Hypertension, blood pressure, and heart rate variability - The Atherosclerosis risk in Communities (ARIC) study

被引:329
作者
Schroeder, EB
Liao, DP
Chambless, LE
Prineas, RJ
Evans, GW
Heiss, G
机构
[1] Univ N Carolina, Sch Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27514 USA
[2] Univ N Carolina, Sch Publ Hlth, Dept Biostat, Chapel Hill, NC 27514 USA
[3] Penn State Univ, Coll Med, Dept Hlth Evaluat Sci, Hershey, PA USA
[4] Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27103 USA
关键词
autonomic nervous system; heart rate; heart rate variability; hypertension; detection and control; blood pressure;
D O I
10.1161/01.HYP.0000100444.71069.73
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Dysregulation of the autonomic nervous system has been implicated in the development of hypertension. Heart rate variability is a noninvasive tool to quantitatively estimate cardiac autonomic activity and has been used to document decreased cardiac autonomic activity in hypertension. The ability of decreased heart rate variability to predict incident hypertension has not been well studied, and there are no studies of whether hypertension leads to changes in heart rate variability. We investigated the temporal sequence linking hypertension, blood pressure, and heart rate variability in a population- based cohort of 11 061 individuals aged 45 to 54 years at baseline. Individuals with hypertension had decreased heart rate variability at baseline, and this association was present across the full blood pressure range. Among 7099 individuals without hypertension at baseline, low heart rate variability predicted greater risk of incident hypertension over 9 years of follow- up. The hazard ratio ( 95% confidence interval [ CI]) for the lowest compared with the highest quartile of the standard deviation of normal- to- normal R- R intervals was 1.24 ( 95% CI, 1.10 - 1.40), for the root mean square of successive differences in normal- to- normal R- R intervals was 1.36 ( 95% CI, 1.21 - 1.54), and for R- R interval was 1.44 ( 95% CI, 1.27 - 1.63). Over 9 years, there was no measurable difference in the rate of change in heart rate variability among those with and without hypertension, although the differences in heart rate variability at follow- up were smaller than those at baseline. These findings thus support the thesis that the autonomic nervous system is involved in the development of hypertension, yet suggest that differences in the autonomic profile of hypertensives and normotensives do not increase with time.
引用
收藏
页码:1106 / 1111
页数:6
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