Comparative study of heart rate variability in normotensive young adults with family history of hypertension
DOI:
https://doi.org/10.18203/2320-6012.ijrms20210051Keywords:
Hypertension, Heart rate variability, Sympathovagal imbalanceAbstract
Background: Hypertension is a risk factor for the development of cardiovascular and cerebro-vascular diseases. Autonomic nervous system plays a crucial role in the development of hypertension. The integrity of autonomic modulation of heart rate is evaluated by analysing heart rate variability (HRV), which refers to oscillations in the intervals between consecutive heartbeats or R-R intervals. The present study was designed to analyse the indices of heart rate variability in the offsprings of hypertensive parents and off springs of normotensive parents to understand if there is any autonomic imbalance between the two groups.
Methods: The study was conducted in the Department of Physiology, Government Medical College, Srinagar. The test group consisted of 30 healthy normotensive subjects studying in 1st year of MBBS with hypertensive parents and the control group consisted of healthy normotensive of 1st year of MBBS with both parents normotensive. In time domain analysis the standard deviation of all normal-to-normal intervals {SDNN(ms)} was taken as index of overall HRV. Frequency domain analysis was done with respect to low frequency (LF) analysis and high frequency (HF) analysis. Low and high frequency power were expressed in normalized units.
Results: The SDNN was reduced in cases but was not statistically significant. RMSSD was also reduced in cases though not statistically significant. LFnu was found to be significantly higher in cases. The HFnu was significantly reduced in cases. LF/HF ratio was found to be higher in cases and the difference was statistically significant.
Conclusions: Our study reveals that incidence of prehypertension and the risk of cardiovascular dysfunction in relation to sympathovagal imbalance is more in the off springs of hypertensive parents than in the off springs of normotensive parents. Sympathovagal imbalance in the form of increased sympathetic drive and decreased parasympathetic drive can lead to prehypertension in these genetically predisposed individuals.
References
Covic A, Goldsmith DJA, Covic M. Reduced blood pressure diurnal variability as a risk factor for progressive left ventricular dilatation in hemodialysis patients. Am J Kidney Dis 2000;35:617–23.
Kikuya M. Prognostic significance of blood pressure and heart rate variabilities: The Ohasama study. Hypertension 2000; 36:901–6.
WHO Cardiovascular Diseases (CVDs). WHO. Available at: http://www.who.int/mediacentre/ factsheets /fs317/en/. Accessed on 20 July 2020.
Steel N. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151-210.
Wu J, Lu F, Yang Y, Lin T, Chen J, Wu C, HuangY, Chang C. Epidemiological Study on the Effect of Pre hypertension and Family History of Hypertension on Cardiac Autonomic Function. J Am Coll Cardiol. 2008;51:1896-901.
Julius S. Autonomic nervous system dysregulation in human hypertension. Am J Cardiol. 1991;67: 3B–7.
Wang NY, Young JH, Meoni LA, Ford DE, ErlingerTP, Klag MJ. Blood pressure change and risk of hypertension associated with parental hypertension: the john’s Hopkins precursor study. Arch Intern Med. 2008;168(6):643-8.
Pal GK, Pal P, Nanda N, Lalita V, Datta TK, Adithan C. Sympathovagal Imbalance in Prehypertensive. Offsprings of Two Parents versus One Parent Hypertensive. Int J Hypertens. 2011.
Task Force Report: Task Force of the European Society of Cardiology and The North American Society of Pacing and Electrophysiology. Heart Rate Variability: Standards of Measurement, physiological interpretation and clinical use. Circulation. 1990;93:1043-65.
Bailey JJ, Berson AS, Garson A Jr, Horan LG, Macfarlane PW, Mortara DW et al. Recommendations for standardization and specifications in automated electrocardiography. Circulation. 1990;81:730-9.
Krishnan M, Kabali B, Badanidiyur VR. Heart Rate Variability in Normotensive Subjects with Family History of Hypertension Indian J Physiol Pharmacol. 2011;55(3):253-61.
Surekharani C, Anita H, Shailaja P, Shashikala G V, Roopa A. Comparative study of Heart Rate Variability in normotensive offsprings of hypertensive parents. Biomedical Research 2013;24(1):123-6
Prakash ES, Madanmohan, Sethuraman KR, Narayanan SK. Cardiovascular Autonomic Regulation in Subjects with Normal Blood Pressure, High- Normal blood pressure and Recent Onset Hypertension. Clin Exper Pharmacol Physiol. 2005;32(5-6): 488-94.
Patel P, Diwan J, Shah C, Mehta H. Study of Heart Rate Variability in Hypertensive Subjects. Natl J Integr Res Med. 2015;6(1):1-6
Karthk S, Pal GK, Nivedita. Sympathovagal balance in thyroid dysfunction in females; correlation with thyroid profile, heart rate and blood pressure. Indian J Physiol Pharmacol. 2009;53:243–52.
Schroeder E, Liao D, Chambless L, Prineas R, Evans G and Heiss G. Hypertension, Blood Pressure, and Heart Rate Variability. The Atherosclerosis Risk in Communities (ARIC) Study. Hypertension. 2003;42:1106-1111.
Singh J, Larson M, Tsuji H, Evans J, O’Donnell C and Levy D. Reduced heart rate variability and new-onset hypertension: insights into pathogenesis of hypertension: The Framingham Heart Study. Hypertension. 1998;32:293–7.
