FEATURES OF HEART RATE regulation IN ADOLESCENTS WITH ESSENTIAL HYPERTENSION
Alina Mikhaylovna VALEEVA1, Oleg Viktorovich SOROKIN2, Zhanna Valerievna NEFEDOVA3, Victoria Gennad’evna KAYNARA4, Lyudmila Mikhaylovna PANASENKO3, Lyudmila Petrovna DERYAGINA3, Nina Petrovna KAREVA3
1Novosibirsk State University
2National Ayurvedic Medical Association
3Novosibirsk State Medical University
4City Children’s Clinical Hospital № 1
Keywords: подростки, эссенциальная гипертензия, кардиоинтервалография, вариабельность сердечного ритма, adolescents, essential hypertension, cardiointervalography, heart rate variability
Abstract
Cardiointervalography is an
important method of analyzing the regulation of heart rate variability,
which allows evaluating the balance of the entire spectrum of
humoral-metabolic and vegetative effects, both in condition of
physiological rest and in various functional tests. It is noted that in
hypertensive patients, in most cases, there is a chronic predominance of
ergotrophic metabolic reactions that reflect the system tension in the
regulatory mechanisms. The aim of our study was to conduct a comparative
analysis of the features of the mechanisms of heart rate regulation in
adolescents with confirmed essential hypertension and their healthy age
mates. Material and methods. The study involved 50 adolescents (12-16
years of age) - 26 boys and 24 girls with labile essential hypertension
(EHT) and stage 1 HT on the background of the standard medical
correction of blood pressure (enalapril 0,58 mg/kg per day). Each
participant of the study and control group underwent recording of at
least 512 cardio cycles in the state of physiological rest in a sitting
position, as well as registration of blood pressure. Results and
discussion. We have found that for adolescents with EHT a significantly
lower (by 15 %) average duration of the heart cycle is typical in
combination with a decrease in the variation range, which indicates some
rigidity of the heart rate regulatory mechanisms. The relative decrease
in the proportion of high-frequency spectrum components in comparison
with the low-frequency and very low-frequency ranges in adolescents with
hypertension also indicated a tendency to predominance of
sympathicotonic effects with the predominant involvement of the
structures of the diencephalic region and the brain stem. At the same
time blood pressure inversely correlated with the index of the variation
range of cardiointervals, reflecting the lower adaptive potential of
the heart rate regulation mechanisms. Conclusion. We have found regular
changes in the regulation of heart rate in adolescents with
hypertension, that can be taken as markers of its progressive
development and used by clinicians to develop more personalized
approaches to medication treatment.
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