Objective: Introduction: Would cardiovascular autonomic reflexes help in understanding the diagnosis and the management of primary hypertension (PHT). The purpose of this study was to evaluate the cardiovascular autonomic reflexes in patients with primary hypertension (PHT), including masked hypertension (MHT), hypertension with type 2 diabetes (DHT), orthostatic hypertension (OHT) and orthostatic hypotension (OHypoT). Design and method: Patients and Methods. This prospective study included two groups: normotensive group, NT (N = 120) and primary hypertensive group, PHT (N = 120). The PHT group was divided in different subgroup: N1 = subgroup of MHT, N2 = subgroup of DHT, N3 = subgroup of OHT and N4 = subgroup of OHypoT. The PHT group as well as the subgroups were compared to NT group. The cardiovascular autonomic tests performed in these groups, included deep breathing (DB), hand-grip (Hg), mental stress (MS) and orthostatic (Orth) tests. Statistical analysis was done using the Student's t-test. Results: Results. Cardiovascular autonomic reflexes responses were as follows: Compared to NT, 1. Central alpha adrenergic response to mental stress test was of 20,0 ± 9,8% vs 15,2 ± 8,6% (p < 0,001) in PHT; 24,7 ± 7,2% vs 15,2 ± 4,5% (p < 0,001) in MHT; and 23,48 ± 9,82% vs 20,28 ± 9,60%(p = 0,243) in DHT. 2. Peripheral alpha adrenergic response to hand grip test of 16,7 ± 7,5% vs 13,3 ± 6,5% (p < 0,001) in PHT; 27,0 ± 5,4% vs 16,4 ± 4,5% (P < 0,001) in MHT; and 20,03 ± 8,05 vs 21,71 ± 11,23% (p = 0,588) in DHT. 3. Vagal response to deep breathing test was of 30,2 ± 8,1% vs 46,1 ± 2,1% (p < 0,001) in PHT; 30,5 ± 10,4% vs 32,7 ± 11,3% (p = 0,1) in MHT; and 23,09 ± 11,06% vs 34,15 ± 17,7% (p < 0,001) in DHT. Of interest orthostatic test showed that 70% of PHT had orthostatic hypertension and 15% orthostatic hypotension. Conclusions: Conclusion. PHT, hypertensive with type 2 diabetes, MHT have a significantly higher sympathetic response when compared to controls and vagal response significantly lower. The latter is accentuated by the association of diabetes to hypertension. The results attest that cardiovascular autonomic reflexes study is of high interest in assessing PHT
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