Heart Rate Variability in Patients with Hypertension: the Effect of Metabolic Syndrome and Antihypertensive Treatment

Abstract

Metabolic syndrome (MetS) is a combination of factors which, collectively, increase cardiovascular risk to a greater extent than each of them separately. Previous studies showed high cardiovascular risk to be associated with autonomic nervous system dysfunction. The purpose of this study was to assess the effects of antihypertensive treatment on heart rate variability (HRV) in patients with hypertension (HTN), depending on cooccurrence of MetS. 118 patients with uncontrolled HTN were enrolled to the study. HRV was compared among patients with and without MetS (MetS [+], n = 70 ) at baseline and following 12 months antihypertensive treatment. The HRV indices measured from RR intervals recorded form using 24-hour ambulatory electrocardiography. The measured HRV domains were the standard deviation of the average of NN intervals [SDNN], square root of the mean of the sum of the squares of differences between adjacent NN intervals [rMSSD], percentage of NN50 [pNN50], low frequency [LF], high frequency [HF], total power of variance of all NN intervals [TP], and LF/HF ratio. Baseline parameters: SDNN, rMSSD, pNN50, and HF were significantly lower in the MetS[+] compared to the MetS[-] subgroup ( p < 0.05 ). After a 12-month antihypertensive treatment, MetS[+] patients achieved a significant improvement in parameters: SDNN, rMSSD, pNN50, and TP ( p < 0.05 ), while the changes in HRV observed in the MetS[-] subgroup were not statistically significant. The cooccurrence of HTN and other components of MetS is associated with disturbances of the autonomic balance. HTN control has a beneficial effect on HRV, with the effect being more evident in patients with MetS.

Cardiac Autonomic Modulation and Response to Sub-Maximal Exercise in Chilean Hypertensive Miners

“…Given that in non-treated hypertension the parasympathetic HRV indices are usually lower than those of normotensive individuals ( Singh et al, 1998 ), our data suggest that the pharmacologic intervention in our HT individuals has somehow restored the normal autonomic modulation of resting HR. This is in line with what reported in many papers, and in particular with what has been reported as the main effect of ARB and ACE inhibitor treatments in hypertensive patients ( Maciorowska et al, 2020 ). Interestingly, however, in our study the total power of the tachogram spectrum was still significantly reduced in baseline condition at SL in HT versus NT individuals.…”

“…Heart rate variability (HRV) is a non-invasive tool known since long time to be able to assess cardiac autonomic modulation. HRV represents an informative tool for all pathological conditions where autonomic derangements typically develop, such as arterial hypertension, diabetes ( Parati et al, 1995 ; Villafaina et al, 2017 ; Maciorowska et al, 2020 ; Yılmaz et al, 2020 ) and heart failure ( Hsu et al, 2015 ; Tsai et al, 2020 ). Moreover, HRV has been proposed as a monitoring/predicting tool for estimating the level of athletic performance ( Plews et al, 2013 ).…”

The effect of a home-based coaching program on heart rate variability in subacute stroke patients: a randomized controlled trial

“…This situation was caused by a technical issue with a cardiac recording device, beta-blocker medication and discontinued intervention. Additionally, we did not control antihypertensive drugs, which may have modified HRV parameters [43].…”

Blood Pressure Variability in Fabry Disease Patients

“…Decreased HR variability is associated with a higher risk of developing hypertension, cardiac events, and death in the general population [32]. Although it has been reported that antihypertensive therapy may improve HR variability in patients with essential hypertension, there is no clear consensus for antihypertensive treatment in these population [33]. In some studies, β-blockers and calcium channel blockers have been shown to improve HR variability [34, 35].…”