Analysis Of Heart Rate Variability Among Patients With Different Grades Of Essential Hypertension In Kunming

Objective:In different blood pressure classification of primary hypertension in Kunming region(Essential hypertension,EH)patients with Heart rate variability(Heart rate variability,HRV)characteristics of HRV can reflect a certain degree of autonomic nervous function,through the analysis of different blood pressure classification characteristics of HRV in patients with primary hypertension,to understand the change of autonomic nervous function and the degree of the impact.Methods:Hypertension patients in the department of Cardiology who visited the First Affiliated Hospital of Kunming Medical University from December 2018 to December 2019(experimental group,n=192)and healthy physical examinants(control group,n=45)were included.(1)General clinical data were collected on all patients and healthy physical examinees:gender,age,body mass index(BMI),ethnic minority status,smoking and alcohol consumption;Previous history of disease and medication,including angiotensin-converting enzyme inhibitor(ACEI)drugs,beta blockers and anticholinergics;(2)According to the blood pressure grading standards in The 2018 Revision of Chinese Hypertension Guidelines,patients with essential hypertension are grouped as follows:Grade 1 hypertension group {SBP,140?159 mmHg and(or)DBP 90?99 mmHg,n=61),grade 2 hypertension group {SBP,160-179 mmHg and(or)DBP 100?109 mmHg,n=62),the level 3 hypertension group{SBP 180 or higher and(or)DBP acuity 110 mmHg,n=69},24-hour dynamic electrocardiogram record method,record each grouped all the research object of HRV indices,and record the average heart rate,the slow heart rate,heart rate,the fastest Analyze and compare the differences among the five time-domain indicators of HRV among groups:The R-R interphase of sinus heartbeat is denoted by the N-n interphase,?SDNN(normal phase standard deviation between N-N,ms),?PNN50(percentage of>,50ms in total heart rate,unit%),?rMSSD(N-N,root mean square value of the difference between the adjacent units ms),?HRV triangular index(N-N period between the total number of N-N period between the height of the histogram,dimensionless),?SDANN(every 5 min period average standard deviation between normal N-N,unit ms).Results:(1)Compared with the healthy physical examination group,the SDNN index of grade 1 hypertension group,grade 2 hypertension group and grade 3 hypertension group were all reduced,and the difference was statistically significant(P<0.05).The level 3 hypertension group was compared with the level 1 hypertension group and the level 2 hypertension group,respectively.SDNN index was reduced,and the difference was statistically significant(P<0.05).It suggests that the overall autonomic function of hypertensive patients is worse than that of normal people,and the overall autonomic function is worse when the blood pressure grading is higher.(2)The rMSSD index of patients with grade 1 hypertension was lower than that of healthy subjects,and the difference was statistically significant(P<0.05).It is suggested that the patients with hypertension show the characteristics of decreased vagus nerve activity compared with normal people.(3)Compared with the control group,grade 2 hypertension group and grade 3 hypertension group were compared with the control group and grade 1 group respectively.SDANN and HRV triangle index were reduced,and the differences were statistically significant(P<0.05).It was suggested that the hypertensive patients showed enhanced sympathetic activity and impaired overall autonomic nerve function compared with normal people,and the above characteristics were more obvious in the patients with higher blood pressure grading.(4)The mean values of the five time-domain indexes of HRV in the patients with essential hypertension were all decreased compared with those in the healthy physical examination group.The higher the blood pressure grading was,the greater the decrease was in the mean values of SDNN,HRV triangle index and SDANNConclusion:The patients with essential hypertension in Kunming showed the characteristics of autonomic overactivity.The degree of autonomic nervous system overactivity in patients with essential hypertension in Kunming is proportional to the clinical severity;To carry out heart rate variability analysis in hypertensive population and improve the early recognition rate of impaired autonomic nerve function may be a key point worth paying attention to in the field of hypertension prevention and control in the future.