Discussion On The Relationship Between H-type Hypertention And Autonomic Nervous System

Objective: To investigate the change of heart rate variability in patients of primary hypertension with or without Hcy levels of the changes.Discussing whether hypertension and hyperhomocysteinemia have synergistic effect on the severity of cardiac autonomic nervous function balance disorders.Methods: A total of 139 hypertensive and 116 normotensive patients hospitalized in the First Affiliated Hospital of Guangxi Medical University from April 2015 to February 2017 were retrospectively reviewed.According to level of blood pressure and homocysteine,patients were divided into four groups:H-type hypertension group(n=101),non-H-type hypertension group(n=38),HHcy+non-hypertension group(n=66)and control group(n=50).The clinical and dynamic electrocardiography data of these patients were retrospectively reviewed.The serum level of homocysteine(Hcy),FPGcose(FBG),glycosylated hemoglobin(Hb A1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high-density lipoprotein(HDL-C)and the heart rate variability time-domain analysis indexes were compared among groups.Correlation analysis was taken between Hcy and HRV.The factors affected the cardiac autonomic nervous were analysed with logistic regression model.Results: There were no significant differences in biochemical parameters but HCY(P<0.05)among four groups.The heart rate variability time-domain analysis indexes(SDNN?SDANN?SDNNindex?rMSSM?PNN50 and TRIIDX)in H-type hypertension group were lower than those of other three groups(P<0.001).The Hcy was positively correlated with level of blood pressure and negatively correlated with the heart rate variability time-domain analysis.Logistic regression analysis showed that HHcy,hypertension and advanced age were the risk factors of dysfunction of autonomic nervous system(OR=2.98,3.78 and 1.03,P<0.05).The risk was higher in patients with H-type hypertension than in patients with non-H-type hypertension or patients with HHcy and non-hypertension(OR=4.86,P<0.01).Conclusion:The HRV reduce in patients with non-H-type hypertension an d HHcy,and HRV declines even more in patients with H-type hypertension,whi ch prompts the hypertension and HHcy have synergistic effect on cardiac autono mic nervous function.