The Relationship Between Ambulatory Pulse Pressure And Heart Rate Variability And Left Ventricular Hypertrophy In Patients With Essential Hypertension

Objective: To investigate the relationship between ambulatory pulsepressure (APP) and heart rate variability(HRV) and left ventricularhypertrophy (LVH) in patients with essential hypertension(EH)..Methods:45patients with essential hypertension were selected in ourdepartment of cardiology in the hospital from September2010to January2012.45patients were taken the echocardiography, synchronous24-hourambulatory blood pressure (ABMP) and dynamic electrocardiogram(DCG).According to the APP,45patients were divided into2groups, normal pulsepressure:(NPP, APP＜60mmHg, n=19,42.2%,12males and7females.),wide pulse pressure(WPP, APP≥60mmHg, n=26,57.8%,16males and10females). Compare HRV and left ventricular mass index(LVMI)between twogroups. Indexes of HRV include SDNN, SDANN, rMSSD, pNN50, LF, HFand LF/HF. The LVMI, male≥125g/m2, female≥110g/m2as the standard ofLVH.Results:1HRV of two groups:SDNN and SDANN were lower separately in WPP group compared withNPP group [(120.08±16.96) vs (142.79±12.41),(110.35±18.58) vs(127.42±28.75),P＜0.05]. rMSSD and PNN50were lower in WPP groupcompared with NPP group [(33.35±18.30) vs (54.63±22.61),(23.12±6.89) vs(34.47±10.47),P＜0.001]. LF and HF were lower in WPP group comparedwith NPP group [(231.91±119.80) vs (316.05±148.44),(207.38±107.18) vs(367.18±152.98),P＜0.05], LF/HF was higher in NPP group compared withNPP group [(1.17±0.49) vs (0.89±0.26),P＜0.05]. 2LVH of two groups:LVMI increased with elevation of APP in WPP group compared with NPPgroup [(99.08±23.65) vs (80.47±29.70),P＜0.05]. Three factors affect LVMI,including LVIDD, IVDST and LVDPWT. They were increased, onlyLVDPWT has statistical significant [(1.0±0.2) vs (0.9±0.2),P＜0.05].Conclusions:1HRV was significantly reduced with increase of APP in EH patients. Itindicates autonomic nerve function was damaged seriously. It is means thatsympathetic tone was increased, and vagal tone was reduced;2Increased APP may be one of risk factors to the LVH, suggesting the greaterof APP, the higher of incidence of LVH.