24-Hour Heart Rate Profile in Assessment of Target Organs in Women With Arterial Hypertension

Aim. To study relationships of 24-hour heart rate (HR) profile with involvement of the heart and kidney in women with arterial hypertension (AH). Material. We examined women (n=273) aged 40-70 years with essential 2-3 degree AH. Methods. Blood pressure (BP) measurements (8 times in a week), electrocardiography, echocardiography, ambulatory BP monitoring, complex laboratory diagnostics. Results. Less than 10% HR lowering was registered in 22.7% of patients. Compared with the group with normal HR profile this group was characterized by high levels of clinical systolic and diastolic BP (SBP, DBP), mean 24-hour BP, nocturnal BP, SBP time index, as well as low levels of 24-hour SBP, HR, and HR variability. Same group had also significantly greater left atrial dimensions, and higher values of NT-proBNP and total risk according to SCORE (Systematic Coronary Risk Estimation). Correlation analysis revealed significant reverse association between 24-hour HR index which reflected circadian character of cardiac rhythm, left atrial dimension (r=-0.212) and NT-proBNP (r=-0.346). Flat HR profile was not statistically significant for detection of cardiac pathology (odds ratio 1.19; 95% confidence interval from 0.67 to 2.14). Conclusion. Insufficient nocturnal HR lowering in women with AH was not associated with significant changes of the myocardium and kidney and clear cat links with dyslipidemia, obesity, and smoking.