Attenuation of heart rate recovery after exercise in hypertensive patients with blunting of the nighttime blood pressure fall

• Type: Article in International Scientific Journal
• Date: 2006

Authors

polonia, j (Author) FMUP; amaral, c (Author) Other; bertoquini, s (Author) Other; martins, l (Author) Other

Journal

Title: International Journal of Cardiology

Vol. 106

Pages: 238-243

ISSN: 0167-5273

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 23 Citations

Scopus - 24 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-004-NPH

DOI: 10.1016/j.ijcard.2005.02.006

Abstract (EN): Objectives: To evaluate whether hypertensive patients with attenuation of nighttime blood pressure (BP) fall exhibit a delay of the recovery of heart rate (HR) after exercise as an index of a general decrease in the vagal tone. Methods: Mild-moderate hypertensive patients (n =219, age 55 +/- 3, 77% men) underwent a maximal exercise test (Bruce > 85% heart rate limited) in whom we calculated the recovery of HR as the percent decrease of HR from peak to 1 min after stopping exercise (%HR fall - 1 min), a 24-h ambulatory BP monitoring, calculating the percent decrease of nighttime vs. daytime BP (% night SBP fall). Left ventricular mass index (LVMI) was measured by echo and aortic stiffness by pulse wave velocity (PWV). Sixty percent were on antihypertensive drugs (not on beta-blockers nor on non-dihydropiridine calcium blockers); 12 subjects were type 2 diabetics. Results: The "% night SBP fall" ranged from - 6.3% to 38.9% and the "%HR fall - 1 min" ranged from 3.3% to 43.7%. There was a significant positive correlation between these two variables (r = 0.594, p < 0.001). Population was divided into five groups according to quintiles of values for the "% night SBP fal". For similar daytime BP and age, the lowest quintile for % night SBP fall (- 6.3% to 7.2%) showed the lower "%HR fall - 1 min" (3.1 +/- 0.5%), and the higher LVMI (92 +/- 3 g/m(2)) and P W (12.1 +/- 0.4 m/s) values comparing to the other quintiles (p < 0.02). Conclusions: In hypertensives, blunting of the nocturnal fall of BP is associated with a delayed recovery in heart rate after graded maximal exercise and with greater aortic stiffness and ventricular mass. This may indicate that in non-dipper subjects a relative general decrease of parasympathetic reactivation after exercise is linked to the failure of nighttime fall of BP, both of which might contribute to target-organs deterioration.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6