FEATURES OF HEART RATE REGULATION IN ADOLESCENTS WITH ESSENTIAL HYPERTENSION

Author: Valeeva A.M.¹, Sorokin O.V.², Nefedova Zh.V.³, Kaynara V.G.⁴, Panasenko L.M.⁵, Deryagina L.P.⁶, Kareva N.P.⁷

Abstract

Cardiointervalography is an important method of analyzing the regulation of heart rate variability, which allows evaluating the balance of the entire spectrum of humoral-metabolic and vegetative effects, both in condition of physiological rest and in various functional tests. It is noted that in hypertensive patients, in most cases, there is a chronic predominance of ergotrophic metabolic reactions that reflect the system tension in the regulatory mechanisms. The aim of our study was to conduct a comparative analysis of the features of the mechanisms of heart rate regulation in adolescents with confirmed essential hypertension and their healthy age mates. Material and methods. The study involved 50 adolescents (12–16 years of age) – 26 boys and 24 girls with labile essential hypertension (EHT) and stage 1 HT on the background of the standard medical correction of blood pressure (enalapril 0,58 mg/kg per day). Each participant of the study and control group underwent recording of at least 512 cardio cycles in the state of physiological rest in a sitting position, as well as registration of blood pressure. Results and discussion. We have found that for adolescents with EHT a significantly lower (by 15 %) average duration of the heart cycle is typical in combination with a decrease in the variation range, which indicates some rigidity of the heart rate regulatory mechanisms. The relative decrease in the proportion of high-frequency spectrum components in comparison with the low-frequency and very low-frequency ranges in adolescents with hypertension also indicated a tendency to predominance of sympathicotonic effects with the predominant involvement of the structures of the diencephalic region and the brain stem. At the same time blood pressure inversely correlated with the index of the variation range of cardiointervals, reflecting the lower adaptive potential of the heart rate regulation mechanisms. Conclusion. We have found regular changes in the regulation of heart rate in adolescents with hypertension, that can be taken as markers of its progressive development and used by clinicians to develop more personalized approaches to medication treatment.

Key words

adolescents, essential hypertension, cardiointervalography, heart rate variability

References

1) Antonova L.K., Kushnir S.M., Kulakova N.I., Pavlova A.V., Antonov V.V., Bogomolova E.A. Heart rate variability in adolescents. Byulleten' Vostochno-Sibirskogo nauchnogo tsentra Sibirskogo otdeleniya Rossiyskoy akademii meditsinskikh nauk = Bulletin of East Siberian scientific center of Siberian Branch of Russian Academy of Medical Sciences. 2007; (3): 63-64. 63-64. [In Russian].

2) Baevsky R.M., Ivanov G.G. Heart rate variability: theoretical aspects and features in clinical use. Ul'trazvukovaya i funktsional'naya diagnostika = Ultrasound and functional diagnostics. 2001; (3): 108-127. [In Russian].

3) Baibursian E.D., Krukov N.N., Kiseleva G.I., Malofeeva N.S., Germanova I.K. Heart rate variability in assessment of severity level of hypertension. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention, 2005; (4): 30. [In Russian].

4) Kainara V.G., Valeeva A.M., Sorokin O.V., Nefedova Zh.V. Application of cardiobioregulation method in children with essential hypertension. Rossiyskiy vestnik perinatologii i pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2016; 61 (3): 212. [In Russian].

5) Valeeva A.M., Sorokin O.V. The features of cardiac cycle duration in vagotonic patients within cardio bioregulation. Meditsina i obrazovanie v Sibiri = Medicine and Education in Siberia. 2013; (4). Available at: http://ngmu.ru/cozo/mos/article/text_full.php?id=1056. [In Russian].

6) Gromnatska N.M. The state of vegetative nervous system in children with essential hypertension. Arterial'na gipertenziya = Hypertension. 2014; (4): 46-50. [In Ukrainian].

7) Gunicheva E.A., Logacheva I.V., Ozhegov A.M. Heart rate variability dependence on the type of primary vegetative tone in adolescents with arterial hypertension. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2009; 8 (6 S1): 107. [In Russian].

8) Iliamakova N.A., Gorbunov V.V., Aksenova T.A. Heart rate variability in patients with hypertensive disorder. Arterial hypertension: from theory to practice: Collection of abstracts, XI All-Russian congress, Kemerovo, March 18-20, 2015. Moscow: InterMedService, 2017. 9-10. [In Russian].

9) Lebedenko A.A, Tarakanova T.D., Ianovskaia T.A. Geometric and spectral methods of analysis of heart rate variability in adolescents with arterial hypertension. Meditsinskiy vestnik Yuga Rossii = Medical Herald of the South of Russia. 2013; (2): 86-89. [In Russian].

10) Nefedova Zh.V. Metabolic and neuro-physiological aspects of arterial hypertension in children and adolescents]. Abstract of thesis… doct. med. sciences. Novosibirsk, 2008. [In Russian].

11) Sorokin O.V., Markova E.V., Trufakin S. V., Abramov V.V., Kulikov V.Yu., Kozlov V.A. Factorial analysis of the heart rate vegetative regulation parameters in children. Byulleten' Sibirskogo otdeleniya Rossiyskoy akademii meditsinskikh nauk = Bull. of Siberian Branch of Russian Academy of Medical. 2004; 24 (1): 32-39. [In Russian].

12) Cheremisina A.Yu., Saifutdinov R.G., Ismagilov M.F. Heart rate variability and intraday monitoring of blood pressure in patients with hypertension. Dnevnik kazanskoy meditsinskoy shkoly = Diary of Kazan medical school. 2013; (1): 138. [In Russian].

13) Fleishman A.N. Heart rate variability and slow fluctuations of hemodynamics: non-linear phenomena in clinical practice. Novosibirsk, 2009. 194 р. [In Russian].

14) Shlyk N.I. Heart rate and type of regulation in children, adolescents and sportsmen. Izhevsk: Udmurt University, 2009. 102-116. [In Russian].

15) Carthy E.R. Autonomic dysfunction in essential hypertension: A systematic review. Ann. Med. Surg (Lond). 2013. 3. 1. 2-7.

16) Gui-Ling X., Jing-Hua W., Yan Z., Hui X., Jing-Hui S., Si-Rui Y. Association of high blood pressure with heart rate variability in children. Iran. J. Pediatrics. 2013. 23. 1. 37-44.

17) Jagodziński L., Sielańczyk A., Ciesiółka A., Gmyrek J., Niepsuj K. The analysis of heart rate variability as non-invasive method of cardiovascular system assessment. Wiad. Lek. 2001. 54. 9. 551-555.

18) Pal G.K., Pal P., Nanda N., Amudharaj D., Karthik S. Spectral analysis of heart rate variability (HRV) may predict the future development of essential hypertension. Med. Hypotheses. 2009. 72. 2. 183-185.

19) Sacha J. Interaction between heart rate and heart rate variability. Ann Noninvasive Electrocardiol. 2014. 19. 3. 207-216.

20) Task Force of The European Society of Cardiology and The North American. Society of Pacing and Electrophysiology (Membership of the Task Force listed in the Appendix). Heart rate variability Standards of measurement, physiological interpretation, and clinical use. European Heart Journal. 1996. 17. 354–381.

21) Terathongkum S., Pickler R.H. Relationships among heart rate variability, hypertension, and relaxation techniques. J. Vasc. Nurs. 2004. 22. 3. 78-82.

22) Thayer J.F., Yamamoto S.S., Brosschot J.F. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol. 2010. 141. 2. 122-131.

23) Xhyheri B., Manfrini O., Mazzolini M., Pizzi C., Bugiardini R. Heart rate variability today.. Prog Cardiovasc Dis. 2012. 55. 3. 321-331.

24) Goit R.K., Ansari A.H. Reduced parasympathetic tone in newly diagnosed essential hypertension. Indian Heart Journal. 2016. 68. 2. 153-157.

25) De Andrade P.E., do Amaral J.A., Paiva L.D., Adami F., Raimudo J.Z., Valenti V.E., Abreu L.C., Raimundo R.D. Reduction of heart rate variability in hypertensive elderly. Blood Pressure, 2017. 26. 6. 350-358.

About Authors (Correspondence):

Valeeva A.M., e-mail: alinvaleeva1994@gmail.com

Full Text

snmzh_4-2019_valeeva_143-149.pdf

Received: 02/09/2019

Accepted: 02/09/2019