The relationship between the antihypertensive effect of b-adrenergic blockers and the initial daily variability of sinus rhythm

Abstract

The objective of rhe study was to identify the features of the daily sinus rhythm variability (HRV), affecting the manifestations of the antihypertensive effect of b-adrenergic blockers and to establish the connection of this effect with the dynamics of the daily HRV. Material and methods. 52 patients with grade 1-2 degree essential arterial hypertension (32 to 60 years old - 21 men and 31 women) underwent general clinical and functional examination using bifunctional monitoring of ECG and blood pressure before and after treatment with carvedilol, nebivolol and bisoprolol. Monitor daily mean systolic (MSAD) and diastolic (MDAD) pressure were assessed in comparison with the distribution of heart rate during the day and the amount of HRV corresponding to different ranges of heart rate. Results. The initial average group values of the MSAD and MDAD parameters and the HR distribution during the day were equal in groups in groups with achieved (ABP) and not achieved (NABP) target blood pressure levels. Achievement of target levels of mean daily blood pressure (SBP≤130 mm Hg and DBP≤80 mm Hg) is associated with the initial quantitative parameters of daily HRV, corresponding to different ranges of HR. Differences between HRV in the ABP and NABP groups appear in the HR ranges of less than 75 beats/min: the initial values of HRV are greater in the ABP group than in the NABP group. In the range of heart rates 69-75 beats/min, the differences in HRV values become significant. As a result of therapy, the initially high mean group values of HRV in the ABP group decrease, while in the NABP group they remain unchanged. Conclusion. With initially high values of HRV in the heart rate range of 69-75 beats/min, the likelihood of a decrease in blood pressure to the target level during treatment with b-adrenergic blockers increases

New approaches to the analysis of daily variability of sinus rhythm in assessing the antihypertensive effect of various drugs

“…Связь между антигипертензивной эффективностью b-АБ и снижением исходно высокой ВСР в диапазонах ЧСС, близких к 75 уд/мин, отмечалась нами ранее [5].…”

“…Эти находки позволяли предположить разные механизмы, влияющие на вегетативную регуляцию ритма и, соответственно, разный механизм развития АГ. Наши предыдущие исследования [2][3][4][5][6][7] выявили связь динамики параметров суточной ВСР с изменением функционального класса сердечной недостаточности, состоянием больных, перенесших операцию коронарного шунтирования и баллонной ангиопластики [2,3]. Нами начаты исследования ВСР у больных АГ, в том числе на фоне антигипертензивной терапии b-адреноблокаторами (b-АБ).…”

“…Нами начаты исследования ВСР у больных АГ, в том числе на фоне антигипертензивной терапии b-адреноблокаторами (b-АБ). Показано, что антигипертензивный эффект (АЭ) часто сопровождался нормализацией ряда исходно сниженных показателей ВСР [4,5].…”