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Background: This study aimed to investigate the potential association between the circadian rhythm of blood pressure and deceleration capacity (DC)/acceleration capacity (AC) in patients with essential hypertension.

Methods: This study included 318 patients with essential hypertension, whether or not they were being treated with anti-hypertensive drugs, who underwent 24-hour ambulatory blood pressure monitoring (ABPM). Patients were categorized into three groups based on the percentage of nocturnal systolic blood pressure (SBP) dipping: the dipper, non-dipper and reverse dipper groups. Baseline demographic characteristics, ambulatory blood pressure monitoring parameters, Holter recordings (including DC and AC), and echocardiographic parameters were collected.

Results: In this study, the lowest DC values were observed in the reverse dipper group, followed by the non-dipper and dipper groups (6.46 ± 2.06 vs. 6.65 ± 1.95 vs. 8.07 ± 1.79 ms, P < .001). Additionally, the AC gradually decreased (-6.32 ± 2.02 vs. -6.55 ± 1.95 vs. -7.80 ± 1.73 ms, P < .001). There was a significant association between DC (r = .307, P < .001), AC (r=-.303, P < .001) and nocturnal SBP decline. Furthermore, DC (β = 0.785, P = .001) was positively associated with nocturnal SBP decline, whereas AC was negatively associated with nocturnal SBP (β = -0.753, P = .002). By multivariate logistic regression analysis, deceleration capacity [OR (95% CI): 0.705 (0.594-0.836), p < .001], and acceleration capacity [OR (95% CI): 1.357 (1.141-1.614), p = .001] were identified as independent risk factors for blood pressure nondipper status. The analysis of ROC curves revealed that the area under the curve for DC/AC in predicting the circadian rhythm of blood pressure was 0.711/0.697, with a sensitivity of 73.4%/65.1% and specificity of 66.7%/71.2%.

Conclusions: Abnormal DC and AC density were correlated with a blunted decline in nighttime SBP, suggesting a potential association between the circadian rhythm of blood pressure in essential hypertension patients and autonomic nervous dysfunction.

Titel:	Heart rate deceleration and acceleration capacities associated with circadian rhythm of blood pressure in essential hypertension.
Autor/in / Beteiligte Person:	Wang, J ; Xu, J ; Yang, L ; Zhang, Y ; Wu, R ; Wang, W ; Gao, C
Zeitschrift:	BMC cardiovascular disorders, Jg. 24 (2024-05-17), Heft 1, S. 257
Veröffentlichung:	London : BioMed Central, [2001-, 2024
Medientyp:	academicJournal
ISSN:	1471-2261 (electronic)
DOI:	10.1186/s12872-024-03933-9
Schlagwort:	Humans Male Female Middle Aged Time Factors Aged Predictive Value of Tests Adult Risk Factors Electrocardiography, Ambulatory Acceleration Deceleration Circadian Rhythm Blood Pressure Heart Rate Blood Pressure Monitoring, Ambulatory Essential Hypertension physiopathology Essential Hypertension diagnosis Essential Hypertension drug therapy Antihypertensive Agents therapeutic use
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [BMC Cardiovasc Disord] 2024 May 17; Vol. 24 (1), pp. 257. <i>Date of Electronic Publication: </i>2024 May 17. MeSH Terms: Circadian Rhythm* ; Blood Pressure* ; Heart Rate* ; Blood Pressure Monitoring, Ambulatory* ; Essential Hypertension* / physiopathology ; Essential Hypertension* / diagnosis ; Essential Hypertension* / drug therapy ; Antihypertensive Agents* / therapeutic use ; Humans ; Male ; Female ; Middle Aged ; Time Factors ; Aged ; Predictive Value of Tests ; Adult ; Risk Factors ; Electrocardiography, Ambulatory ; Acceleration ; Deceleration References: Int J Cardiol. 2006 Sep 20;112(2):171-7. (PMID: 16316694) ; Physiol Meas. 2020 Aug 11;41(7):07TR01. (PMID: 32498055) ; Clin Exp Hypertens. 2023 Dec 31;45(1):2229535. (PMID: 37358045) ; J Hypertens. 2023 Dec 1;41(12):1874-2071. (PMID: 37345492) ; Hypertension. 2008 Nov;52(5):797-8. (PMID: 18779437) ; Am J Hypertens. 2002 Feb;15(2 Pt 1):111-8. (PMID: 11863245) ; Lancet. 2006 May 20;367(9523):1674-81. (PMID: 16714188) ; Hypertension. 1983 Jan-Feb;5(1):100-4. (PMID: 6848457) ; Acta Cardiol. 2023 Aug;78(6):648-662. (PMID: 36803313) ; Hypertension. 2019 Dec;74(6):1333-1342. (PMID: 31630575) ; Handb Clin Neurol. 2013;117:379-93. (PMID: 24095141) ; J Clin Hypertens (Greenwich). 2021 Mar;23(3):411-421. (PMID: 33319412) ; JAMA. 2019 Aug 6;322(5):409-420. (PMID: 31386134) ; Eur J Clin Invest. 2016 Apr;46(4):312-20. (PMID: 26800852) ; Clin Interv Aging. 2018 Jul 02;13:1169-1176. (PMID: 29997434) ; Ethn Dis. 2016 Jul 21;26(3):279-84. (PMID: 27440966) ; Ann Noninvasive Electrocardiol. 2015 Mar;20(2):158-66. (PMID: 25112779) ; J Interv Card Electrophysiol. 2021 Jan;60(1):21-29. (PMID: 31912449) ; Ann Noninvasive Electrocardiol. 2020 Jul;25(4):e12748. (PMID: 32103582) ; J Cardiovasc Pharmacol. 2007 Nov;50(5):487-96. (PMID: 18030057) ; Clin Exp Hypertens. 2013;35(2):102-7. (PMID: 22676318) ; Hypertens Res. 2014 Feb;37(2):151-7. (PMID: 24048485) ; Ageing Res Rev. 2018 Dec;48:40-50. (PMID: 30300712) ; Ann Noninvasive Electrocardiol. 2016 Sep;21(5):508-18. (PMID: 27038287) ; Int Heart J. 2008 Mar;49(2):175-81. (PMID: 18475017) ; Biomolecules. 2021 Jun 11;11(6):. (PMID: 34207942) ; Circ Res. 2014 May 23;114(11):1804-14. (PMID: 24855203) ; Lancet. 2003 May 10;361(9369):1629-41. (PMID: 12747893) ; Blood Press Monit. 2023 Apr 1;28(2):79-85. (PMID: 36728923) ; J Hypertens. 2006 Sep;24(9):1873-80. (PMID: 16915038) ; Front Physiol. 2021 Jan 18;11:536146. (PMID: 33536928) ; Int J Cardiol. 2006 Mar 8;107(3):343-9. (PMID: 16503256) ; Med Biol Eng Comput. 2006 Dec;44(12):1031-51. (PMID: 17111118) ; J Clin Hypertens (Greenwich). 2017 Jul;19(7):713-721. (PMID: 28692165) ; J Diabetes Complications. 2006 Jan-Feb;20(1):1-7. (PMID: 16389160) ; Clin Cardiol. 2023 May;46(5):529-534. (PMID: 36946388) Grant Information: 2018YFC0114502 National Key Research and Development Program of China; 2018YFC0114502 National Key Research and Development Program of China Contributed Indexing: Keywords: Circadian rhythm of blood pressure; Deceleration capacity; Essential hypertension.; Heart rate variability Entry Date(s): Date Created: 20240517 Date Completed: 20240518 Latest Revision: 20240520 Update Code: 20240520 PubMed Central ID: PMC11100176

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Heart rate deceleration and acceleration capacities associated with circadian rhythm of blood pressure in essential hypertension.