Analysis of heart rate variability in masked hypertension

Area of Science:

• Cardiology
• Autonomic Nervous System Function
• Hypertension Research

Background:

• Masked hypertension (MH) is a condition where blood pressure is normal in a clinical setting but elevated during ambulatory monitoring.
• Cardiac autonomic dysfunction is increasingly recognized as a contributor to cardiovascular disease.
• Heart rate variability (HRV) is a non-invasive measure of autonomic nervous system activity.

Purpose of the Study:

• To investigate heart rate variability (HRV) in patients with masked hypertension (MH).
• To compare HRV parameters between patients with MH, essential hypertension (EH), and normotension (NT).
• To assess for cardiac autonomic nerve dysfunction in MH.

Main Methods:

• Participants were categorized into three groups: EH (n=40), MH (n=36), and NT (n=48) based on clinic and 24-h ambulatory blood pressure monitoring.
• Heart rate variability (HRV) parameters were assessed over 24 hours using a Holter monitor.
• Standard HRV metrics including SDNN, SDANN, SDNN Index, RMSSD, and HF were analyzed.

Main Results:

• Patients with essential hypertension (EH) and masked hypertension (MH) showed significantly decreased HRV parameters compared to normotensive (NT) controls.
• Key HRV parameters such as SDNN, SDANN, SDNN Index, RMSSD, and HF were significantly reduced in both EH and MH groups versus NT.
• No statistically significant differences in HRV parameters were observed between the EH and MH groups.

Conclusions:

• The findings indicate cardiac autonomic nerve dysfunction in patients with masked hypertension.
• Both masked hypertension and essential hypertension are associated with impaired autonomic regulation of the heart.
• HRV analysis is a valuable tool for detecting autonomic dysfunction in hypertensive patients, including those with MH.