Analysis of baroreflex under essential hypertension in clinical practice

Aim. The aim of this article is to study heart rate turbulence in healthy people and in patients with stages II and III of essential hypertension and to analyze possibilities of using the results obtained in clinical practice. Materials and methods. Weexamined 68 people (48.5 % female participants) aged 56.21 ± 1.06 years. We analyzed the results of 24-hour ECG Holter monitoring obtained with the help of Kardiotekhnica-04 computer appliance (INCART). Essential hypertension was diagnosed using a standard diagnostic scheme recommended by the Society of Cardiology of the Russian Federation guidelines (2013). This diagnosis was not confirmed in 6 participants. We registered stage II hypertension in 28 examinees with respect to disturbances of target organs. We diagnosed stage III hypertension in 34 patients taking into account such an associated clinical condition as ischemic heart disease. The assessment of heart rate turbulence indices was performed within the standard procedure. Results. The results obtained show that in patients with essential hypertension there is a relative decrease in the parasympathetic activity of the vegetative nervous system and baroreflex sensitivity. As essential hypertension worsens, a decrease in the parasympathetic activity of the vegetative nervous system is becoming more pronounced. The comparative analysis of heart rate disturbance indices revealed a decrease in TO and TS as essential hypertension progresses, however these values remain within reference limits. Conclusion. We gave the examples of heart rate turbulence analysis with TO and TS pathological values. Heart rate turbulence is the method of assessment of the autonomous nervous system. It can be used for a complex assessment of essential hypertension in clinical conditions and during rehabilitation.