AIMS: The prognostic value of baroreflex sensitivity in hypertensive patients has not much been studied. METHOD: A cohort of 451 hypertensive patients without cardiovascular history was studied for an average of 6.2 +/- 2.8 years follow-up. Each patient had a baroreflex sensitivity measurement by the sequence method, which is represented by the slope of up-sequences (systolic blood pressure+/pulse interval+) and down-sequences (systolic blood pressure-/pulse interval-) of spontaneous fluctuations in systolic blood pressure and pulse interval. RESULTS: During the follow-up, there were 20 deaths from any cause and 30 patients presented a major adverse cardiovascular event. Deaths and major adverse cardiovascular events were associated with a reduction in baroreflex sensitivity (systolic blood pressure+/pulse interval+ and systolic blood pressure-/pulse interval-). In multivariate analysis, the reduction in baroreflex sensitivity systolic blood pressure+/pulse interval+ was associated with an increased risk of deaths from any cause (Odds ratio 1.23; 95% confidence interval 1.02-1.67, P = 0.04). A baroreflex sensitivity systolic blood pressure+/pulse interval+ under 4.5 ms/mmHg was associated with a 2.5-increased relative risk of major adverse cardiovascular event (95% confidence interval 1.11-5.93, P = 0.03). However, multivariate analysis showed that baroreflex sensitivity systolic blood pressure-/pulse interval- was not associated either with death or major adverse cardiovascular events. CONCLUSIONS: Reduction in baroreflex sensitivity marked by a reduction in vagal reflexes is an independent marker of the risk of mortality and major adverse cardiovascular events in hypertensive patients.
AIMS: The prognostic value of baroreflex sensitivity in hypertensivepatients has not much been studied. METHOD: A cohort of 451 hypertensivepatients without cardiovascular history was studied for an average of 6.2 +/- 2.8 years follow-up. Each patient had a baroreflex sensitivity measurement by the sequence method, which is represented by the slope of up-sequences (systolic blood pressure+/pulse interval+) and down-sequences (systolic blood pressure-/pulse interval-) of spontaneous fluctuations in systolic blood pressure and pulse interval. RESULTS: During the follow-up, there were 20 deaths from any cause and 30 patients presented a major adverse cardiovascular event. Deaths and major adverse cardiovascular events were associated with a reduction in baroreflex sensitivity (systolic blood pressure+/pulse interval+ and systolic blood pressure-/pulse interval-). In multivariate analysis, the reduction in baroreflex sensitivity systolic blood pressure+/pulse interval+ was associated with an increased risk of deaths from any cause (Odds ratio 1.23; 95% confidence interval 1.02-1.67, P = 0.04). A baroreflex sensitivity systolic blood pressure+/pulse interval+ under 4.5 ms/mmHg was associated with a 2.5-increased relative risk of major adverse cardiovascular event (95% confidence interval 1.11-5.93, P = 0.03). However, multivariate analysis showed that baroreflex sensitivity systolic blood pressure-/pulse interval- was not associated either with death or major adverse cardiovascular events. CONCLUSIONS: Reduction in baroreflex sensitivity marked by a reduction in vagal reflexes is an independent marker of the risk of mortality and major adverse cardiovascular events in hypertensivepatients.
Authors: Myles W O'Brien; Jarrett A Johns; Tristan W Dorey; Ryan J Frayne; Jonathon R Fowles; Said Mekary; Derek S Kimmerly Journal: Clin Auton Res Date: 2019-10-12 Impact factor: 4.435
Authors: Rodica Pop-Busui; Patricia A Cleary; Barbara H Braffett; Catherine L Martin; William H Herman; Phillip A Low; Joao A C Lima; David A Bluemke Journal: J Am Coll Cardiol Date: 2012-12-19 Impact factor: 24.094