Associations between Intrinsic Heart Rate, P Wave and QT Interval Durations and Pulse Wave Analysis in Patients with Hypertension and High Normal Blood Pressure.

Ioana Mozos,Marius Pricop,Daniela Jianu,Cristina Gug,Costin Mozos,Dana Stoian

doi:10.3390/ijerph17124350

Abstract

The present study aimed to explore the relationship between electrocardiographic (ECG) and pulse wave analysis variables in patients with hypertension (HT) and high normal blood pressure (HNBP). A total of 56 consecutive, middle-aged hypertensive and HNBP patients underwent pulse wave analysis and standard 12-lead ECG. Pulse wave velocity (PWV), heart rate, intrinsic heart rate (IHR), P wave and QT interval durations were as follows: 7.26 ± 0.69 m/s, 69 ± 11 beats/minute, 91 ± 3 beats/minute, 105 ± 22 mm and 409 ± 64 mm, respectively. Significant correlations were obtained between PWV and IHR and P wave duration, respectively, between early vascular aging (EVA) and P wave and QT interval durations, respectively. Linear regression analysis revealed significant associations between ECG and pulse wave analysis variables but multiple regression analysis revealed only IHR as an independent predictor of PWV, even after adjusting for blood pressure variables and therapy. Receiver-operating characteristic (ROC) curve analysis revealed P wave duration (area under curve (AUC) = 0.731; 95% CI: 0.569–0.893) as a predictor of pathological PWV, and P wave and QT interval durations were found as sensitive and specific predictors of EVA. ECG provides information about PWV and EVA in patients with HT and HNBP. IHR and P wave durations are independent predictors of PWV, and P wave and QT interval may predict EVA.

Highlights

Central and Eastern Europe are regions with a high cardiovascular burden [1]
Our objective is to explore the relationship between electrocardiographic (ECG) and pulse wave analysis variables in patients with hypertension and high normal blood pressure
Essential hypertension and high normal blood pressure were diagnosed according to the criteria of the European Society of Cardiology [23]

Summary

Introduction

Central and Eastern Europe are regions with a high cardiovascular burden [1]. Romania was considered a high-cardiovascular-risk country according to the European Guidelines [2]. The consequence of arteriosclerosis and subclinical atherosclerosis, is involved in cardiovascular disease development and, if assessed, can improve risk prediction, especially in hypertensive and intermediate risk patients [4,5,6,7,8]. Especially repolarization variables, including QT interval duration, can provide useful information in cardiovascular risk assessment [9,10,11,12,13]. The links between increased resting heart rate and mortality include sympathetic overactivity, increased metabolic rate and systemic inflammation, present in several systemic conditions, as well as cardiovascular risk factors [12]. An accelerated heart rate enables low, oscillatory endothelial shear stress and increased tensile stress, inducing a proinflammatory phenotype, with elevated levels of adhesion molecules, promoting atherogenesis and arterial stiffness [14,15]. Intrinsic heart rate is the heart rate under the simultaneous beta-blockade and muscarinic receptor blockade with propranolol and atropine, respectively [16,17]

Objectives

Methods

Results

Conclusion