[PP.16.25] FEATURES OF FREQUENCY CHARACTERISTICS OF HEART RATE IN HYPERTENSIVE PATIENTS OF 1–2 DEGREE WITH PROLONGED HEART-RATE-LOWERING THERAPY

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Abstract

Objective:

To evaluate the frequency characteristics of the heart rate, recorded at the office measurement and Holter ECG monitoring in patients with arterial hypertension (AH) receiving the heart-rate-lowering therapy (HRLT) within 48 weeks.

Design and method:

The study involved 102 patients with hypertension 1–2 degree, 1–2 stage, 27 (24%) men and 75 (76%) of women aged 55 (50; 58) years. Patients received heart-rate-lowering medication during 48 weeks: 78 people (79%) - metoprolol tartrate at a dose of 50–200 mg/day, and 24 people (21%) - diltiazem at a dose of 180–360 mg/day. All patients underwent ECG monitoring twice with evaluation of the frequency characteristics of sinus rhythm using the Holter system Astrokard (JSC, Meditec). An additional option of Astrokard allows to calculate the percentage of heart rate exceeding the input threshold values for the selected period of time - chronotropic load (CL), and the normalized index of area of heart rate trend (NIA), with the analyses of the following frequency characteristics: the maximum, minimum and mean heart rate per day, the average heart rate during the day and night, CL and NIA per day, in the daytime and nighttime.

Results:

The results for the 48 weeks of the HRLT showed a significant decrease in office and maximum heart rate of 11 beats/min and 14 beats/min, respectively (p < 0,05). On other frequency characteristics of the heart rate there was no statistically significant dynamics: minimum heart rate per day decreased by 1 beats / min (p > 0,05), the average heart rate by 2 beats/min (p > 0,05), daily average heart rate by 4 beats / min (p > 0,05) and the average rate per night for 1 beats/min (p > 0,05); CL per day, daytime and night decreased by 3,26%, 2,64% and 4,81%, respectively (p > 0,05), and the NIA in the specified time intervals - 0,95, 0,66 and 0,45 (p > 0,05).

Conclusions:

The data obtained allow to ascertain the absence of an unidirectional dynamics of the office, average heart rate and indicators of CL, as well as to doubt of the full control of chronotropic function of the heart, evaluated only by the office measurement of HR.

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