The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes

• Published in: Diagnostics (Basel) Vol. 13; no. 4; p. 785
• Main Authors: Yugar, Louise Buonalumi Tacito, Yugar-Toledo, Juan Carlos, Dinamarco, Nelson, Sedenho-Prado, Luis Gustavo, Moreno, Beatriz Vaz Domingues, Rubio, Tatiane de Azevedo, Fattori, Andre, Rodrigues, Bruno, Vilela-Martin, Jose Fernando, Moreno, Heitor
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-02-2023; MDPI
• Subjects: autonomic dysfunction; Blood pressure; chronic kidney disease; Confidence intervals; Diabetes; Diagnosis; Electrocardiography; Exercise; Health aspects; Heart beat; Heart rate; heart rate variability; Hemodynamics; Hypertension; Mortality; Nervous system; prehypertension; resistant hypertension; Respiration; Review; Brazil; chronic kidney disease; parasympathetic nervous system; heart rate variability; autonomic dysfunction; prehypertension; sympathetic nervous system; hypertension; resistant hypertension
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics13040785

Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a "tool" to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD).