transfer function between SBP and pulse interval was examined in mid-frequency band (66 to 127 MHz) and was considered as an index of BRS when the coefficient of coherence was > 0.5 [24].…”

Section: ■ Assessing Baroreflex Sensitivitymentioning

confidence: 99%

“…This, despite the fact that it has been shown in many studies that ambulatory blood pressure monitoring (ABPM) is a more reliable prognostic modality than office BP results [18][19][20][21][22][23][24][25][26][27]. Certain subjects who have readings in the normal range when assessed in the office are found to be hypertensive by ABPM (the phenomenon of white-coat normotension; (WCNT) or masked hypertension).…”

Section: Introductionmentioning

confidence: 99%

Is there any real target organ damage associated with white-coat normotension?

et al. 2004

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Subjects with white-coat normotension (WCNT) or masked hypertension, i. e. a normal office blood pressure (BP) reading but elevated ambulatory blood pressure monitoring (ABPM) results, have not been extensively studied. The aim of this work was to compare true normotensive subjects (NT), WCNT and nevertreated hypertensive subjects (HT, with elevated BP according to both office and ABPM readings). One hundred and fifty subjects were recruited to analyze cardiovascular characteristics. Office BP readings coupled with ABPM results were used to break this population down into 51 NT, 18 WCNT and 81 HT. Office BP readings were higher in WCNT than in NT. In WCNT, carotid-femoral pulse wave velocity (PWV) was higher than in NT (with a borderline significance p = 0.05) and the standing baroreflex sensitivity (BRS) was lower (p = 0.04). Left ventricular mass index (LVMI) and carotid intima-media thickness (IMT) tended to increase and BRS measurements tended to decrease from NT through WCNT to HT. However, the difference across the board is only significant (p < 0.05) between NT and HT. If only the subset of NT subjects with SBP readings comparable to those of the WCNT subjects (i. e. SBP > 120 mmHg) is considered, no significant difference is detected in PWV and the only difference is detected in BRS (respectively for standing [PS+/RR+]: 5.7 +/- 1.4 ms/mmHg vs 4.9 +/- 1.2 ms/mmHg, p = 0.04). In conclusion, the principal cardiovascular differences measured between the NT and the WCNT can probably be explained by their difference in clinical level of pressure at rest. Only the BRS remains different between NT and WCNT when the real level of clinical pressure is taken into account.

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“…Heart rate variability (HRV) has emerged as a practical, noninvasive tool to quantitatively investigate cardiac autonomic dysregulation in hypertension. Studies have reported decreased HRV among hypertensives [1][2][3][4][5][6][7][8][9][10][11][12] and that the relation between blood pressure and HRV is present across a wide range of blood pressures. 12,13 Data from the Framingham cohort and a subset of the Atherosclerosis Risk in Communities (ARIC) cohort suggest that individuals with decreased HRV have an increased risk of developing hypertension, although results are inconsistent across measures of HRV 1,2 and sex.…”

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confidence: 99%

Hypertension, Blood Pressure, and Heart Rate Variability

et al. 2003

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Abstract-Dysregulation of the autonomic nervous system has been implicated in the development of hypertension. Heart rate variability is a noninvasive tool to quantitatively estimate cardiac autonomic activity and has been used to document decreased cardiac autonomic activity in hypertension. The ability of decreased heart rate variability to predict incident hypertension has not been well studied, and there are no studies of whether hypertension leads to changes in heart rate variability. We investigated the temporal sequence linking hypertension, blood pressure, and heart rate variability in a population-based cohort of 11 061 individuals aged 45 to 54 years at baseline. Individuals with hypertension had decreased heart rate variability at baseline, and this association was present across the full blood pressure range. Among 7099 individuals without hypertension at baseline, low heart rate variability predicted greater risk of incident hypertension over 9 years of follow-up. The hazard ratio (95% confidence interval [CI]) for the lowest compared with the highest quartile of the standard deviation of normal-to-normal R-R intervals was 1.24 (95% CI, 1.10 -1.40), for the root mean square of successive differences in normal-to-normal R-R intervals was 1.36 (95% CI, 1.21-1.54), and for R-R interval was 1.44 (95% CI, 1.27-1.63). Over 9 years, there was no measurable difference in the rate of change in heart rate variability among those with and without hypertension, although the differences in heart rate variability at follow-up were smaller than those at baseline. These findings thus support the thesis that the autonomic nervous system is involved in the development of hypertension, yet suggest that differences in the autonomic profile of hypertensives and normotensives do not increase with time. Key Words: autonomic nervous system Ⅲ heart rate Ⅲ heart rate variability Ⅲ hypertension, detection and control Ⅲ blood pressure A lthough the pathogenesis of most hypertension is unclear, dysregulation of the autonomic nervous system has been implicated in its development. Heart rate variability (HRV) has emerged as a practical, noninvasive tool to quantitatively investigate cardiac autonomic dysregulation in hypertension. Studies have reported decreased HRV among hypertensives [1][2][3][4][5][6][7][8][9][10][11][12] and that the relation between blood pressure and HRV is present across a wide range of blood pressures. 12,13 Data from the Framingham cohort and a subset of the Atherosclerosis Risk in Communities (ARIC) cohort suggest that individuals with decreased HRV have an increased risk of developing hypertension, although results are inconsistent across measures of HRV 1,2 and sex. 2 It is also unknown to what degree hypertensives and normotensives experience similar declines in HRV. Thus, although the autonomic nervous system is involved in the regulation of blood pressure, the temporal sequence linking hypertension and HRV is unclear. This study was designed to investigate this temporal sequence over 9 years in the...

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Examination of variability in arterial blood pressure at rest using spectral analysis in hypertensive patients

Cited by 8 publications

References 0 publications

Oxidative stress and baroreflex sensitivity in healthy subjects and patients with mild-to-moderate hypertension

Oxidative stress and baroreflex sensitivity in healthy subjects and patients with mild-to-moderate hypertension

Is there any real target organ damage associated with white-coat normotension?

Hypertension, Blood Pressure, and Heart Rate Variability

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