基础自主神经功能在早晨血压升高患者中的作用。

IF 1.2 4区医学 Q4 PERIPHERAL VASCULAR DISEASE Blood Pressure Monitoring Pub Date : 2023-04-01 Epub Date: 2022-12-23 DOI:10.1097/MBP.0000000000000634

Ertan Akbay, Sinan Akinci

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The mean age of the patients was 57.2 ± 18.2 years, and 63 (48.8%) were male. HF, the square root of the mean squared differences of successive normal-to-normal intervals (rMSSD), and the proportion of adjacent RR intervals differing by >50 ms in the 24-h recording (pNN50) were statistically significant between the groups ( P = 0.039, P = 0.013, P = 0.011, respectively). In univariate regression analysis, low-frequency/high-frequency ratio was positively associated with MS and HF, SDNNi, rMSSD, and pNN50 were negatively associated ( β = 0.207, P = 0.019; β = -0.272, P = 0.002; β = -0.201, P = 0.022; β = -0.265, P = 0.002; β = -0.278, P = 0.001, respectively). 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引用次数: 1

摘要

背景：早晨血压（BP）飙升（MS）与心血管事件有关。自主神经系统在BP的调节中起着积极作用，其功能可以通过心率变异性（HRV）分析来评估。本研究旨在评估MS增加患者的自主神经系统功能。方法：对2017年至2022年同期在我院接受动态血压监测（ABPM）和24小时动态心电图检查的患者进行评估。HRV参数从24小时动态心电图记录中获得。根据ABPM记录计算患者的MS值，并根据MS四分位数将患者分为四组。比较两组之间的HRV参数和其他参数。结果：本研究共纳入129例患者。患者的平均年龄为57.2岁 ± 18.2 男性63例（48.8%）。HF，连续正态-正态间期（rMSSD）的均方差的平方根，以及相差>50的相邻RR间期的比例 24小时记录中的ms（pNN50）在两组之间具有统计学意义（P = 0.039，P = 0.013，P = 0.011）。在单因素回归分析中，低频/高频率与MS呈正相关，HF、SDNNi、rMSSD和pNN50呈负相关（β = 0.207，P = 0.019；β = -0.272，P = 0.002；β = -0.201，P = 0.022；β = -0.265，P = 0.002；β = -0.278，P = 0.001）。多元线性回归分析显示HF、低频/高频比、rMSSD、pNN50和MS之间存在独立相关性（β = -0.247，P = 0.005；β=0.206，P = 0.017；β = -0.209，P = 0.005；β = -0.227，P = 结论：我们发现与迷走神经张力相关的HRV参数与MS之间存在独立的相关性。我们的研究结果表明，在先前的研究中，在高MS患者中检测到的交感神经活动增加可能是由于基础迷走神经张力的降低。

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Role of basal autonomic functions in patients with increased morning blood pressure surge.

Background: Morning blood pressure (BP) surge (MS) is associated with cardiovascular events. The autonomic nervous system plays an active role in the regulation of BP and its function can be evaluated by heart rate variability (HRV) analysis. This study aimed to evaluate autonomic nervous system functions in patients with increased MS.

Methods: Patients who underwent ambulatory BP monitoring (ABPM) and 24-h rhythm Holter in our hospital during the same period between 2017 and 2022 were evaluated. HRV parameters were obtained from 24-h rhythm Holter recordings. MS values of the patients were calculated from ABPM records and patients were divided into four groups according to the MS quartiles. HRV parameters and other parameters were compared between the groups.

Results: A total of 129 patients were included in the study. The mean age of the patients was 57.2 ± 18.2 years, and 63 (48.8%) were male. HF, the square root of the mean squared differences of successive normal-to-normal intervals (rMSSD), and the proportion of adjacent RR intervals differing by >50 ms in the 24-h recording (pNN50) were statistically significant between the groups ( P = 0.039, P = 0.013, P = 0.011, respectively). In univariate regression analysis, low-frequency/high-frequency ratio was positively associated with MS and HF, SDNNi, rMSSD, and pNN50 were negatively associated ( β = 0.207, P = 0.019; β = -0.272, P = 0.002; β = -0.201, P = 0.022; β = -0.265, P = 0.002; β = -0.278, P = 0.001, respectively). Multiple linear regression analysis showed an independent association between HF, low-frequency/high-frequency ratio, rMSSD, pNN50, and MS ( β = -0.247, P = 0.005; β=0.206, P = 0.017; β = -0.209, P = 0.005; β = -0.227, P = 0.008, respectively).

Conclusion: We found an independent association between HRV parameters associated with vagal tone and MS. The findings of our study suggest that the increased sympathetic activity detected in patients with high MS in previous studies may be due to a decrease in basal vagal tone.

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来源期刊

Blood Pressure Monitoring 医学-外周血管病

CiteScore

2.00

自引率

7.70%

发文量

110

审稿时长

>12 weeks

期刊介绍： Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.