Racial Differences in Blood Pressure Variability, Baroreflex Sensitivity and Heart Rate Variability Following Maximal Exercise

Abstract Introduction Insomnia is a risk factor for hypertension and cardiovascular events, and this association is strongest for sleep-onset insomnia. However, little is known about insomnia on cardiovascular modulation, especially soon after morning awakening, the peak period of time for cardiovascular incidents. This study explored morning cardiovascular function in individuals with sleep-onset insomnia by analysing heart rate variability, blood pressure variability, and baroreflex sensitivity. Methods Sleep structure of the participants (15 good sleepers and 13 individuals with sleep-onset insomnia) was measured by laboratory polysomnography, followed by continuous recordings of the participant’s blood pressure and heart rate for 10 min in the morning. Results When compared to the good sleepers, the insomnia group showed significant reductions in total sleep time, a longer sleep-onset latency, and reduced sleep efficiency. The sleep structure, including durations of sleep stages, numbers of awakenings and arousal index did not differ between the groups. After morning awakening (averaged time: 12.33 ± 10.48 min), the shorter R-R intervals, lower total power, and lower high-frequency power of heart rate variability were observed among individuals with sleep-onset insomnia, compared with good sleepers. Elevated slopes of systolic and diastolic blood pressure, as well as lower baroreflex sensitivity, were also shown in the insomnia group. Indices of sympathetic activity, including low-frequency percentage of heart rate variability or low-frequency power of blood pressure variability, did not differ between the groups. Conclusion Weak vagal activity and blunted baroreflex sensitivity were evident among sleep-onset insomnia. These findings indicate difficulty in initiating sleep, without significant sleep fragmentation, can independently affect morning cardiovascular function. This study provides a possible link between sleep-onset insomnia and risk of cardiovascular events. Support N/A

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Abstract WP301: Noninvasive Beat-to-Beat Assessment of Blood Pressure Variability, Heart Rate Variability and Baroreflex Sensitivity: Which Parameters Best Predict Clinical Outcome After Acute Ischemic Stroke?

Stroke ◽

10.1161/str.47.suppl_1.wp301 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Li Xiong ◽

Ge Tian ◽

Xiangyan Chen ◽

Howan Leung ◽

Thomas Leung ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Ischemic Stroke ◽

Clinical Outcome ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Low Frequency ◽

Prognostic Information ◽

Power Spectral

Background and Objectives: Blood pressure variability (BPV), heart rate variability (HRV) and baroreflex sensitivity (BRS) as measures of autonomic function might provide prognostic information in ischemic stroke. We aimed to study noninvasive beat-to-beat assessment of BPV, HRV and BRS in the acute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods & Patients: Consecutive ischemic stroke patients within 7 days of symptom onset were enrolled. The frequency components of BPV and HRV by means of power spectral analysis [very low frequency (VLF; < 0.04 Hz); low frequency (LF; 0.04-0.15 Hz); high frequency (HF; 0.15-0.40 Hz); power spectral density (PSD; <0.40 Hz) and LF/HF ratio] were calculated from 10-minute recordings of beat-to-beat blood pressure and heart rate monitoring. The baroreflex slope and baroreflex effectiveness index (BEI) were determined using the sequence method for BRS. Clinical outcome was assessed at 3 months after stroke onset as good or poor by modified Rankin Scale (mRS) (good outcome, mRS ≤ 2). Results: 82 patients were recruited (mean age, 64.6 ± 9.9 years; 89.3% males). Univariate analysis showed that there were significant differences in National Institutes of Health Stroke Scale (NIHSS) at recruitment, VLF diastolic BPV, VLF, HF and PSD systolic BPV, and down ramp BEI between the good and poor outcome groups (all P < 0.05). After adjusting for NIHSS, multivariate logistic regression showed that only HF systolic BPV (OR 1.320; 95% CI, 1.050-1.659; P=0.017) and down BEI (OR 0.950; 95% CI, 0.912-0.990; P=0.014) were independently correlated with poor functional outcome. Conclusions: Beat-to beat highly variable systolic blood pressure and impaired BRS as evaluated by decreased down BEI are associated with an unfavorable functional outcome after acute ischemic stroke. Important prognostic information can be readily obtained from a short period of noninvasive hemodynamics monitoring in the acute stroke patient.

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Anesthesia and autonomic nervous system: is measurement of heart rate variability, blood pressure variability and baroreflex sensitivity useful in anesthesiology specialty?

Korean Journal of Anesthesiology ◽

10.4097/kjae.2008.55.3.265 ◽

2008 ◽

Vol 55 (3) ◽

pp. 265 ◽

Cited By ~ 2

Author(s):

Gyu Sam Hwang

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Nervous System ◽

Autonomic Nervous System ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Autonomic Nervous

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Stroke Outcome Prediction by Blood Pressure Variability, Heart Rate Variability, and Baroreflex Sensitivity

Stroke ◽

10.1161/strokeaha.119.027981 ◽

2020 ◽

Vol 51 (4) ◽

pp. 1317-1320 ◽

Cited By ~ 1

Author(s):

Shujin Tang ◽

Li Xiong ◽

Yuhua Fan ◽

Vincent C.T. Mok ◽

Ka Sing Wong ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Outcome Prediction ◽

Stroke Outcome

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Heart rate and blood pressure variability and baroreflex sensitivity in patients with acute brain injury

Journal of Critical Care ◽

10.1016/j.jcrc.2005.09.048 ◽

2005 ◽

Vol 20 (4) ◽

pp. 394 ◽

Cited By ~ 1

Author(s):

V. Papaioannou ◽

M. Giannakou ◽

N. Maglaveras ◽

E. Sofianos ◽

M. Giala

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Brain Injury ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Acute Brain Injury

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Reproducibility of heart rate variability, blood pressure variability and baroreceptor sensitivity during rest and head-up tilt

Blood Pressure Monitoring ◽

10.1097/00126097-200502000-00005 ◽

2005 ◽

Vol 10 (1) ◽

pp. 19-24 ◽

Cited By ~ 17

Author(s):

Michael V. H??jgaard ◽

Niels-Henrik Holstein-Rathlou ◽

Erik Agner ◽

J??rgen K. Kanters

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Blood Pressure Variability ◽

Baroreceptor Sensitivity ◽

Head Up Tilt

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Effect of heavy exercise on spectral baroreflex sensitivity, heart rate, and blood pressure variability in well-trained humans

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00003.2008 ◽

2008 ◽

Vol 295 (3) ◽

pp. H1150-H1155 ◽

Cited By ~ 24

Author(s):

François Cottin ◽

Claire Médigue ◽

Yves Papelier

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Exercise Test ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Low Frequency ◽

Mechanical Effect ◽

Heavy Exercise ◽

Gas Exchange Parameters

The aim of the study was to assess the instantaneous spectral components of heart rate variability (HRV) and systolic blood pressure variability (SBPV) and determine the low-frequency (LF) and high-frequency baroreflex sensitivity (HF-BRS) during a graded maximal exercise test. The first hypothesis was that the hyperpnea elicited by heavy exercise could entail a significant increase in HF-SBPV by mechanical effect once the first and second ventilatory thresholds (VTs) were exceeded. It was secondly hypothesized that vagal tone progressively withdrawing with increasing load, HF-BRS could decrease during the exercise test. Fifteen well-trained subjects participated in this study. Electrocardiogram (ECG), blood pressure, and gas exchanges were recorded during a cycloergometer test. Ventilatory equivalents were computed from gas exchange parameters to assess VTs. Spectral analysis was applied on cardiovascular series to compute RR and systolic blood pressure power spectral densities, cross-spectral coherence, gain, and α index of BRS. Three exercise intensity stages were compared: below (A1), between (A2), and above (A3) VTs. From A1 to A3, both HF-SBPV (A1: 45 ± 6, A2: 65 ± 10, and A3: 120 ± 23 mm2Hg, P < 0.001) and HF-HRV increased (A1: 20 ± 5, A2: 23 ± 8, and A3:40 ± 11 ms2, P < 0.02), maintaining HF-BRS (gain, A1: 0.68 ± 0.12, A2: 0.63 ± 0.08, and A3: 0.57 ± 0.09; α index, A1: 0.58 ± 0.08, A2: 0.48 ± 0.06, and A3: 0.50 ± 0.09 ms/mmHg, not significant). However, LF-BRS decreased (gain, A1: 0.39 ± 0.06, A2: 0.17 ± 0.02, and A3: 0.11 ± 0.01, P < 0.001; α index, A1: 0.46 ± 0.07, A2: 0.20 ± 0.02, and A3: 0.14 ± 0.01 ms/mmHg, P < 0.001). As expected, once VTs were exceeded, hyperpnea induced a marked increase in both HF-HRV and HF-SBPV. However, this concomitant increase allowed the maintenance of HF-BRS, presumably by a mechanoelectric feedback mechanism.

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