An Analytical Study of Heart Rate Variability in Newly Diagnosed Hypertensive Patients and Normotensive Subjects

Diagnostic Value of Ambulatory Blood Pressure Monitoring for Hypertension in Private Cardiology Practice in Senegal

Hypertension is a major contributor to cardiovascular morbidity and mortality. Ambulatory blood pressure monitoring (ABPM) complements office blood pressure measurement by detecting white-coat hypertension, masked hypertension, and nocturnal blood pressure abnormalities, and this study aimed to assess its diagnostic value in the management of hypertension in private cardiology practice in Senegal. A prospective, descriptive, and analytical study was conducted from July to September 2024 at Clinique Urgence Cardio in Dakar, including patients aged 18 years or older with a valid 24-hour ABPM recording. Clinical, anthropometric, and treatment data, together with cardiovascular risk factors, were collected; office and ambulatory blood pressure measurements were compared; and logistic regression was used to identify factors associated with discordance between the two methods. Of the 104 patients assessed, 97 had valid ABPM recordings. The mean age was 53.2 ± 14.1 years, and women predominated. Cardiovascular risk factors included abdominal obesity (77.3%), known hypertension (54.6%), physical inactivity (43.3%), dyslipidemia (37.1%), and diabetes (16.5%). Mean office blood pressure was 145.7/91.4 mmHg, compared with 130.5/80.2 mmHg over 24 hours, 134.4/82.4 mmHg during daytime, and 125/75 mmHg during nighttime. ABPM identified sustained hypertension in 53.61% of patients, white-coat hypertension in 18.56%, masked hypertension in 9.28%, and normotension in 18.56%, with overall agreement between office and ambulatory measurements of 72.2%. Among patients with elevated office blood pressure, 25.7% had white-coat hypertension, while 33.3% of those with normal office blood pressure had masked hypertension. Non-dipping and reverse-dipping patterns were observed in 45.4% and 19.6% of patients, respectively, and discordance was independently associated with alcohol consumption (OR = 5.08; p = 0.007). ABPM improves the diagnostic classification of hypertension and reveals a high prevalence of discordant phenotypes and nocturnal blood pressure abnormalities, and wider use of ABPM may help optimize patient management in this setting.

Continuous assessment and research on enhanced blood pressure control – CareBP study

The results of the CareBP study show the extended value of 14 days of individual blood pressure monitoring and underline the relevance of this approach for cardiovascular disease prevention.

Hyperuricemia in newly diagnosed Hypertension: A Study of Prevalence and Implications

An Observational and Comparative Study of Cardiovascular Drug: Chlorthalidone and Hydrochlorothiazide the First Line Drug Therapy of Hypertension

Background: Hypertension is when the pressure in blood pressure vessels is too high. The heart has to work harder to pump blood. Hypertension also known as silent killer. There are 2 types of hypertensions each has a different cause. It causes complications such as heart attack or stroke heart failure, kidney problems, metabolic syndrome, etc. The risk of hypertension increases with age. Smoking and alcohol consumption also raises blood pressure. Objective: The present investigation to observe and compare cardiovascular drug chlorthalidone versus hydrochlorothiazide the first line drug therapy of hypertension. Methodologies: - The present observational study was conducted on 133 hypertension patients. This study was evaluated for the comparative study of two prescribed drugs that is, hydrochlorothiazide and chlorthalidone on hypertension patient the data was collected using suitable design data collection form. Patients having comorbidities conditions were excluded. Results: Among 133 patients, 26% of total study population were females and 74% of total population were males. Majority of the patients were in the age group of 45-54 years accounting 33.83% of total study population and total 24.06% were alcoholic and chronic smoker. In this study we were included the patient on drug therapy of hydrochlorothiazide and chlorthalidone in which 61% were prescribed for hydrochlorothiazide treatment and 39% to a prescribed for chlorthalidone treatment and as per the data collected chlorthalidone lasts longer in the body than hydrochlorothiazide and it lasts up to 36 hours in the body. Chlorthalidone is 1 to 2 times as potent as hydrochlorothiazide but the quality of life of hydrochlorothiazide is better than chlorthalidone accounting with 61% Conclusion: The present study revealed that the hypertension patients have poor quality of life and it is very important to improve their quality of life so that the patients can enjoy their day-to-day life. Experts prefer chlorthalidone and hydrochlorothiazide both works well but hydrochlorothiazide prescribe more often. Keywords: Hypertension, blood pressure, chlorthalidone and hydrochlorothiazide

Evaluation of Cardiac Autonomic Function in Relation to Post-Exercise Heart Rate Recovery Among Medical Students

Introduction: Heart rate variability is the indicator that reflects the cardiovascular autonomic nervous system. Regular exercise stimulates structural and functional changes in the cardiovascular and peripheral system that can be measured by heart rate variability. This study was necessary to evaluate cardiac autonomic tone and its relation with physical fitness level in healthy medical students. So that it could provide important data regarding autonomic status and physical status which will be useful for both clinical and research purposes. Aims: To measure cardiac autonomic tone of medical students using heart rate variability and to look for the relationship between recovery heart rate and cardiac autonomic tone. Methods: In this cross-sectional study, 57 consenting healthy medical students age 17-30 years, underwent cardiac autonomic tone evaluation through heart rate variability and the cardiac autonomic tone was compared with their physical fitness level which was categorized into four groups that is good, satisfactory, poor and very poor. Results: No changes in Heart rate variability among four fitness groups were found. But when Spearman’s correlation was done we found out association of heart rate variability measures with recovery heart rate. The recovery heart rate showed significant negative correlation with pNN50, high frequency power and high frequency normalized unit. Whereas, recovery heart rate showed significant positive correlation with low frequency normalized unit and Low frequency/ high Frequency ratio of frequency domain measures of heart rate variability. Conclusion: This study reflects that parasympathetic activity was higher in increasing fitness level. But in lower fitness level sympathetic activity was higher.

Cardiovascular autonomic dysfunction in Morvan syndrome: A comparative study of heart rate variability and cardiovascular autonomic reflex tests.

BACKGROUND AND OBJECTIVE Morvan syndrome is a rare neurological disorder characterized by peripheral nerve hyperexcitability, autonomic instability, and encephalopathy. Autonomic dysfunction in these patients may have important cardiovascular implications. We characterized cardiovascular autonomic function in Morvan syndrome and compared it with that of healthy controls. METHODS In this comparative cross-sectional study, 19 patients with Morvan syndrome and 24 healthy controls broadly comparable in age at the group level were evaluated. Heart rate variability (HRV) was assessed using non-invasive electrocardiography, including time-domain and frequency-domain measures. Autonomic function was evaluated using Ewing's battery, including heart-rate response to deep breathing, Valsalva maneuver, orthostatic testing, and isometric handgrip. RESULTS Morvan syndrome patients showed significant autonomic impairment compared with healthy controls. HRV parameters, including standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), total power, low-frequency power, and high-frequency power, were significantly reduced in patients. Ewing's battery also demonstrated marked abnormalities, including reduced deep-breathing difference, lower Valsalva ratio, impaired orthostatic blood pressure response, and diminished isometric handgrip response. Effect sizes ranged from moderate to large (0.504-0.934), indicating substantial clinical relevance. Disease duration showed significant negative correlations with several HRV indices, including RMSSD (r=-0.68, P=0.001), suggesting progressive autonomic impairment. CONCLUSION Morvan syndrome patients demonstrated significant cardiovascular autonomic dysfunction compared with healthy controls, reflected by impaired HRV and abnormal autonomic reflex testing. These findings support the value of routine HRV and Ewing's battery assessment in Morvan syndrome for early detection of cardiovascular autonomic involvement and improved clinical monitoring.