Effects of Angiotensin II Receptor Blockers on the Relationships Between Ambulatory Blood Pressure and Anti-Hypertensive Effects, Autonomic Function, and Health-Related Quality of Life

Okano, Yasuko; Tamura, Kouichi; Masuda, Shinitirou; Ozawa, Motoko; Tochikubo, Osamu; Umemura, Satoshi

doi:10.3109/10641960903407041

Cited by 9 publications

(7 citation statements)

References 21 publications

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“…The reference lists of analysed articles were also searched. Additional articles were included from the author's own library, screened to meet the aforementioned criteria [4–7] . Inclusion criteria included: i) peer-reviewed publications reporting original data; ii) a minimum of 10 subjects tested to maximise reliability; iii) subjects had autonomic function tested via heart rate variability (HRV), muscle sympathetic nerve activity (MSNA) or plasma noradrenaline levels; iv) studies with hypertensive groups had a mean resting blood pressure (BP) of ≥140/90 mmHg (or ≥135/85 mmHg if measured via home BP measurements) [8] or normotensive groups must have a mean BP of ≤140/90 mmHg (or ≤135/85 mmHg if measured via home BP measurements); v) studies must have provided details of at least one of: epidemiology, pathophysiology, mechanism of action or long-term progression.…”

Section: Methodsmentioning

confidence: 99%

Autonomic dysfunction in essential hypertension: A systematic review

Carthy

2014

Annals of Medicine &Amp; Surgery

106

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IntroductionGreater sympathetic drive has been established in the early stages of essential hypertension, suggesting that neurohormonal dysregulation may be key to its aetiology and progression. The aims of this review are to discuss evidence of the role of autonomic dysfunction in essential hypertension and proposed mechanisms, and also some applications of this knowledge to current management strategies of essential hypertension.MethodsA computer search was performed using the PUBMED database for peer reviewed original articles comparing autonomic function tested via heart rate variability (HRV), muscle sympathetic nerve activity (MSNA) or plasma noradrenaline levels in normotensive (mean blood pressure (BP) of ≤140/90 mmHg or ≤135/85 mmHg if measured via home BP measurements) and hypertensive groups (mean resting BP of ≥140/90 mmHg (or ≥135/85 mmHg if measured via home BP measurements). Subjects were excluded with secondary causes of hypertension or autonomic dysfunction.ResultsA total of 17 studies were included for discussion. The main findings of this study include that of reduced baroreflex sensitivity, believed to be secondary to increased arterial stiffness, is hypothesised to be implicated in the pathogenesis of essential hypertension. Also, angiotensin converting enzyme inhibitors were not as effective on markers of autonomic control of blood pressure when compared with alternative anti-hypertensive drugs.ConclusionsConsistent research is needed to establish the effectiveness of pharmacotherapies at each of stage of hypertension, and on markers of autonomic dysfunction. Consistent study designs will enable more accurate accumulation of data across multiple studies, and appropriate application of such data into clinical practice.

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Section: Methodsmentioning

confidence: 99%

Autonomic dysfunction in essential hypertension: A systematic review

Carthy

2014

Annals of Medicine &Amp; Surgery

106

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“…Importantly, many antihypertensive medications like betablockers (Vaile et al, 1999), calcium channel blockers (Karas et al, 2005), angiotensin receptor blockers (Karas et al, 2005;Okano et al, 2009) and angiotensin-converting enzyme inhibitors (Karas et al, 2005) can influence HRV. Hypertension is very common in MetS, and in many studies evaluating HRV in MetS, subjects with antihypertensive medication were included (Stuckey et al, 2014), and this has probably also contributed the discrepancy in the published results.…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome is associated with decreased heart rate variability in a sex‐dependent manner: a comparison between 252 men and 249 women

Kangas

Tikkakoski

Uitto

et al. 2018

Clin Physio Funct Imaging

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Summary Impaired heart rate variability (HRV) is associated with increased risk of cardiovascular disease, but evidence regarding alterations of HRV in metabolic syndrome (MetS) remains elusive. In order to examine HRV in MetS, we subjected 501 volunteers without atherosclerosis, diabetes or antihypertensive medication, mean age 48 years, to passive head‐up tilt. The subjects were divided to control men (n = 131), men with MetS (n = 121), control women (n = 191) and women with MetS (n = 58) according to the criteria by Alberti et al. (Circulation, 2009, 120, 1640). In unadjusted analyses (i) men and women with MetS had lower total power and high‐frequency (HF) power of HRV than controls whether supine or upright (P<0·05 for all). (ii) Supine low‐frequency (LF) power of HRV was lower in men (P = 0·012) but not in women (P = 0·064) with MetS than in controls, while men and women with MetS had lower upright LF power of HRV than controls (P <0·01 for both). (iii) The LF:HF ratio did not differ between subjects with and without MetS. After adjustment for age, smoking habits, alcohol intake, height, heart rate and breathing frequency, only the differences in upright total power and HF power of HRV between women with MetS and control women remained significant (P<0·05). In conclusion, reduced total and HF power of HRV in the upright position may partially explain why the relative increase in cardiovascular risk associated with MetS is greater in women than in men. Additionally, the present results emphasize that the confounding factors must be carefully taken into consideration when evaluating HRV.

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“…It is known that beta-receptor antagonists, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers aff ect HRV and are not administered without previous testing [22][23][24][25][26] . Th e antiarrhythmics propafenone and fl ecainide reduce HRV 27 .…”

Section: Discussionmentioning

confidence: 99%

The Influence of Corticosteroids on Heart Rate Variablity in Acute Cervical Spinal Cord Injury

Krstačić

Gamberger

2016

ACC

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SUMMARY -Heart rate variability (HRV) gives information on the sympathetic-parasympathetic autonomic balance. Th e aim of the study was to analyze sympathovagal balance after acute spinal cord injury (SCI), demonstrated by linear measures in time and frequency domain of HRV and to analyze the eff ect of corticosteroids on HRV parameters in SCI. Th e study included 40 tetraplegic patients with acute SCI and 40 healthy subjects as control group. In the SCI group, 29 patients received and 11 patients did not receive corticosteroid therapy. All patients underwent 24-hour Holter monitoring for evaluation of HRV. Cardiac autonomic balance was evaluated by analysis of HRV in time and frequency domain. Sympathovagal balance (LF/HF) was signifi cantly reduced in the groups of acute SCI patients, both with and without corticosteroid therapy, as compared with controls. However, there was no statistically signifi cant diff erence between the two SCI groups (1.74 (0524) with and 1.75 (0534) without corticosteroid therapy). Th is study showed the sympathovagal balance to be altered in the acute phase of cervical spinal cord trauma. Finally, there was no eff ect of corticosteroid therapy on HRV parameters in SCI patients.

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Effects of Angiotensin II Receptor Blockers on the Relationships Between Ambulatory Blood Pressure and Anti-Hypertensive Effects, Autonomic Function, and Health-Related Quality of Life

Cited by 9 publications

References 21 publications

Autonomic dysfunction in essential hypertension: A systematic review

Autonomic dysfunction in essential hypertension: A systematic review

Metabolic syndrome is associated with decreased heart rate variability in a sex‐dependent manner: a comparison between 252 men and 249 women

The Influence of Corticosteroids on Heart Rate Variablity in Acute Cervical Spinal Cord Injury

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