Global link between heart rate and blood pressure oscillations at rest and during mental arousal in normotensive and hypertensive subjects

UNLABELLED Complex phenomena modulate the interplay between heart rate and blood pressure variability, in particular after adjustments induced by stimuli or in pathophysiological conditions. This study sought to investigate in 25 hypertensive and 16 normotensive male subjects whether relationships operating at rest may be preserved after a central nervous system arousal induced by a mental stress test. As a secondary endpoint, we evaluated the potential changes of the components of heart rate and blood pressure variability during stress. RESULTS A significant correlation was observed between components of RR and systolic blood pressure (SBP) variability (p<0.0001), after controlling for the subject's status (normotensive vs. hypertensive) and for stress-steps (baseline condition, during stress test and recovery). Moreover, the multiple regression model accounted for the potential effects of the baseline alpha(LF) value and for the baseline heart rate and systolic blood pressure. The relationship operating between the LF/HF(RR) ratio and LF/HF(SBP) ratio was not different either at the different steps of stress test (interaction: p=0.87) or in the two groups of normotensive and hypertensive subjects (interaction: p=0.76). The variables of RR and SBP variabilities were modified during stress and recovery. In particular, the LF/HF(RR) ratio and LF/HF(SBP) ratio increased during stress and decreased during recovery. CONCLUSIONS The association between heart rate and blood pressure oscillations was preserved during central nervous system arousal by mental stress both in normotensives and hypertensives. A central integration may account for this constant relationship, the correlation being independent from baseline heart rate, blood pressure and baroreflex sensitivity.

[1]  A. Porta,et al.  Relationship between spectral components of cardiovascular variabilities and direct measures of muscle sympathetic nerve activity in humans. , 1997, Circulation.

[2]  G. Mulder,et al.  Effects of lorazepam on cardiac vagal tone during rest and mental stress: assessment by means of spectral analysis , 1994, Psychopharmacology.

[3]  R. Sloan,et al.  Blood pressure variability responses to tilt are buffered by cardiac autonomic control. , 1997, The American journal of physiology.

[4]  Peter Nickel,et al.  Sensitivity and Diagnosticity of the 0.1-Hz Component of Heart Rate Variability as an Indicator of Mental Workload , 2003, Hum. Factors.

[5]  D L Eckberg,et al.  Fundamental relations between short-term RR interval and arterial pressure oscillations in humans. , 1996, Circulation.

[6]  A. Porta,et al.  Spectral analysis of sympathetic discharge, R-R interval and systolic arterial pressure in decerebrate cats. , 1992, Journal of the autonomic nervous system.

[7]  A Malliani,et al.  Effects of Spinal Section and of Positive-Feedback Excitatory Reflex on Sympathetic and Heart Rate Variability , 2000, Hypertension.

[8]  Catherine Klersy,et al.  Hypertension-related hypoalgesia, autonomic function and spontaneous baroreflex sensitivity , 2002, Autonomic Neuroscience.

[9]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[10]  Raffaello Furlan,et al.  Quantifying the strength of the linear causal coupling in closed loop interacting cardiovascular variability signals , 2002, Biological Cybernetics.

[11]  R. Sloan,et al.  Cardiac autonomic control is inversely related to blood pressure variability responses to psychological challenge. , 1997, The American journal of physiology.

[12]  B. Folkow Psychosocial and central nervous influences in primary hypertension. , 1987, Circulation.

[13]  S Cerutti,et al.  Assessment of the neural control of the circulation during psychological stress. , 1991, Journal of the autonomic nervous system.

[14]  Hartmut Schächinger,et al.  Reduced vagal activity in salt-sensitive subjects during mental challenge. , 2003, American journal of hypertension.

[15]  G Baselli,et al.  Assessing baroreflex gain from spontaneous variability in conscious dogs: role of causality and respiration. , 2000, American journal of physiology. Heart and circulatory physiology.

[16]  S Cerutti,et al.  Analysis of short-term oscillations of R-R and arterial pressure in conscious dogs. , 1990, The American journal of physiology.

[17]  W. C. Randall,et al.  SA nodal parasympathectomy delineates autonomic control of heart rate power spectrum. , 1991, The American journal of physiology.

[18]  A. Malliani,et al.  Sympathetic rhythms and cardiovascular oscillations , 2001, Autonomic Neuroscience.

[19]  P. Sleight,et al.  Effects of controlled breathing, mental activity and mental stress with or without verbalization on heart rate variability. , 2000, Journal of the American College of Cardiology.

[20]  G. Billman,et al.  Low-frequency component of the heart rate variability spectrum: a poor marker of sympathetic activity. , 1999, The American journal of physiology.

[21]  L Faes,et al.  Causal linear parametric model for baroreflex gain assessment in patients with recent myocardial infarction. , 2001, American journal of physiology. Heart and circulatory physiology.

[22]  D. Eckberg Sympathovagal balance: a critical appraisal. , 1997, Circulation.

[23]  T. Lüscher,et al.  Increased activation of sympathetic nervous system and endothelin by mental stress in normotensive offspring of hypertensive parents. , 1996, Circulation.

[24]  A. Porta,et al.  Heart rate variability is encoded in the spontaneous discharge of thalamic somatosensory neurones in cat , 2000, The Journal of physiology.

[25]  J. Taylor,et al.  Spontaneous Indices Are Inconsistent With Arterial Baroreflex Gain , 2003, Hypertension.

[26]  Dirk Ramaekers,et al.  Cardiovascular Autonomic Function in Conscious Rats: A Novel Approach to Facilitate Stationary Conditions , 2002, Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc.

[27]  Juha Hartikainen,et al.  Sympathovagal balance is major determinant of short-term blood pressure variability in healthy subjects. , 1999, American journal of physiology. Heart and circulatory physiology.

[28]  A. Grandi,et al.  Effects of arithmetic mental stress test on hypertension‐related hypalgesia , 1995, Journal of hypertension.

[29]  C Cerutti,et al.  Autonomic nervous system and cardiovascular variability in rats: a spectral analysis approach. , 1991, The American journal of physiology.

[30]  K Scheuch,et al.  Sympathetic and parasympathetic activation in heart rate variability in male hypertensive patients under mental stress , 2004, Journal of Human Hypertension.

[31]  A. Porta,et al.  Oscillatory patterns in sympathetic neural discharge and cardiovascular variables during orthostatic stimulus. , 2000, Circulation.

[32]  R. Sloan,et al.  Pharmacologic responses and spectral analyses of spontaneous fluctuations in heart rate and blood pressure in SHR rats. , 1991, Journal of the autonomic nervous system.

[33]  J. Floras,et al.  Epinephrine and the genesis of hypertension. , 1992, Hypertension.

[34]  R. Cohen,et al.  Hemodynamic regulation: investigation by spectral analysis. , 1985, The American journal of physiology.

[35]  S Cerutti,et al.  Identification techniques applied to processing of signals from cardiovascular systems. , 1985, Medical informatics = Medecine et informatique.

[36]  N. Montano,et al.  Evidence for a central origin of the low-frequency oscillation in RR-interval variability. , 1998, Circulation.

[37]  A. Porta,et al.  Evidence for Central Organization of Cardiovascular Rhythms , 2001, Annals of the New York Academy of Sciences.

[38]  E. Schiffrin Reactivity of small blood vessels in hypertension: relation with structural changes. State of the art lecture. , 1992, Hypertension.

[39]  H. Snieder,et al.  Dissecting the genetic architecture of the cardiovascular and renal stress response , 2002, Biological Psychology.

[40]  P. Sleight,et al.  Lack of peripheral modulation of cardiovascular central oscillatory autonomic activity during apnea in humans. , 1997, The American journal of physiology.

[41]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[42]  A. Steptoe,et al.  Exaggerated blood pressure responses to submaximal exercise in normotensive adolescents with a family history of hypertension. , 1988, Journal of hypertension.

[43]  A. Malliani,et al.  Cardiovascular Neural Regulation Explored in the Frequency Domain , 1991, Circulation.

[44]  Luca Faes,et al.  Surrogate data analysis for assessing the significance of the coherence function , 2004, IEEE Transactions on Biomedical Engineering.

[45]  Luca Faes,et al.  Causal transfer function analysis to describe closed loop interactions between cardiovascular and cardiorespiratory variability signals , 2004, Biological Cybernetics.

[46]  A. Malliani,et al.  Changes in Autonomic Regulation Induced by Physical Training in Mild Hypertension , 1988, Hypertension.