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Blood pressure and heart rate variability in elderly patients with isolated systolic hypertension
S Muneta1, E Murakami, T Sumimoto
1Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
Insights
Elderly patients with isolated systolic hypertension (ISH) exhibit greater blood pressure (BP) variability and nocturnal BP fall. Their BP is more strongly correlated with heart rate, suggesting autonomic nerve activity influences their BP fluctuations.
Area of Science:
- Cardiology
- Gerontology
- Physiology
Background:
- Isolated systolic hypertension (ISH) is common in the elderly.
- Understanding circadian blood pressure (BP) and heart rate (HR) patterns is crucial for managing hypertension.
- Autonomic nerve activity plays a role in BP regulation.
Purpose of the Study:
- To compare circadian BP and HR profiles in elderly patients with ISH versus essential hypertensive (EHT) and normotensive (NT) individuals.
- To evaluate daytime BP and HR variability and nocturnal BP fall amplitude in these groups.
- To explore the relationship between BP and HR in ISH patients.
Main Methods:
- Prospective study comparing three groups: ISH (n=19), EHT (n=18), and NT (n=16) of similar age.
- 24-hour ambulatory BP and HR monitoring to assess circadian profiles.
- Analysis of daytime variability and nocturnal fall amplitude for BP and HR.
- Correlation analysis between BP and HR over 24 hours.
Main Results:
- ISH patients demonstrated significantly wider daytime BP variability and a greater amplitude of nocturnal BP fall compared to EHT and NT groups.
- No significant differences were observed in daytime HR variability or nocturnal HR fall amplitude among the groups.
- A stronger positive correlation between BP and HR was found in ISH patients (approx. 80%) compared to EHT and NT groups.
Conclusions:
- Elderly ISH patients exhibit distinct circadian BP patterns characterized by increased variability and nocturnal dipping.
- The heightened correlation between BP and HR in ISH suggests increased susceptibility to autonomic nervous system influences.
- These findings highlight the importance of considering autonomic function in the management of ISH in the elderly.
Abstract:
To investigate the circadian profiles of BP and heart rate in elderly patients with isolated systolic hypertension (ISH), the variability of BP and heart rate during day time (daytime) and the amplitudes of nocturnal fall were evaluated in ISH (n = 19) comparing with those of essential hypertensive patients (EHT, n = 18) and normotensive subjects (NT, n = 16) in the same age range. ISH showed a significantly wider BP variability during the day time and a greater amplitude of nocturnal fall compared with EHT and NT. However, the heart rate variability during the daytime and the amplitude of nocturnal fall were similar among the three groups. ISH showed a stronger correlation between BP and heart rate during 24 hours compared with EHT and NT. Approximately 80% of ISH showed a significant positive correlation between BP and heart rate. These results suggest that the BP of ISH patients is susceptible to fluctuations in autonomic nerve activity.