open access

Vol 13, No 5 (2018)
Review Papers
Published online: 2018-09-14
Get Citation

Assessment of heart rate variability in hypertensive patients — systematic review

Małgorzata Maciorowska, Paweł Krzesiński
DOI: 10.5603/FC.a2018.0092
·
Folia Cardiologica 2018;13(5):428-434.

open access

Vol 13, No 5 (2018)
Review Papers
Published online: 2018-09-14

Abstract

Arterial hypertension (AH) is the leading cause of cardiovascular mortality and a risk factor for ischaemic heart disease,
heart failure, renal failure and stroke. Although many factors are responsible for AH development, autonomic dysfunction
seems to be an important element in the development and progression of this disease.

Analysis of heart rate variability (HRV) offers a noninvasive, quantitative evaluation of the autonomic mechanisms
involved in cardiovascular control. This analysis can be made using various methods, including time, spectral and nonlinear
techniques. Data from large population studies indicate that people with normal blood pressure and reduced
HRV have an increased risk of developing AH. Lower HRV rates have been demonstrated in people with ‘white coat’
hypertension, as well as in people with an abnormal daily blood pressure profile i.e. with an excessive blood pressure
decrease at night (extreme dippers) or higher blood pressure values at night (reverse dippers) compared to people with
normotension. Similar observations have been made in hypertensives with end-organ damage. Studies have shown the
differing impacts of different groups of antihypertensive drugs on autonomic nervous system (AUN) function markers.
A particularly beneficial effect on HRV of beta-blockers and angiotensin receptor antagonists has been demonstrated.

The analysis of heart rate variability, despite its limitations, is an easily available method of noninvasive assessment
of the AUN. This may be useful as part of a comprehensive clinical assessment of hypertensive patients, especially in
low-risk and medium-risk patients with subclinical cardiovascular disorders.

Abstract

Arterial hypertension (AH) is the leading cause of cardiovascular mortality and a risk factor for ischaemic heart disease,
heart failure, renal failure and stroke. Although many factors are responsible for AH development, autonomic dysfunction
seems to be an important element in the development and progression of this disease.

Analysis of heart rate variability (HRV) offers a noninvasive, quantitative evaluation of the autonomic mechanisms
involved in cardiovascular control. This analysis can be made using various methods, including time, spectral and nonlinear
techniques. Data from large population studies indicate that people with normal blood pressure and reduced
HRV have an increased risk of developing AH. Lower HRV rates have been demonstrated in people with ‘white coat’
hypertension, as well as in people with an abnormal daily blood pressure profile i.e. with an excessive blood pressure
decrease at night (extreme dippers) or higher blood pressure values at night (reverse dippers) compared to people with
normotension. Similar observations have been made in hypertensives with end-organ damage. Studies have shown the
differing impacts of different groups of antihypertensive drugs on autonomic nervous system (AUN) function markers.
A particularly beneficial effect on HRV of beta-blockers and angiotensin receptor antagonists has been demonstrated.

The analysis of heart rate variability, despite its limitations, is an easily available method of noninvasive assessment
of the AUN. This may be useful as part of a comprehensive clinical assessment of hypertensive patients, especially in
low-risk and medium-risk patients with subclinical cardiovascular disorders.

Get Citation

Keywords

heart rate variability, hypertension, autonomic dysfunction, cardiovascular risk

About this article
Title

Assessment of heart rate variability in hypertensive patients — systematic review

Journal

Folia Cardiologica

Issue

Vol 13, No 5 (2018)

Pages

428-434

Published online

2018-09-14

DOI

10.5603/FC.a2018.0092

Bibliographic record

Folia Cardiologica 2018;13(5):428-434.

Keywords

heart rate variability
hypertension
autonomic dysfunction
cardiovascular risk

Authors

Małgorzata Maciorowska
Paweł Krzesiński

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