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Interaction Between Cardiovascular
Risk Factors. From Autonomics to
Pulse Pressure

Freitas, J.P.; Santos, R.M.; Lima, M. J.;
Teixeira, E.; Carvalho, M.; Freitas, A. F.

Centro de Estudos da Função Autonomica, Hospital de São João and
Oporto Medical School, Porto, Portugal

   Potential new cardiovascular risk factors (CRF) are emerging everyday. Pulse pressure and autonomic nervous system (ANS) dysfunction are recent CRF that predict morbidity and mortality on hypertension and cardiac diseases.

   The goal of this study was the assessment of CRF in hypertensive and the relationship between these novel variables.

   Thirty untreated patients with essential hypertension (H) and thirty aged-adjust normotensive (N) subjects underwent ABMP and ANS evaluation at supine and tilt position. Pulse pressure (PP) was calculated by ABMP (24h, day and night) and by Finapres® during 10 min supine and 10 min tilt position. FFT was used to access heart rate and systolic blood pressure variability. Baroreceptor gain (BR) was calculated by cross-spectral coherence (a-index). Hemodynamics indexes using the non-invasive modelflow® analysis were calculated.

   PP of N in AMBP was 53±8, 52±7 and 53±10 mmHg on 24h, day and night. PP of C in ABMP was 47±6, 47±5 and 47±6 mmHg on 24h, day and night (p<0,01 between H and N). Systolic volume was 67±22 ml in H and 70±13 in N (ns). Total vascular resistances (TVR) was 2044±1185 dyn.s.cm-5 in H and 1410±359 dyn.s.cm-5 in N (p<0.01). HR was 79±9, 83±9 and 72±9 bpm on 24h, day and night in H. HR was 78±7, 83±8 and 65±7 bpm on 24h, day and night in N (p<0.01 only at night). BR was 6.7±3.4 ms/mmHg on H and 14.7±8.1 in N (p<0.01). HF_RR (vagal tonus) was 219±181 ms2 in H and 1493±2909 in N (p<0.05) in supine and 85±82 ms2 in H and 323±295 in N (p<0.01) in orthostasis. LF_SBP (sympathetic tonus) was 6.1±4.4 mmHg2 in H and 5.8±4.3 in N (ns).

   Twenty-four hour PP had correlation with VS (r=0,40 in H and r=0,64 in N). PP correlated with BR only in H (r= -0,21). PP had a weak negative correlation with vagal activity (r= -0,14 in H and r= -0,17 in N) and correlated with sympathetic vasomotor activity (r= 0,33) only on H.

   In mild hypertension it seems that PP, ANS and TPR are already impaired. These CRF have some correlation, particular in hipertensive subjects.



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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
Dr. Raúl Bretal
Scientific Committee
Dr. Armando Pacher
Technical Committee - CETIFAC

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