Hypertension, Vol 8, 147-153, Copyright © 1986 by American Heart Association
G Mancia, G Parati, G Pomidossi, R Casadei, M Di Rienzo and A Zanchetti
The factors responsible for 24-hour blood pressure and heart rate
variabilities have never been clarified; however, studies performed in
unanesthetized animals have shown an increase in blood pressure variability
after sinoaortic denervation, and a negative relationship has been reported
occasionally between blood pressure variability and baroreflex control of
heart rate in humans. We have systematically investigated this issue in 82
ambulant hypertensive subjects using 24- hour intraarterial blood pressure
recording (Oxford method) in which blood pressure and heart rate
variabilities were measured by calculating the standard deviations of the
values obtained throughout the 24 hours or during separate daytime and
nighttime periods. Baroreflex sensitivity was assessed by the bradycardic
or tachycardic responses to intravenous injections of phenylephrine or
nitroglycerin and by the blood pressure response to changes in carotid
transmural pressure obtained with a neck chamber. The sensitivity of the
baroreceptor-heart rate reflex as assessed by the vasoactive drug technique
showed a negative relationship with 24-hour blood pressure variability as
well as with daytime and nighttime blood pressure variabilities measured
separately (r = -0.28 to -0.50, p less than 0.05). These variabilities also
correlated negatively with the sensitivity of the baroreceptor-blood
pressure reflex as assessed by the neck chamber technique. By contrast,
baroreflex sensitivity showed a positive correlation with heart rate
variabilities (r = 0.32 to 0.47, p less than 0.05). The relationship
between baroreflex sensitivity and blood pressure and heart rate
variabilities was confirmed when the data were analyzed by multiple
regression to adjust for blood pressure and age differences among the 82
subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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