Assessment of heart rate turbulence in hypertensive patients: Rationale, perspectives, and insight into autonomic nervous system dysfunction

BACKGROUND: Heart rhythm turbulence is classically impaired in patients with previous myocardial infarction and congestive heart failure and is poorly investigated in patients with essential hypertension. OBJECTIVE: To evaluate heart rhythm turbulence parameters (turbulence onset, (TO); turbulence slope, (TS) in a series of hypertensive patients while gaining insight into autonomic nervous system dysfunction. SETTING AND DESIGN: University hospital, cross-sectional monocentric study. MATERIALS AND METHODS: Heart rhythm turbulence was assessed in 50 hypertensive (case group) and 40 normotensive patients (control group). RESULTS: TO and TS were found independently correlated with hypertension. The mean TO was found at -1.64% ± 2.85% in the normotensive patients compared to 1.21% ± 1.95% in the hypertensive patients; the mean TS was found at 4.29 ± 3.18 ms/RR in the normotensive patients compared to 2.27 ± 0.93 ms/RR in the hypertensive patients. Hypertension has a predictive value on heart rhythm turbulence impairment (OR 4.99, 95% CI 1.28-19.41, P = 0.02). Insights into the role of autonomic nervous system dysfunction for the management of hypertensive patients and prevention of malignant ventricular arrhythmia are presented and discussed with regard to heart rhythm turbulence. CONCLUSION: Essential hypertension is correlated with blunted heart rhythm turbulence parameters.