scholarly journals Development of Causal Interactions Between Systolic Blood Pressure and Inter-Beat Intervals in Adolescents

2015 ◽  
pp. 821-829 ◽  
Author(s):  
J. SVAČINOVÁ ◽  
M. JAVORKA ◽  
Z. NOVÁKOVÁ ◽  
E. ZÁVODNÁ ◽  
B. CZIPPELOVÁ ◽  
...  

Systolic blood pressure (SBP) changes control the cardiac inter-beat intervals (IBI) duration via baroreflex. Conversely, SBP is influenced by IBI via non-baroreflex mechanisms. Both causal pathways (feedback – baroreflex and feedforward – non-baroreflex) form a closed loop of the SBP – IBI interaction. The aim of this study was to assess the age-related changes in the IBI – SBP interaction. We have non-invasively recorded resting beat-to-beat SBP and IBI in 335 healthy subjects of different age, ranging from 11 to 23 years. Using a linear autoregressive bivariate model we obtained gain (GainSBP,IBI, used traditionally as baroreflex sensitivity) and coherence (CohSBP,IBI) of the SBP–IBI interaction and causal gain and coherence in baroreflex (GainSBPIBI, CohSBPIBI) and coherence in non-baroreflex (CohIBISBP) directions separately. A non-linear approach was used for causal coupling indices evaluation (CSBPIBI, CIBISBP) quantifying the amount of information transferred between signals. We performed a correlation to age analysis of all measures. CohIBISBP and CIBISBP were higher than CohSBPIBI and CSBPIBI, respectively. GainSBP,IBI increased and CohSBPIBI decreased with age. The coupling indices did not correlate with age. We conclude that the feedforward influence dominated at rest. The increase of GainSBP,IBI with age was not found in the closed loop model. A decrease of CohSBPIBI could be related to a change in the cardiovascular control system complexity during maturation.

1986 ◽  
Vol 70 (5) ◽  
pp. 489-494 ◽  
Author(s):  
Kazuyuki Shimada ◽  
Tadao Kitazumi ◽  
Hisakazu Ogura ◽  
Noriko Sadakane ◽  
Toshio Ozawa

1. Inter-relationship between age, systolic blood pressure and baroreflex sensitivity index derived from the Valsalva manoeuvre was investigated in either combined or separated groups of normal and hypertensive subjects. 2. Both in the total population as a whole and in each blood pressure subgroup, the baroreflex sensitivity index was significantly inversely related to age and to systolic blood pressure. Furthermore, age was significantly related to systolic blood pressure except in the hypertensive group. 3. Partial correlation analysis showed that, in the total and hypertensive population, the baroreflex sensitivity index was significantly related to age and systolic blood pressure independently of each other variable. In the normal group, however, the baroreflex sensitivity index was not related to systolic blood pressure after adjusting for the effect of age, but remained significantly related to age independently of systolic blood pressure. The estimates of relative effects of the two variables on baroreflex sensitivity by multiple regression analysis were consistent with these results. 4. Thus a prevailing concept of the inhibitory effect of blood pressure on baroreflex function may be accurate exclusively in hypertensive patients, and baroreflex function appears to be more sensitive to age-related changes in this system than to those related to blood pressure level, particularly in non-hypertensive normal subjects.


2002 ◽  
Vol 102 (4) ◽  
pp. 465-473 ◽  
Author(s):  
Hagen MALBERG ◽  
Niels WESSEL ◽  
Annett HASART ◽  
Karl-Josef OSTERZIEL ◽  
Andreas VOSS

Baroreflex sensitivity (BRS) is an important parameter in the classification of patients with reduced left ventricular function. This study aimed at investigating BRS in patients with dilated cardiomyopathy (DCM) and in healthy subjects (controls), as well as comparing the values of BRS parameters with parameters of heart rate variability (HRV) and blood pressure variability (BPV). ECG, continuous blood pressure and respiration curves were recorded for 30min in 27 DCM patients and 27 control subjects. The Dual Sequence Method (DSM) includes the analysis of spontaneous fluctuations in systolic blood pressure and the corresponding beat-to-beat intervals of heart rate to estimate bradycardic, opposite tachycardic and delayed baroreflex fluctuations. The number of systolic blood pressure/beat-to-beat interval fluctuations in DCM patients was reduced in comparison with controls (DCM patients: male, 154.4±93.9ms/mmHg; female, 93.7±40.5ms/mmHg; controls: male, 245.5±112.9ms/mmHg; female, 150.6±55.8ms/mmHg, P < 0.05). The average slope in DCM patients was lower than in controls (DCM, 5.3±1.9ms/mmHg; controls, 8.0±5.4ms/mmHg; P < 0.05). Discriminant function analysis showed that, in the synchronous range of the standard sequence method, the DCM and control groups could be discriminated to only 76% accuracy, whereas the DSM gave an improved accuracy of 84%. The combination of six parameters of HRV, BPV and DSM gives an accuracy of classification of 96%, whereas six parameters of HRV and BPV could separate the two groups to only 88% accuracy. Thus the DSM leads to an improved characterization of autonomous regulation in order to differentiate between DCM patients and healthy subjects. BRS in DCM patients is significantly reduced and apparently less effective.


2005 ◽  
Vol 288 (2) ◽  
pp. H710-H715 ◽  
Author(s):  
Mikko P. Tulppo ◽  
Heikki V. Huikuri ◽  
Elli Tutungi ◽  
Derek S. Kimmerly ◽  
Adrian W. Gelb ◽  
...  

The amplitude of low-frequency (LF) oscillations of heart rate (HR) usually reflects the magnitude of sympathetic activity, but during some conditions, e.g., physical exercise, high sympathetic activity results in a paradoxical decrease of LF oscillations of HR. We tested the hypothesis that this phenomenon may result from a feedback inhibition of sympathetic outflow caused by circulating norepinephrine (NE). A physiological dose of NE (100 ng·kg−1·min−1) was infused into eight healthy subjects, and infusion was continued after α-adrenergic blockade [with phentolamine (Phe)]. Muscle sympathetic nervous activity (MSNA) from the peroneal nerve, LF (0.04–0.15 Hz) and high frequency (HF; 0.15–0.40 Hz) spectral components of HR variability, and systolic blood pressure variability were analyzed at baseline, during NE infusion, and during NE infusion after Phe administration. The NE infusion increased the mean blood pressure and decreased the average HR ( P < 0.01 for both). MSNA (10 ± 2 vs. 2 ± 1 bursts/min, P < 0.01), LF oscillations of HR (43 ± 13 vs. 35 ± 13 normalized units, P < 0.05), and systolic blood pressure (3.1 ± 2.3 vs. 2.0 ± 1.1 mmHg2, P < 0.05) decreased significantly during the NE infusion. During the NE infusion after PHE, average HR and mean blood pressure returned to baseline levels. However, MSNA (4 ± 2 bursts/min), LF power of HR (33 ± 9 normalized units), and systolic blood pressure variability (1.7 ± 1.1 mmHg2) remained significantly ( P < 0.05 for all) below baseline values. Baroreflex gain did not change significantly during the interventions. Elevated levels of circulating NE cause a feedback inhibition on sympathetic outflow in healthy subjects. These inhibitory effects do not seem to be mediated by pressor effects on the baroreflex loop but perhaps by a presynaptic autoregulatory feedback mechanism or some other mechanism that is not prevented by a nonselective α-adrenergic blockade.


2008 ◽  
Vol 295 (3) ◽  
pp. H1150-H1155 ◽  
Author(s):  
François Cottin ◽  
Claire Médigue ◽  
Yves Papelier

The aim of the study was to assess the instantaneous spectral components of heart rate variability (HRV) and systolic blood pressure variability (SBPV) and determine the low-frequency (LF) and high-frequency baroreflex sensitivity (HF-BRS) during a graded maximal exercise test. The first hypothesis was that the hyperpnea elicited by heavy exercise could entail a significant increase in HF-SBPV by mechanical effect once the first and second ventilatory thresholds (VTs) were exceeded. It was secondly hypothesized that vagal tone progressively withdrawing with increasing load, HF-BRS could decrease during the exercise test. Fifteen well-trained subjects participated in this study. Electrocardiogram (ECG), blood pressure, and gas exchanges were recorded during a cycloergometer test. Ventilatory equivalents were computed from gas exchange parameters to assess VTs. Spectral analysis was applied on cardiovascular series to compute RR and systolic blood pressure power spectral densities, cross-spectral coherence, gain, and α index of BRS. Three exercise intensity stages were compared: below (A1), between (A2), and above (A3) VTs. From A1 to A3, both HF-SBPV (A1: 45 ± 6, A2: 65 ± 10, and A3: 120 ± 23 mm2Hg, P < 0.001) and HF-HRV increased (A1: 20 ± 5, A2: 23 ± 8, and A3:40 ± 11 ms2, P < 0.02), maintaining HF-BRS (gain, A1: 0.68 ± 0.12, A2: 0.63 ± 0.08, and A3: 0.57 ± 0.09; α index, A1: 0.58 ± 0.08, A2: 0.48 ± 0.06, and A3: 0.50 ± 0.09 ms/mmHg, not significant). However, LF-BRS decreased (gain, A1: 0.39 ± 0.06, A2: 0.17 ± 0.02, and A3: 0.11 ± 0.01, P < 0.001; α index, A1: 0.46 ± 0.07, A2: 0.20 ± 0.02, and A3: 0.14 ± 0.01 ms/mmHg, P < 0.001). As expected, once VTs were exceeded, hyperpnea induced a marked increase in both HF-HRV and HF-SBPV. However, this concomitant increase allowed the maintenance of HF-BRS, presumably by a mechanoelectric feedback mechanism.


2004 ◽  
Vol 96 (6) ◽  
pp. 2333-2340 ◽  
Author(s):  
Tomi Laitinen ◽  
Leo Niskanen ◽  
Ghislaine Geelen ◽  
Esko Länsimies ◽  
Juha Hartikainen

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23–77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70° HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component ( r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV ( r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 465-470
Author(s):  
Steven Shea ◽  
Charles E. Basch ◽  
Bernard Gutin ◽  
Aryeh D. Stein ◽  
Isobel R. Contento ◽  
...  

Objective. To determine whether changes in aerobic fitness and body mass index are related to the age-related rise in blood pressure in healthy preschool children. Study design. Longitudinal analyses of 196 free-living children aged 5 years at baseline who were followed over a mean of 19:7 months. Aerobic fitness was assessed using a treadmill All measures were obtained on multiple occasions at scheduled visits as part of a longitudinal cohort study. Setting. An inner-city medical center. Outcome measures. Blood pressure was measured using an automated Dinamap device. Results. Mean systolic blood pressure was 95.3 mmHg (SD 8.38) at baseline and increased by 4.46 mmHg per year. Mean diastolic blood pressure was 53.9 mmHg (SD 5.81) at baseline and did not change significantly. Children in the highest quintile of increase in fitness had a significantly smaller increase in systolic blood pressure compared to children in the lowest quintile (2.92 vs 5.10 mmHg/year; P = .03). Children in the lowest quintile of increase in body mass index did not differ significantly in rate of increase in systolic blood pressure compared to children in the highest quintile (3.92 vs 4.96 mmHg/year). In a multiple regression model including baseline systolic blood pressure, fitness, height, body mass index, and other covariates, greater increase in fitness (P = .03) and lesser increase in body mass index (P &lt; .01) were associated with lower rates of increase in systolic blood pressure. In a similar multivariate analysis, an increase in fitness was also associated with a lower rate of increase in diastolic blood pressure (P = .02) Conclusion. Young children who increase their aerobic fitness or decrease their body mass index reduce the rate of the age-related increase in blood pressure. These observations may have implications for development of interventions directed at the primary prevention of hypertension.


2020 ◽  
Vol 15 (1) ◽  
pp. 6-10
Author(s):  
Sadia Afrin Rimi ◽  
Shamima Sultana ◽  
Iffat Rezwana ◽  
Sultana Ferdousi

Background: Tilt table test is used for the last few decades to detect cause in unexplained syncope. The response to tilting may vary physiologically with obesity. Objective: To assess the relationship of BMI to cardiovascular response to tilting. Methods: This experimental study was conducted from March 2019 to Feb 2020 on 90 healthy subjects with different BMI. Fifty one subjects of both gender with BMI 18.5-24.9 kg/m2 were included in the non-obese group and 39 subjects of both gender with BMI of 25-29.9 kg/m2 were included in overweight group and they were further subdivided into male and female. Head up tilting was done for 10 minutes at 600 by using a motorized tilt table. Systolic blood pressure (SBP), diastolic blood pressure (DBP) were recorded by an automatic sphygmomanometer. Heart rate (HR) and peripheral capillary oxygen saturation (SpO2) were measured by a pulse oximeter. For statistical analysis, Independent sample ‘t’ test, Pearson’s correlation test and Chi square tests were applied. Results: Significantly smaller rise of heart rate was observed in overweight males and greater fall of systolic blood pressure was observed in overweight females. Conclusion: This study concluded that over weight is associated with reduced orthostatic tolerance to head up tilt test in both genders. J Bangladesh Soc Physiol. 2020, June; 15(1): 6-10


1982 ◽  
Vol 63 (s8) ◽  
pp. 411s-414s ◽  
Author(s):  
Jun Ogawa ◽  
Shigeo Takata ◽  
Gakuji Nomura ◽  
Shiro Arai ◽  
Takayuki Ikeda ◽  
...  

1. We studied the effects of aging on the variability of blood pressure in mild to moderate essential hypertensive subjects. 2. Cardiac index was greater and total peripheral resistance index was less in patients under 40 years (by an average of 1.06 litres min−1 m−2 and 9.23 mmHg 1−1 min−1 m−2) than in those over 40 respectively (P < 0.001 for each). 3. Pulse pressure/stroke volume was less by an average of 0.345 mmHg/ml in patients under 40 years than that in those over 40 (P < 0.001). Pulse pressure/stroke volume was correlated with age (r = 0.621), average systolic blood pressure (r = 0.623) and inversely with baroreflex sensitivity (r = −0.494). 4. Baroreflex sensitivity was less by an average of 3.1 ms/mmHg in patients over 30 years than in those under 30 (P < 0.025). Baroreflex sensitivity was inversely correlated with age (r = −0.617) and average systolic blood pressure (r = −0.589). 5. Beat by beat variability of systolic blood pressure was correlated with age (r = 0.460), particularly when the data of those in their twenties were excluded (r = 0.618), and significantly with pulse pressure/stroke volume (r = 0.650), average systolic blood pressure (r = 0.618) and inversely with baroreflex sensitivity (r = −0.477). These relationships were not observed for diastolic blood pressure. 6. Maximum difference in systolic blood pressure in a day was correlated with pulse pressure/stroke volume (r = 0.482) and average systolic blood pressure (r = 0.648) but not with baroreflex sensitivity. These relationships were not observed for diastolic blood pressure. 7. Variability of systolic blood pressure in patients over 30 years gradually increased with age. In contrast, those of systolic and diastolic blood pressures in subjects in their twenties were relatively large. This might be related to factors other than aging, presumably those which underlie the hyperdynamic circulatory state.


2012 ◽  
Vol 51 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Concetta Irace ◽  
Claudio Carallo ◽  
Faustina Scavelli ◽  
Antonio Loprete ◽  
Valentina Merante ◽  
...  

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