Circadian hemodynamics in men and women with high blood pressure

Hill, LaBarron K.; Blumenthal, James A.; Hinderliter, Alan L.

doi:10.1097/hjh.0000000000001533

Cited by 22 publications

(9 citation statements)

References 45 publications

(51 reference statements)

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“…There are some important differences in diagnosis, clinical course, end-organ damage and complications, prognosis, clinical management, and treatment among different subtypes of hypertension [2,[17][18][19]. Recently, patients with dipping and nondipping patterns of hypertension have drawn the utmost attention of the researchers [20,21]. The most important reason for the researchers' interest is the presence of growing evidence about the higher incidence of target organ damages like stroke, myocardial hypertrophy and infarction, arrhythmia, and heart failure in patients with non-dipper hypertension [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions

Alp¹,

Doğru²,

Demir³

2021

Turk J Med Sci

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Background/aim: Hypertensive patients have shown autonomic dysfunction that is closely associated with the measurements of heart rate variability (HRV) and heart rate turbulence (HRT). We aimed to show the alterations of HRV and HRT measurements in patients with both dipper and non-dipper hypertension. Materials and methods:This was a retrospective study consisting of one hundred and twenty-three participants (Mean age ±SD), 55.7 ±14.8 years; range, 18-90 years ) .The participants were divided into two groups: Group1: The patients with dipper hypertension Group2: The patients with non-dipper hypertension Two cardiologists performed, HRV and HRT using 24-h electrocardiography (ECG) Holter and ambulatory blood pressure monitoring (ABPM) of patients. Results:The results indicated that patients in group 2 had higher Low Frequency power/High Frequency power ratio (LF/HF), lower high frequency power (HF) , Root Mean Square of Standard Deviation (RMSSD) values than group 1 (p = 0.007, p = 0.008, and p = 0.002 respectively).Group 2 also showed higher heart rate turbulence onset (HRTTO) and lower heart rate turbulence slope (HRTTS) values than Group 1 (p = 0.004, p = 0.001, respectively).We performed multivariate analysis and observed that HRTTS and HRTTO have statistically significant associations with the presence of dipper or non-dipper hypertension [F = 7.755, p = 0.001], LF/HF [F = 7.868, p = 0.001], and HF [F = 4.081, p = 0.020]. Conclusion:This study shows a statistically significant difference in HRT measurements between dipper and non-dipper hypertensive patients. Deteriorated autonomic circadian rhythm and autonomic functions may contribute to these results.

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Section: Discussionmentioning

confidence: 99%

Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions

Alp¹,

Doğru²,

Demir³

2021

Turk J Med Sci

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“…Therefore, the prominent vascular HP described here in healthy normotensive AAs may be among the earliest precursors to the development of hypertension in this ethnic group. Recent studies have suggested that the greater prevalence of hypertension observed in AAs may reflect a larger underlying pattern of vascular remodelling, by demonstrating (i) that total peripheral resistance was positively associated with minimal forearm vascular resistance, an index of vascular hypertrophy, among AAs, but not Whites, with elevated blood pressure (Hill, Sherwood, Blumenthal, & Hinderliter, 2016), and (ii) that in a sample of individuals with undiagnosed, untreated hypertension, AAs exhibited a blunted night-time BP dipping which was accompanied by an attenuated fall in total peripheral resistance compared with Whites (Sherwood, Hill, Blumenthal, & Hinderliter, 2018). The present findings in healthy normotensive young adults indicate statistically reliable higher values of resting diastolic BP in AAs, while no statistically reliable ethnic differences are observed in resting measures of MAP, systolic BP, cardiac output and total peripheral resistance although they were in the expected direction.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress

Carnevali

Ottaviani

Williams

et al. 2019

Biological Psychology

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Increased vascular reactivity to stress has been suggested to contribute to the greater risk for developing hypertension in African Americans. Here, we examined the way (hemodynamic profile) and the extent to which (compensation deficit) cardiac output and total peripheral resistance compensate for each other in determining blood pressure responses to a physical (orthostasis) and a mental (anger recall) stress task, in normotensive African American (AA, n = 30) and European American (EA, n = 48) college students. Blood pressure stress reactivity did not differ as a function of race. However, AAs showed a prominent vascular hemodynamic profile and a significant compensation deficit in response to both tasks, while EAs showed no hemodynamic response to orthostasis and a mixed profile in response to anger recall. The present findings demonstrate a more prominent vascular hemodynamic reactivity to stress in AAs, which could contribute to the pathogenesis of hypertension in this ethnic group.

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“…SVR also has been shown to play a stronger role in diurnal BP regulation among African Americans relative to European Americans [16]. Moreover, recent evidence has further shown that the well-known non-dipping phenomenon in nighttime BP, which is also more common among African Americans and is associated with elevated CVD morbidity and mortality risk, also is characterized by a corresponding blunted decline in nighttime SVR [17]. Importantly, research examining the role of psychosocial stress in CVD risk has consistently revealed that African Americans tend to exhibit exaggerated or enhanced vasoconstrictive, and/or impaired vasodilatory responses to a range of behavioral and psychological stressors [14,15].…”

Section: Taking a Closer Look At Autonomic (Im) Balancementioning

confidence: 99%

The Autonomic Nervous System and Hypertension: Ethnic Differences and Psychosocial Factors

Hill

Thayer

2019

Curr Cardiol Rep

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Purpose of the Review-In the present paper, we overview emerging research examining the autonomic nervous system (ANS), especially the parasympathetic nervous system as indexed by heart rate variability (HRV), and the impact of psychosocial factors on hypertension-related disease in African Americans. Recent Findings-A growing corpus of studies has shown that (1) usual patterns of compensatory sympathetic-parasympathetic regulation differ between African Americans and European Americans; (2) despite their enhanced cardiovascular disease risk profile, African Americans tend to exhibit higher HRV relative to European Americans; and (3) racial discrimination and other forms of psychosocial stress are associated with diminished HRV among African Americans. Summary-Significant disparities in hypertension-related disease exist such that African Americans have greater risk. The underlying factors associated with this increased risk are, to date, not fully understood. The present review provides evidence for a unique pattern of ANS regulation in African Americans and shows that psychosocial factors such as racial discrimination may contribute to this paradoxical situation.

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Circadian hemodynamics in men and women with high blood pressure

Cited by 22 publications

References 45 publications

Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions

Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions

Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress

The Autonomic Nervous System and Hypertension: Ethnic Differences and Psychosocial Factors

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