Heart Rate Variability: for real doctors. Regulation in the disease. Some pathological conditions. Arterial hypertension

Yabluchansky N.I., Martynenko A.V.

Heart rate variability: for real doctors. Translation from the Russian version of the book, published at Kharkiv, 2010, 131 p.
The basics and practice of the clinical use of the technology of heart rate variability are outlined for doctors of all specialties and students of medical faculties of universities.

9. Regulation in the disease

Some pathological conditions

Arterial hypertension accompanies by a drop in HRV with a relative and in severe cases even an absolute increase in LF power. Its reactions in functional tests, such as, for example, active orthostasis, are impaired. Circadian changes in HRV are often leveled or even become altered. Indicators of HRV are responsible for the differences in blood pressure.
Different medications act on HRV in different ways. Beta-blockers and carvedilol increase HRV, inhibitors of the angiotensin-converting enzyme and angiotensin receptors – decrease it.
Beta-blockers are most useful for the relative growth of HF.
ACE inhibitors and aldosterone antagonists are responsible for the relative growth of-of LF components of HRV.

Arterial hypertension in orthostatic reaction of HRV. Patient, 53 years old. Mild arterial hypertension St. I HF 0. No reaction of HRV to the active tilt test. In the horizontal position, the arterial pressure is 155/90 mm Hg, HR is 75 beats/min, and in the vertical position, the blood pressure is 165/80 mm Hg, HR is 58 beats/min. HRV data on the left before and on the right – after an active tilt test. There is no change during the active tilt test.


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