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Is blunted heart rate decrease at night associated with prevalent organ damage in essential hypertension?

Cesare Cuspidi1, Stefano Meani, Francesca Negri

  • 1Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy. cesare.cuspidi@unimib.it

Blood Pressure Monitoring
|February 2, 2011
PubMed

Insights

A blunted heart rate circadian rhythm in hypertension is not linked to subclinical organ damage. This study found no association between heart rate dipping patterns and cardiovascular disease markers in essential hypertension patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Circadian Rhythms

Background:

  • The relationship between blunted day-night heart rate decrease and subclinical organ damage in hypertension is under-investigated.
  • Essential hypertension affects a significant portion of the adult population, increasing cardiovascular risk.

Purpose of the Study:

  • To investigate the association between a blunted decrease in day-night heart rate (heart rate dipping) and subclinical organ damage in untreated essential hypertensive patients.

Main Methods:

  • A cohort of 658 untreated essential hypertensive patients were assessed.
  • Methods included cardiac and carotid ultrasonography, 24-h urine microalbuminuria, and two 24-h ambulatory blood pressure monitoring sessions with simultaneous heart rate assessment.
  • Nondipping heart rate was defined as <10% reduction in nocturnal heart rate compared to daytime.

Main Results:

  • A reproducible nocturnal dipping profile was observed in 78% of patients, a nondipping profile in 12%, and a variable dipping profile in 10%.
  • No significant differences were found between groups regarding age, sex, body size, metabolic variables, blood pressure, left ventricular mass, carotid intima-media thickness, carotid plaque, or microalbuminuria.
  • Univariate analysis revealed no correlation between the decrease in nocturnal heart rate and any parameter of subclinical organ damage.

Conclusions:

  • Findings do not support a link between a flattened heart rate circadian rhythm and prevalent organ damage in essential hypertension.
  • An altered heart rate dipping pattern is not identified as a marker for subclinical cardiovascular disease in this cohort.
  • Prospective studies are needed to define the prognostic significance of these findings.
Abstract

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