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Effect of antihypertensive drug therapy on short‐term heart rate variability in newly diagnosed essential hypertension
Author(s) -
Pavithran Purushothaman,
Prakash E Sankaranarayanan,
Dutta Tarun K,
Madanmohan Trakroo
Publication year - 2010
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/j.1440-1681.2009.05295.x
Subject(s) - atenolol , medicine , amlodipine , blood pressure , enalapril , heart rate variability , essential hypertension , cardiology , heart rate , hydrochlorothiazide , angiotensin converting enzyme
Summary 1. Abnormalities of cardiac autonomic regulation are a potential mechanism for morbidity despite blood pressure (BP) lowering in hypertension. Analysis of short‐term (5 min) heart rate variability (HRV) provides a non‐invasive probe of autonomic regulation of sino‐atrial (SA) node automaticity. 2. We hypothesized that antihypertensive drug therapy would be associated with an increase in 5 min overall HRV, along with a decrease in blood pressure (BP), at 8 weeks follow up in subjects with newly diagnosed, never‐treated essential hypertension. 3. One hundred and fifty patients (84 men and 66 women; mean (±SD) age 48 ± 10 years) with newly diagnosed essential hypertension were divided to five groups of 30 patients each to receive one of the following antihypertensive drugs (or drug combinations): 5 mg/day amlodipine; 50 mg/day atenolol; 5 mg/day enalapril; 25 mg/day hydrochlorothiazide; or a combination of 5 mg/day amlodipine and 50 mg/day atenolol. 4. The only significant change in HRV indices was an increase in total variability of RR intervals and an increase in high‐frequency (HF) RR interval spectral power in the amlodipine + atenolol‐treated group ( P < 0.05). 5. The results indicate that there is a dissociation between changes in short‐term HRV and mean RR interval and BP lowering in patients with newly diagnosed hypertension. 6. We interpret the increase in HF RR interval spectral power in the amlodipine + atenolol‐treated group as being due to an increase in vagal modulation of RR intervals and/or diminution in sympathetic restraint of respiratory sinus arrhythmia.