Key result
The incidence of orthostatic hypotension during active orthostatic testing in young males with arterial hypertension was 17.7%, which did not differ significantly from the 15% observed in healthy controls.
Why the study?
The study aimed to improve the prognosis of orthostatic hypotension in young males with hypertension during antihypertensive therapy.
Does heart rate variability during an active orthostatic test predict the development of orthostatic hypotension in young males with hypertension?
Cross-Sectional (n=82)
No
Does heart rate variability during an active orthostatic test predict the development of orthostatic hypotension in young males with hypertension?
Absolute Event Rate: 17.7% vs 15%
The absence of changes in heart rate variability parameters during an active orthostatic test in young males with hypertension indicates autonomic dysfunction and can predict the development of orthostatic hypotension.
Comparable orthostatic hypotension incidence in young hypertensive males and controls; leaves open predictive value of heart rate variability.
Objective. The aim of the study was to improve the prognosis of orthostatic hypotension (OH) in young males with hypertension (AH) during antihypertensive therapy. Methods. Total of 62 male patients were examined, mean age 31.5 ± 3.6 years with AH of the 1st and 2nd degrees. The control group consisted of 20 practically healthy persons (mean age 31.0 ± 3.7 years). All patients underwent general clinical examination, measurement of office blood pressure (BP), daily monitoring of BP with the help of the ABPM-02 device (Meditech, Hungary), active orthostatic test (AOT) with determination of the Kerdo vegetative index (KI). During AOT, ECG and heart rate variability (HRV) were monitored according to the conventional methodology using monitors CardioTens-01 ("Meditech", Hungary). All patients underwent antihypertensive therapy. In 80.6% of patients, AH was controlled with drugs. Results. The incidence of OH in patients with AH was 17.7% and did not differ significantly from the control group - 15%. The patients with AH showed a decrease of the degree of parasympathetic effect according to KI data, while in the control group KI became positive. It was found that at the baseline, in the subgroup of young males with AH and OH in the orthostatic test, the spectral indices of HRV (LF and total power of the spectrum) were significantly lower than in patients with AH and negative orthostatic trial. Analysis of the dynamics of the HRV spectral indices during AOT showed that no significant changes were detected in the subgroup of patients with AH and OH. Therefore, in the course of AOT, the absence of changes in HRV parameters in patients with AH confirms the presence of autonomic dysfunction and dysfunction of the autonomic supply, and also allows to predict the development of OH. Conclusion. Thus, prognosis of the development of OH in case of AH in young patients will allow more effective correction of BP in the specified cohort of patients.
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Бiловол et al. (2019) conducted a cross-sectional in Arterial hypertension (n=82). Arterial hypertension vs. Healthy individuals was evaluated on Incidence of orthostatic hypotension during active orthostatic test. The incidence of orthostatic hypotension during active orthostatic testing in young males with arterial hypertension was 17.7%, which did not differ significantly from the 15% observed in healthy controls.
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