Vol 7, No 1 (2003)
Review paper
Published online: 2003-01-16
Heart Rate Variability in Essential Hypertension. Part IV. The Influence of the Antihypertensive Treatment on Heart Rate Variability in Hypertension
Ryszard Piotrowicz, Katarzyna Stolarz
Nadciśnienie tętnicze 2003;7(1):51-57.
Vol 7, No 1 (2003)
REVIEV
Published online: 2003-01-16
Abstract
Essential hypertension exerts disturbing effect on heart rate
variability components, representing alterations in autonomic nervous system activity. Several classes of antihypertensive drugs, among their hypotensive effect, also influence
heart rate variability. Short-acting dihydropiridine calcium antagonists lead to increase of the low-to-high frequency index, which causes stimulation of the sympathetic
nervous system, but their slow-release formulations, as well as newer classes of dihydropiridines, do not induce sympathetic activation or even have beneficial effects on parameters
of heart rate variability. Improvement of heart rate variability indices after angiotensin-converting enzyme inhibitors
mainly depends on their beneficial effect leading to the regression of structural changes, such us left ventricular hypertrophy and vascular smooth muscle growth. Moreover, they correct diurnal profile of heart rate variability components and improve reactivity of the autonomic nervous system on orthostatic stimuli. Beta-adrenergic receptors blocking agents improve parasympathetic activity,
as reflected by the increase in high-frequency component and decrease of low-frequency component. Thus, varying influence of antihypertensive agents on heart rate variability should be considered when antihypertensive
treatment is being chosen.
Abstract
Essential hypertension exerts disturbing effect on heart rate
variability components, representing alterations in autonomic nervous system activity. Several classes of antihypertensive drugs, among their hypotensive effect, also influence
heart rate variability. Short-acting dihydropiridine calcium antagonists lead to increase of the low-to-high frequency index, which causes stimulation of the sympathetic
nervous system, but their slow-release formulations, as well as newer classes of dihydropiridines, do not induce sympathetic activation or even have beneficial effects on parameters
of heart rate variability. Improvement of heart rate variability indices after angiotensin-converting enzyme inhibitors
mainly depends on their beneficial effect leading to the regression of structural changes, such us left ventricular hypertrophy and vascular smooth muscle growth. Moreover, they correct diurnal profile of heart rate variability components and improve reactivity of the autonomic nervous system on orthostatic stimuli. Beta-adrenergic receptors blocking agents improve parasympathetic activity,
as reflected by the increase in high-frequency component and decrease of low-frequency component. Thus, varying influence of antihypertensive agents on heart rate variability should be considered when antihypertensive
treatment is being chosen.
Keywords
heart rate variability; hypertension; antihypertensive treatment
Title
Heart Rate Variability in Essential Hypertension. Part IV. The Influence of the Antihypertensive Treatment on Heart Rate Variability in Hypertension
Journal
Arterial Hypertension
Issue
Vol 7, No 1 (2003)
Article type
Review paper
Pages
51-57
Published online
2003-01-16
Page views
480
Article views/downloads
1526
Bibliographic record
Nadciśnienie tętnicze 2003;7(1):51-57.
Keywords
heart rate variability
hypertension
antihypertensive treatment
Authors
Ryszard Piotrowicz
Katarzyna Stolarz
About this article