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Increase of Short-Term Heart Rate Variability Induced by Blood Pressure Measurements during Ambulatory Blood Pressure
Attila Frigy1, Annamária Magdás1, Victor-Dan Moga2
1Department of Internal Medicine IV, University of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureș, Romania.
Insights
Blood pressure measurements during combined monitoring increase short-term heart rate variability (HRV). This effect, observed in hypertensive patients, warrants further investigation into its physiological basis and clinical significance.
Area of Science:
- Cardiology
- Physiology
- Biomedical Engineering
Background:
- Ambulatory blood pressure monitoring (ABPM) and Holter ECG monitoring (HM) are crucial for cardiovascular assessment.
- The potential influence of the measurement process itself on physiological parameters like heart rate variability (HRV) is not fully understood.
Purpose of the Study:
- To investigate the effect of blood pressure measurements per se on heart rate variability (HRV).
- To analyze short-term HRV changes in response to concomitant ABPM and HM in hypertensive patients.
Main Methods:
- 24-hour combined ABPM and HM were performed in 25 hypertensive patients.
- Short-term HRV parameters (SDNN, rMSSD) were analyzed from 2-minute ECG segments before, during, and after each blood pressure measurement.
- Statistical analysis using one-way ANOVA identified significant variations in HRV parameters related to blood pressure measurements.
Main Results:
- Analysis included 2281 blood pressure measurements (1518 daytime, 763 nighttime).
- Both SDNN and SDNN/MNN showed a consistent and significant increase during blood pressure measurements and a decrease afterward (p < 0.01).
- This pattern was observed across 24-hour, daytime, and nighttime periods.
Conclusions:
- Blood pressure measurement procedures during combined ABPM and HM induce a measurable increase in short-term HRV.
- The findings suggest a physiological response to the measurement process itself.
- Further research is needed to elucidate the underlying mechanisms and potential clinical implications of this observed HRV alteration.
Abstract:
Objective. The possible effect of blood pressure measurements per se on heart rate variability (HRV) was studied in the setting of concomitant ambulatory blood pressure monitoring (ABPM) and Holter ECG monitoring (HM). Methods. In 25 hypertensive patients (14 women and 11 men, mean age: 58.1 years), 24-hour combined ABPM and HM were performed. For every blood pressure measurement, 2-minute ECG segments (before, during, and after measurement) were analyzed to obtain time domain parameters of HRV: SDNN and rMSSD. Mean of normal RR intervals (MNN), SDNN/MNN, and rMSSD/MNN were calculated, too. Parameter variations related to blood pressure measurements were analyzed using one-way ANOVA with multiple comparisons. Results. 2281 measurements (1518 during the day and 763 during the night) were included in the analysis. Both SDNN and SDNN/MNN had a constant (the same for 24-hour, daytime, and nighttime values) and significant change related to blood pressure measurements: an increase during measurements and a decrease after them (p < 0.01 for any variation). Conclusion. In the setting of combined ABPM and HM, the blood pressure measurement itself produces an increase in short-term heart rate variability. Clarifying the physiological basis and the possible clinical value of this phenomenon needs further studies.
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