ANALYSIS OF BAROREFLEX UNDER ESSENTIAL HYPERTENSION IN CLINICAL PRACTICE
Keywords:
Arterial hypertension, heart rate turbulence, beginning of turbulence, turbulence slope, vegetative nervous system.
Abstract
Aim. The aim of this article is to study heart rate turbulence in healthy people and in patients with stages II and III of essential hypertension and to analyze possibilities of using the results obtained in clinical practice. Materials and methods. Weexamined 68 people (48.5 % female participants) aged 56.21 ± 1.06 years. We analyzed the results of 24-hour ECG Holter monitoring obtained with the help of Kardiotekhnica-04 computer appliance (INCART). Essential hypertension was diagnosed using a standard diagnostic scheme recommended by the Society of Cardiology of the Russian Federation guidelines (2013). This diagnosis was not confirmed in 6 participants. We registered stage II hypertension in 28 examinees with respect to disturbances of target organs. We diagnosed stage III hypertension in 34 patients taking into account such an associated linical condition as ischemic heart disease. The assessment of heart rate turbulence indices was performed within the standard procedure. Results. The results obtained show that in patients with essential hypertension there is a relative decrease in the parasympathetic activity of the vegetative nervous system and baroreflex sensitivity. As essential hypertension worsens, a decrease in the parasympathetic activity of the vegetative nervous system is becoming more pronounced. The comparative analysis of heart rate disturbance indices revealed a decrease in TO and TS as essential hypertension progresses, however these values remain within reference limits. Conclusion. We gave the examples of heart rate turbulence analysis with TO and TS pathological values. Heart rate turbulence is the method of assessment of the autonomous nervous system. It can be used for a complex assessment of essential hypertension in clinical conditions and during rehabilitation.References
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3. Balczewska D., Ptaszynski P., Cygankiewicz I. Baroreflex Sensitivity: Measurement and Clinical Aspects. Przegl Lek., 2015, no. 72(11), pp. 682–689.
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5. Bauer et al. Heart Rate Turbulence to Guide Treatment for Prevention of Sudden Death. Journal of Cardiovascular Pharmacology, 2010, vol. 55, iss. 6, pp. 531–538. DOI: 10.1097/FJC.0b013e3181d4c973
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7. Kossaify A., Garcia A., Ziade F. Assessment of Heart Rate Turbulence in Hypertensive Patients: Rationale, Perspectives, and Insight into Autonomic Nervous System Dysfunction. Heart Views, 2014, no. 15 (3), pp. 8–73.
8. Kilit C., Pasali Kilit T., Onrat E. Autonomic Modulation in Hypertension Without Hypertrophy. Acta Cardiol., 2015, no. 70 (6), pp. 21–27.
9. Song C.L., Zhang X., Liu Y.K., Yue W.W., Wu H. Heart Rate Turbulence in Masked Hypertension and White-Coat Hypertension. Eur. Rev. Med Pharmacol. Sci., 2015, no. 19 (8), pp. 457–460.
10. Erdem A., Uenishi M., Kucukdurmaz Z., Matsumoto K. Сardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clin. Exp. Hypertens., 2013, no. 5 (2), pp. 102–107.
2. Komolyatova V.N. and others. [National Russian Recommendations on the Use of the Holter Monitoring Methodology in Clinical Practice]. Rossiyskiy kardiologicheskiy zhurnal [Russian Cardiology Journal], 2014, no. 2, pp. 6–71. (in Russ.)
3. Balczewska D., Ptaszynski P., Cygankiewicz I. Baroreflex Sensitivity: Measurement and Clinical Aspects. Przegl Lek., 2015, no. 72(11), pp. 682–689.
4. Erdem A. et al. Cardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clinical and Experimental Hypertension, 2013, vol. 35, iss. 2, pp. 102–107. DOI: 10.3109/10641963.2012.690475
5. Bauer et al. Heart Rate Turbulence to Guide Treatment for Prevention of Sudden Death. Journal of Cardiovascular Pharmacology, 2010, vol. 55, iss. 6, pp. 531–538. DOI: 10.1097/FJC.0b013e3181d4c973
6. Bauer et al. Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use. International Society for Holter and Noninvasive Electrophysiology Consensus. J. Am. Coll. Cardiology, 2008, vol. 52, suppl. 17, pp. 1353–1365. DOI: 10.1016/j.jacc.2008.07.041
7. Kossaify A., Garcia A., Ziade F. Assessment of Heart Rate Turbulence in Hypertensive Patients: Rationale, Perspectives, and Insight into Autonomic Nervous System Dysfunction. Heart Views, 2014, no. 15 (3), pp. 8–73.
8. Kilit C., Pasali Kilit T., Onrat E. Autonomic Modulation in Hypertension Without Hypertrophy. Acta Cardiol., 2015, no. 70 (6), pp. 21–27.
9. Song C.L., Zhang X., Liu Y.K., Yue W.W., Wu H. Heart Rate Turbulence in Masked Hypertension and White-Coat Hypertension. Eur. Rev. Med Pharmacol. Sci., 2015, no. 19 (8), pp. 457–460.
10. Erdem A., Uenishi M., Kucukdurmaz Z., Matsumoto K. Сardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clin. Exp. Hypertens., 2013, no. 5 (2), pp. 102–107.
2. Komolyatova V.N. and others. [National Russian Recommendations on the Use of the Holter Monitoring Methodology in Clinical Practice]. Rossiyskiy kardiologicheskiy zhurnal [Russian Cardiology Journal], 2014, no. 2, pp. 6–71. (in Russ.)
3. Balczewska D., Ptaszynski P., Cygankiewicz I. Baroreflex Sensitivity: Measurement and Clinical Aspects. Przegl Lek., 2015, no. 72(11), pp. 682–689.
4. Erdem A. et al. Cardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clinical and Experimental Hypertension, 2013, vol. 35, iss. 2, pp. 102–107. DOI: 10.3109/10641963.2012.690475
5. Bauer et al. Heart Rate Turbulence to Guide Treatment for Prevention of Sudden Death. Journal of Cardiovascular Pharmacology, 2010, vol. 55, iss. 6, pp. 531–538. DOI: 10.1097/FJC.0b013e3181d4c973
6. Bauer et al. Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use. International Society for Holter and Noninvasive Electrophysiology Consensus. J. Am. Coll. Cardiology, 2008, vol. 52, suppl. 17, pp. 1353–1365. DOI: 10.1016/j.jacc.2008.07.041
7. Kossaify A., Garcia A., Ziade F. Assessment of Heart Rate Turbulence in Hypertensive Patients: Rationale, Perspectives, and Insight into Autonomic Nervous System Dysfunction. Heart Views, 2014, no. 15 (3), pp. 8–73.
8. Kilit C., Pasali Kilit T., Onrat E. Autonomic Modulation in Hypertension Without Hypertrophy. Acta Cardiol., 2015, no. 70 (6), pp. 21–27.
9. Song C.L., Zhang X., Liu Y.K., Yue W.W., Wu H. Heart Rate Turbulence in Masked Hypertension and White-Coat Hypertension. Eur. Rev. Med Pharmacol. Sci., 2015, no. 19 (8), pp. 457–460.
10. Erdem A., Uenishi M., Kucukdurmaz Z., Matsumoto K. Сardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clin. Exp. Hypertens., 2013, no. 5 (2), pp. 102–107.
References on translit
1. Redon J. and others. [National Recommendations for the Treatment of Arterial Hypertension ESH / ESC 2013]. Rossiyskiy kardiologicheskiy zhurnal [Russian Cardiology Journal], 2014, no. 1 (105), pp. 7–94. (in Russ.)2. Komolyatova V.N. and others. [National Russian Recommendations on the Use of the Holter Monitoring Methodology in Clinical Practice]. Rossiyskiy kardiologicheskiy zhurnal [Russian Cardiology Journal], 2014, no. 2, pp. 6–71. (in Russ.)
3. Balczewska D., Ptaszynski P., Cygankiewicz I. Baroreflex Sensitivity: Measurement and Clinical Aspects. Przegl Lek., 2015, no. 72(11), pp. 682–689.
4. Erdem A. et al. Cardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clinical and Experimental Hypertension, 2013, vol. 35, iss. 2, pp. 102–107. DOI: 10.3109/10641963.2012.690475
5. Bauer et al. Heart Rate Turbulence to Guide Treatment for Prevention of Sudden Death. Journal of Cardiovascular Pharmacology, 2010, vol. 55, iss. 6, pp. 531–538. DOI: 10.1097/FJC.0b013e3181d4c973
6. Bauer et al. Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use. International Society for Holter and Noninvasive Electrophysiology Consensus. J. Am. Coll. Cardiology, 2008, vol. 52, suppl. 17, pp. 1353–1365. DOI: 10.1016/j.jacc.2008.07.041
7. Kossaify A., Garcia A., Ziade F. Assessment of Heart Rate Turbulence in Hypertensive Patients: Rationale, Perspectives, and Insight into Autonomic Nervous System Dysfunction. Heart Views, 2014, no. 15 (3), pp. 8–73.
8. Kilit C., Pasali Kilit T., Onrat E. Autonomic Modulation in Hypertension Without Hypertrophy. Acta Cardiol., 2015, no. 70 (6), pp. 21–27.
9. Song C.L., Zhang X., Liu Y.K., Yue W.W., Wu H. Heart Rate Turbulence in Masked Hypertension and White-Coat Hypertension. Eur. Rev. Med Pharmacol. Sci., 2015, no. 19 (8), pp. 457–460.
10. Erdem A., Uenishi M., Kucukdurmaz Z., Matsumoto K. Сardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-Hypertensive Subjects. Clin. Exp. Hypertens., 2013, no. 5 (2), pp. 102–107.
Published
2018-02-01
How to Cite
Tuyzarova, I., Kozlov, V., & Shukanov, A. (2018). ANALYSIS OF BAROREFLEX UNDER ESSENTIAL HYPERTENSION IN CLINICAL PRACTICE. Human. Sport. Medicine, 18(1), 74-81. https://doi.org/10.14529/hsm180106
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Physiology
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