A2996 The association among variability of self-measured blood pressure at home, heart rate variability and imbalance of autonomic nervous system activity

Abstract

Objectives: To investigate the association between variability of self-measured blood pressure at home (home BPV), heart rate variability (HRV) and the balance of autonomic nervous system activity. Methods: From August 2015 to June 2017, we enrolled 127 normotensive to moderate hypertensive subjects. Based on home BPV (assessed using SD) level, the 127 subjects were categorized into three groups: low home BPV group (Low group), middle home BPV group (Middle group), and high home BPV group (High group). cold pressor test norepinephrine (CPT), epinephrine plasma concentration, norepinephrine plasma concentration, angiotensin II plasma concentration, and HRV were determined. Results: Compared to Low group, systolic BP response to CPT, norepinephrine plasma concentration, and angiotensin II plasma concentration were higher in Middle group, and highest in High group. The opposite trends were found in time domain parameters of HRV (SDNN, SDANN, and rMSSD), and frequency domain parameter (LF). The results of Spearman correlation and multivariate linear regression analyses showed that home systolic BPV was significantly and positively correlated with systolic BP response to CPT, norepinephrine plasma concentration, angiotensin II plasma concentration, and VLF, and negatively correlated with SDNN, SDANN, rMSSD, and LF. Home diastolic BPV was significantly and positively correlated with systolic BP response to CPT, diastolic BP response to CPT and norepinephrine plasma concentration, and negatively correlated with SDNN. Conclusion: Aggressive home BPV and HRV may be tightly associated with the imbalance of autonomic nervous system activity.