Evaluation of the Cardiac Autonomic Control of Patients with Arterial Hypertension

Abstract

Background: Hypertension remains the most prevalent risk factor for cardiovascular diseases (CVD). Scientific literature had found a dysregulation of heart by autonomic nervous system in hypertensive patients. Objective: Our objective was to evaluate the autonomic nervous control of hypertensive Senegalese patients. Methods: This was a cross-sectional evaluating the autonomic nervous control of hypertensive patients by continuous recording of heart rate, in standing and lying position, using a Holter Shiller AR4Plus ® ECG. Exporting the RR duration and it’s incorporating it into the Kubios HRV Standard software made it possible to obtain the HRV parameters. HRV parameters were classified according reference values. Results: A total of 29 patients aged between 46 and 86 years were included in our study, and 21 of them were women. Controlled patients represented 27% of our population study and were, according to the use of beta-blockers, compared with patients not controlled. At rest, parasympathetic tone was found to be low in some patients. The sympathovagal balance was within normal limits except for some uncontrolled patients under beta-blockers. In orthostatic position, a significant decrease was noted in the parasympathetic tone while LF did not vary significantly. However, uncontrolled patients had a significantly higher LF in orthostatic position. But they did not show significant variation in their parameters while standing, unlike patients with good blood pressure control. Conclusion: Our results suggests that the functioning of the arterial baroreflex, which is the starting point of autonomic responses destined for the heart, is altered with rising blood pressure values.