Utility of HRV, BRS, and BPV to Evaluate the Physiological Response to Antihypertensive Therapy in Women with Hypertension

Objectives: To evaluate the non-invasive autonomic function parameters heart rate variability, baroreceptor sensitivity, blood pressure variability (HRV, BRS, and BPV) in assessing the physiological suitability of antihypertensive therapy in women with primary hypertension. Materials and Methods: Forty-nine individuals were assessed at baseline for HRV, BRS, and BPV using validated non-invasive methods. Post-medication follow-up was completed in forty participants. Time- and frequency-domain HRV measures, BRS indices, and BPV characteristics were analyzed. Echocardiographic parameters including ejection fraction (EF), left ventricular (LV) mass, and early-to-atrial filling velocity ratio (EA ratio) EF, LV mass, and EA ratio were evaluated. Correlation analysis was performed to assess relationships between autonomic indices and cardiovascular measures. Results: Antihypertensive therapy resulted in significant reductions in systolic, mean, and diastolic BP ( P < 0.001) and a decrease in RRI and HRV indices, indicating improved autonomic regulation. Although HRV measures did not show statistically significant changes, BRS indices demonstrated an upward trend following treatment. Correlation analyses revealed a significant association between changes in BRS and changes in systolic BPV ( P = 0.008), while age showed a significant negative association with baroreflex improvement ( P = 0.009). Conclusion: Antihypertensive therapy reduces pressure load and improves autonomic stability. While HRV indices do not change significantly over the short term, BRS and BPV demonstrate favorable physiological adjustments. Autonomic markers, particularly BRS, may provide valuable insights into treatment response beyond conventional BP monitoring.