SPECIFICS OF 24-HOUR BLOOD PRESSURE AND HEART RATE VARIABILITY IN HYPERTENSIVE PATIENTS DEPENDING ON PHYSICAL ACTIVITY AND PSYCHOEMOTIONAL LOAD

• Main Authors: A. V. Ushakov, V. S. Ivanchenko, A. A. Gagarina
• Format: Article
• Language: Russian
• Published: «FIRMA «SILICEA» LLC 2017-05-01
• Series: Российский кардиологический журнал
• Subjects: arterial hypertension; psychoemotional load; hypodynamia; obesity
• Online Access: https://russjcardiol.elpub.ru/jour/article/view/836

Aim. To study the specifics of 24-hour blood pressure (BP) profile and heart rate variability (HRV) according to levels of physical activity and psychoemotional load in arterial hypertension (AH) patients.Material and methods. Totally, 76 male patients studied, having AH of I or II stage (mean age 46,75±0,56 y. o.). Group 1 included 36 patients with AH and obesity, group 2 — 40 AH non-obese patients. All patients underwent 24-hour BP monitoring and ECG monitoring with HRV analysis. Psychoemotional load analysis was assessed with PSM-25 score. The level of reactive and trait anxiety was assessed with Spielberger (translated by Khanin) questionnaire. For physical activity assessment we used short international questionnaire (IPAQ).Results. In analysis of 24-hour BP monitoring there was significant increase of systolic BP variability in 1 group patients, if hypodynamic (17,97±0,64 mmHg) comparing to those having enough activity (15,43±0,73 mmHg, р=0,003). In hypodynamia the 24-hour BP rhythm was a non-dipper type (68,8%) comparing to those with enough exertion (51,6%). Also, in hypodynamia there was significant decrease of time-related HRV — SDNNi and RMSSD, representing the dysbalance of autonomous neural regulation of cardiovascular system, and there was negative correlation of SDNNi and RMSSD with the level of psychoemotional load. In all studied groups there was positive correlation of systolic and diastolic BP variability with the level of reactive and trait anxiety and with psychoemotional load. There was non-sufficient level of systolic and diastolic BP decrease in patients with high level of trait (r=-0,67; p<0,00001 and r=-0,60; p=0,0001) and reactive anxiety (r=-0,54; р=0,0006 и r=-0,43; р=0,009).Conclusion. In AH patients hypodynamia, as the chronic psychoemotional overload are separated factors leading to increase of variability and decrease of nocturnal BP decline, as to HRV decrease irrelevant to obesity.