Vol.6, No 1, 1999 pp. 63 - 68
UC 612.14;612.17
HEART RATE AND BLOOD PRESSURE VARIABILITY
IN HYPERTENSIVE PATIENTS
Ivan S. Tasić, Branko K. Lović, Aleksandar Nikolić, Stevan Ilić,
Marina Deljanin-Ilić, Dragan Đorđević, Irena Milovanović, Dejan Petrović,
Dragan Lović
Institute for Cardiology and Rheumatology Niška Banja, Yugoslavia
e-mail: ivant@ cent.co.yu
Summary. The aim of our research was to compare heart rate variability
and blood pressure variability in hypertensives with (LVH) or without LVH
and to prove their correlation with degree LVH and the degree of ventricular
arrhythmias discovered by Holter monitoring.
Design and Methods: 28 hypertensive patients, aged 56.5+/-7 were examined.
All the patients had a echocardiogram recording, 24 h ambulatory blood
pressure monitoring and 24 h electrocardiographic monitoring (DelMar system).
Eighteen patients, aged 57.5+/-8 had LVH with left ventricular mass index
(ILVM) 168.7+/-17.5 g/m2 while 10 patients without LVH aged
54.7+/-5.4 and ILVM: 110.9+/-8.4.
Results: ILVM correlated to standard deviation of all NN intervals
(SDNN) (R=0.57; p<0.002), standard deviation of the averages of NN intervals
in all 5-minute segments of the entire recording (SDANN) (R=0.57; p<0.001),
standard deviation 24 hours systolic blood pressure (R=0.44; p=0.025) and
to degree BP reduction at night (systolic BP: R=0.52; p=0.013 and diastolic
BP: R=-0.439; p=0.041). Patients with LVH had a considerably lower SDNN-(104.3+/-33
vs 147.7+/-7.9 ms; p<0.001) and lower SDANN-(93.1?26 vs 137+/-8.4 ms;
p<0.005). The degree of ventricular arrhythmias correlated to SDNN (p<0.005)
and SDANN (p<0.005). Standard deviation systolic BP in 24 hour time
was higher in patients with LVH but that deviation was not statistically
relevant (16.4+/-6 vs 13.1+/-2) while the decrease of systolic BP in these
patients was smaller during the night (8.3+/-8 vs 12.4+/-4 %). 12 out of
18 patients with LVH belonged to a non dipper group (67%) while there were
2 patients (33%) in the group without LVH.
Conclusions: Increased sympathetic activity was associated with degree
of LVH and degree ventricular arrhythmias.
Key words: Hypertension, left ventricular hypertrophy, heart
rate variability, blood pressure variability, ventricular arrhythmias
VARIJABILNOST SRČANE FREKVENCE I KRVNOG
PRITISKA U HIPERTENZIVNIH PACIJENATA
Kratak sadržaj: Cilj naše studije bio je da uporedi varijabilnost
srčane frekvence i varijabilnost krvnog pritiska u pacijenata sa hipertrofijom
leve komore (HLK) ili bez nje, i utvrdi njihovu korelaciju sa stepenom
HLK i ventrikularnih aritmijama utvrđenih Holter monitoringom
Metod: 28 pacijenata, starosti 56.5+/-7 uključeno je u studiju. Svim
pacijentima urađen je ehokardiografski pregled, 24 satni monitoring krvnog
pritiska i 24 satni monitoring EKG (Holter sistem - DelMar). Osamnaest
pacijenata, starosti 57.5+/-8 imalo HLK sa prosečnim indeksom mase leve
komore (ILVM) 168.7+/-17.5 g/m2 dok je 10 pacijenata bilo bez
HLK starosti 54.7+/-5.4 i ILVM: 110.9+/-8.4.
Rezultati: ILVM korelisao je standardnom devijacijom svih NN intervala
(SDNN) (R=0.57; p<0.002), standardnom devijacijom NN intervala u 5-minutnim
segmentima registrovanja (SDANN) (R=0.57; p<0.001), standardnom devijacijom
24 satnog sistolnog krvnog pritiska (R=0.44; p=0.025) i stepenom smanjenja
krvnog pritiska u toku noći (sistolni KP:R=-0.52; p=0.013 and diastolni
KP: R=-0.439; p=0.041). Pacijenti sa HLK imali su značajno manju SDNN-(104.3+/-33
vs 147.7+/-7.9 ms; p<0.001) i manju SDANN-(93.1+/-26 vs 137+/-8.4 ms;
p<0.005) nego pacijenti bez HLK. Stepen ventrikularnih aritmija korelisao
je sa SDNN (p<0.005) i SDANN (p<0.005). Standardna devijacija sistolnog
KP u toku 24 sata bila je veća u pacijenata sa HLK ali ta razlika nije
statistički značajna (16.4+/-6 vs 13.1+/-2). Ova grupa pacijenata pokazala
je manji pad sistolnog KP u toku noći (8.3+/-8 vs 12.4+/-4 %). 12 od 18
pacijenata sa HLK pripadalo je non dipper grupi (67%) dok samo 2 pacijenta
(33%) iz te grupe nije imalo HLK.
Zaključak: Povećana simpatička aktivnost u hipertenzivnih bolesnika
udružena je sa težim stepenom HLK i ventrikularnih aritmija.
Ključne reči: Hipertenzija, hipertrofija leve komore, varijabilnost
srčane frekvence, varijabilnost krvnog pritiska, ventrikularne aritmije
