Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions

Alp, Çağlar; Doğru, Mehmet; Demir, Vahit

doi:10.3906/sag-2105-177

Cited by 4 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the best of our knowledge, there is no previous study comparing MS and time-domain HRV parameters in the literature. Disruption of the dipping pattern is known to be associated with a reduction in pNN50 and rMSSD [28]. In our study, we found that the vagal activity markers pNN50 and rMSSD supported frequency domain analysis and were associated with MS. Also, there was an independent association between pNN50 and rMSSD, and MS.…”

Section: Discussionsupporting

confidence: 76%

See 1 more Smart Citation

Role of basal autonomic functions in patients with increased morning blood pressure surge

Akbay

Akıncı

2022

Blood Pressure Monitoring

View full text Add to dashboard Cite

Background Morning blood pressure (BP) surge (MS) is associated with cardiovascular events. The autonomic nervous system plays an active role in the regulation of BP and its function can be evaluated by heart rate variability (HRV) analysis. This study aimed to evaluate autonomic nervous system functions in patients with increased MS.Methods Patients who underwent ambulatory BP monitoring (ABPM) and 24-h rhythm Holter in our hospital during the same period between 2017 and 2022 were evaluated. HRV parameters were obtained from 24-h rhythm Holter recordings. MS values of the patients were calculated from ABPM records and patients were divided into four groups according to the MS quartiles. HRV parameters and other parameters were compared between the groups.Results A total of 129 patients were included in the study. The mean age of the patients was 57.2 ± 18.2 years, and 63 (48.8%) were male. HF, the square root of the mean squared differences of successive normal-tonormal intervals (rMSSD), and the proportion of adjacent RR intervals differing by >50 ms in the 24-h recording (pNN50) were statistically significant between the groups (P = 0.039, P = 0.013, P = 0.011, respectively). In univariate regression analysis, low-frequency/high-frequency ratio was positively associated with MS and HF, SDNNi, rMSSD, and pNN50 were negatively associated (β = 0.207, P = 0.019; β = −0.272, P = 0.002; β = −0.201, P = 0.022; β = −0.265, P = 0.002; β = −0.278, P = 0.001, respectively). Multiple linear regression analysis showed an independent association between HF, low-frequency/high-frequency ratio, rMSSD, pNN50, and MS (β = −0.247, P = 0.005; β=0.206, P = 0.017; β = −0.209, P = 0.005; β = −0.227, P = 0.008, respectively). ConclusionWe found an independent association between HRV parameters associated with vagal tone and MS. The findings of our study suggest that the increased sympathetic activity detected in patients with high MS in previous studies may be due to a decrease in basal vagal tone.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Role of basal autonomic functions in patients with increased morning blood pressure surge

Akbay

Akıncı

2022

Blood Pressure Monitoring

View full text Add to dashboard Cite

show abstract

“…The autonomic equilibrium swings toward the sympathetic nervous system at night, which is believed to be the primary mechanism for non-dipper hypertension. In non-dipper hypertensive patients, ventricular repolarization heterogeneity and cardiac conduction disruption were found at higher frequencies [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

The Significance of Frontal Plane QRS-T Angle for Estimating Non-Dipper Hypertension

Evsen¹,

Karahan²

2022

Cureus

View full text Add to dashboard Cite

Objective: The frontal QRS-T angle (fQRS-T) is linked to myocardial ischemia and ventricular arrhythmias. On the other hand, non-dipper hypertension is a risk factor for cardiac adverse events. The objective of this research was to determine whether the fQRS-T, a marker of ventricular heterogeneity, could be used to predict non-dipper hypertensive individuals in the lack of left ventricular hypertrophy.Methods: The observational study was carried out retrospectively. Patients diagnosed with hypertension were included in this study. Blood tests were routinely conducted for all patients. Electrocardiography (ECG) was conducted for each patient and echocardiography was performed. Blood pressure (BP) values were collected from the ambulatory Holter records. According to ambulatory Holter monitoring, the individuals were separated into two groups. The association between fQRS-T and hypertension was investigated.Results: The research involved 123 patients, with an average age of 51.85±8.22 years, comprising 76 women (61.8%) and 47 males (38.2%). According to ambulatory Holter monitoring, patients were separated into dippers (n=65) and non-dippers (n=58). There were no statistically significant in the laboratory and echocardiographic variables (p>0.05). QT dispersion (QTd) and fQRS-T were substantially greater in the non-dipper group than in the dipper group (p=0.043 and p<0.001, respectively). Independent determinants of non-dipper status were determined by univariate and multivariate logistic regression analyses. fQRS-T was found to be the only independent indicator of non-dipper status (OR: 1.03, 95%CI: 1.02-1.06, p<0.001). Conclusion:The fQRS-T may be a useful marker for estimating non-dipper hypertensive individuals in the lack of left ventricular hypertrophy.

show abstract

“…1,2 The 24-h blood pressure variability curve was mostly presented in a dipper type, that is, "two peaks and one valley." 3 In contrast, non-dipper blood pressure is a circadian rhythm abnormality in hypertensive patients, defined as a decrease in blood pressure of <10% at night or >20% of the daytime blood pressure. 4 Patients with non-dipper hypertension (NDH) have higher risks of target organ damage such as left ventricular hypertrophy, carotid atherosclerosis, and stroke.…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension is a common chronic disease of the cardiovascular system, characterized by increased blood pressure in the arteries and elevated peripheral vascular resistance, which can increase the heart's systolic afterload, leading to structural and functional damage to relevant organs 1,2 . The 24‐h blood pressure variability curve was mostly presented in a dipper type, that is, “two peaks and one valley.” 3 In contrast, non‐dipper blood pressure is a circadian rhythm abnormality in hypertensive patients, defined as a decrease in blood pressure of <10% at night or >20% of the daytime blood pressure 4 . Patients with non‐dipper hypertension (NDH) have higher risks of target organ damage such as left ventricular hypertrophy, carotid atherosclerosis, and stroke 5 .…”

Section: Introductionmentioning

confidence: 99%

Effect of administration of low‐dose irbesartan and hydrochlorothiazide combined with levamlodipine at different times on the circadian rhythm of blood pressure and the levels of MMPs and TIMPs in non‐dipper patients with grade 1 and 2 hypertension

Yan¹,

Luo²,

Zhang³

et al. 2023

J of Clinical Hypertension

View full text Add to dashboard Cite

This study aimed to probe the effects of low‐dose irbesartan and hydrochlorothiazide in combination with levamlodipine at different times on the circadian rhythm of blood pressure, matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs) levels in patients with non‐dipper hypertension (NDH). In this prospective randomized controlled trial, 124 patients with NDH who visited our hospital between August 2018 and July 2021 were enrolled and divided into morning (62 patients) and night (62 patients) medication groups according to the random number table method. All patients received low‐dose irbesartan and hydrochlorothiazide combined with levamlodipine, with the morning medication group taking the medication between 7:00 and 10:00 and the night medication group taking the medication between 19:00 and 22:00 for 24 weeks. The effect of antihypertensive medication in both groups was measured, and changes in ambulatory blood pressure, blood pressure circadian rhythm, left ventricular structure, vascular endothelial function, MMPs, and TIMPs levels were observed before treatment initiation and after 24 weeks of treatment in both groups. The percentage of the dipper type was higher in the night medication group than in the morning medication group, while the percentage of the non‐dipper type was lower in the morning medication group (p < .05). Low‐dose irbesartan and hydrochlorothiazide combined with levamlodipine at different times can effectively treat NDH, but bedtime dosing is more beneficial in reducing nocturnal blood pressure, reversing NDH, improving the circadian rhythm of blood pressure, left ventricular structure, regulating vascular endothelial function, increasing MMPs levels, and reducing TIMP levels.

show abstract

Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions

Cited by 4 publications

References 36 publications

Role of basal autonomic functions in patients with increased morning blood pressure surge

Role of basal autonomic functions in patients with increased morning blood pressure surge

The Significance of Frontal Plane QRS-T Angle for Estimating Non-Dipper Hypertension

Effect of administration of low‐dose irbesartan and hydrochlorothiazide combined with levamlodipine at different times on the circadian rhythm of blood pressure and the levels of MMPs and TIMPs in non‐dipper patients with grade 1 and 2 hypertension

Contact Info

Product

Resources

About