Related Experiment Video
Updated: Aug 2, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Circadian rhythm changes in blood pressure and heart rate during the first year after heart transplantation
D M Lanuza1, K Grady, M Hetfleisch
1Department of Medical-Surgical Nursing, Loyola University Medical Center, Chicago, Ill.
Insights
Heart transplant recipients often develop hypertension and experience altered circadian rhythms in blood pressure and heart rate post-transplant. Monitoring these vital signs is crucial for managing long-term cardiovascular health in these patients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Chronobiology
Background:
- Heart transplantation is a life-saving procedure, but recipients face long-term cardiovascular challenges.
- Understanding the temporal patterns of blood pressure and heart rate is vital for post-transplant care.
Purpose of the Study:
- To investigate circadian patterns of systolic blood pressure, diastolic blood pressure, and heart rate in heart transplant recipients.
- To identify nocturnal blood pressure declines and changes in mean vital signs over the first year post-transplant.
- To assess the prevalence of hypertension in this patient cohort.
Main Methods:
- Ambulatory blood pressure monitoring was used to record blood pressure and heart rate at 1-hour intervals for up to 48 hours.
- Patients were studied before discharge and at 1, 3, 6, and 12 months post-transplantation.
- Data analysis included descriptive statistics, independent t-tests, and cosinor analysis for rhythmicity.
Main Results:
- Most patients exhibited significant circadian rhythms for blood pressure and heart rate.
- Systolic and diastolic blood pressure acrophases showed phase shifts, with no clear relationship to nocturnal declines.
- Hypertension (BP > 140/90 mm Hg) developed in 80% of patients by 6 months and 1 year.
- Mean heart rate increased by approximately 18% during the first postoperative year.
Conclusions:
- Heart transplant recipients frequently develop hypertension and exhibit altered circadian blood pressure patterns.
- Heart rate shows more consistent circadian rhythms compared to blood pressure.
- Long-term monitoring is essential to manage cardiovascular risks, including hypertension and altered vital sign rhythms, after heart transplantation.
Abstract:
Heart transplant recipients (n = 11) were studied before discharge from the hospital and 1, 3, 6, and 12 months after transplantation to (1) examine systolic and diastolic blood pressure and heart rate circadian patterns, (2) detect the presence or absence of nocturnal declines, and (3) describe changes in the mean levels of systolic blood pressure, diastolic blood pressure, and heart rate. An ambulatory blood pressure-monitoring system was used to record blood pressure and heart rate at 1-hour intervals for up to 48 hours. Data were analyzed with descriptive and independent t-test statistics, as well as cosinor analysis for rhythmicity. The majority of the patients had significant (p < 0.05) circadian rhythms for systolic and diastolic blood pressure and heart rate throughout the study, but at times the systolic and diastolic blood pressure acrophases were found to be phase shifted to earlier or later along the time axis (e.g., peak values occurring at 3 AM rather than later in the morning or early afternoon), such that no relationships were found between circadian rhythms and nocturnal declines. More "normal" circadian rhythms were observed for heart rate than for systolic and diastolic blood pressures. The development of hypertension (systolic/diastolic blood pressures > 140/90 mm Hg) was common and by 6 months and 1 year after transplantation 8 of the 10 patients remaining in the study were hypertensive. Increases in mean heart rate of approximately 18% (ranging from 2% to 46%) were also observed during the first postoperative year.
More Related Videos
Related Concept Videos
01:14Decreased pulse rate
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with bradycardia...
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:30Factors Influencing Heart Rate
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
01:18Neural Regulation of Blood Pressure
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...