Changes in Autonomic Nervous System Function in Patients >60 Years of Age with Coronary Heart Disease, and Normotension or Hypertension: An Observational Study

Abstract

Aim: The aim of this observational study was to perform in-depth analysis of autonomic nervous system function in patients older than 60 years of age with coronary artery disease, and normotension or hypertension. Method: A total of 104 patients older than 60 years with coronary heart disease (CHD) were divided into a normotension group and hypertension (HT) group, and 24-hour Holter monitoring was performed to assess autonomic function. Result: Among the 104 patients with CHD analyzed, 52 had normotension, and 52 had hypertension. The 24-hour Holter results based on time-domain methods indicated that the values of the time-domain parameters of heart rate variability were significantly lower in the CHD+HT group than the CHD group. Furthermore, during both the daytime and nighttime, the time-domain parameters were significantly lower in the CHD+HT group than the CHD group. No difference was observed in autonomic function during the daytime and nighttime in each group. Values of frequency-domain parameters of heart rate variability were also significantly lower in the CHD+HT group than the CHD group. More patients in the CHD+HT group than the CHD group received percutaneous coronary intervention (57.69% vs. 50% χ2=0.619, P=0.55). In 12 months of follow-up, we found no significant differences in rehospitalization for unstable angina and target lesion revascularization between patients with CHD with normotension versus hypertension. Conclusion: The heart autonomic nervous system dysfunction in patients older than 60 years with CHD with hypertension was more severe than that in patients with CHD with normotension, and therefore, should receive greater clinical attention.