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Blood pressure and heart rate variability and baroreflex sensitivity in white-coat, masked, and sustained hypertension

Hypertension Research volume 43, pages 772–780 (2020)Cite this article

Abstract

We investigated blood pressure (BP) and heart rate variability and baroreflex sensitivity (BRS) in white-coat, masked and sustained hypertension in untreated patients (n = 645). Normotension and white-coat, masked, and sustained hypertension were defined according to the clinic (cutoff 140/90 mmHg) and 24-h ambulatory (130/80 mmHg) BPs. The Finometer device recorded beat-to-beat finger BP and electrocardiograms in the supine and standing positions for the computation of frequency-domain power-spectral BP and heart rate variability indexes and BRS. In multivariate analysis, BP variability indexes in the supine position differed significantly (P < 0.0001) for both low-frequency (LF) and high-frequency (HF) components and the LF/HF ratio, with the lowest LF and HF power and highest LF/HF ratio in white-coat hypertension (n = 28), the highest LF and HF power and lowest LF/HF ratio in sustained hypertension (n = 198), and intermediate values in normotension (n = 189) and masked hypertension (n = 230). These differences diminished in the standing position, being significant (P < 0.0001) only for the LF component variability. The LF/HF ratio in BP in the supine position decreased with advancing age in normotension and sustained hypertension (P ≤ 0.03) but not white-coat or masked hypertension (P ≥ 0.12). For heart rate variability, a significant difference was observed only for the LF component in the supine position (P = 0.0005), which was lowest in white-coat hypertension. BRS in masked and sustained hypertension was significantly (P ≤ 0.0001) lower than that in normotension in both supine and standing positions and decreased with advancing age (P ≤ 0.0001). In conclusion, masked, but not white-coat, hypertension showed similar patterns of, but slightly less severe, changes in BP and heart rate variability and BRS to sustained hypertension.

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Acknowledgements

The authors gratefully acknowledge the voluntary participation of all study participants and the technical assistance of Bei-Wen Lv, Jun-Wei Li, and Yi Zhou.

Funding

The present study was financially supported by grants from the National Natural Science Foundation of China (81770418, 81770455, 91639203, 81400346 and 81470533), and Ministries of Science and Technology (2018YFC1704902) and Health (2016YFC0905001 and 2016YFC1300103), Beijing, China, and the Shanghai Commissions of Science and Technology (grant19DZ2340200) and Health (grants 201440377, 15GWZK0802, and 2017BR025, and a special grant for “Leading Academics”), Shanghai, China.

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  1. These authors contributed equally: Chang-Sheng Sheng, Fei-Ka Li

Authors and Affiliations

  1. Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Chang-Sheng Sheng, Fei-Ka Li, Yi-Bang Cheng, Fang-Fei Wei, Jian-Feng Huang, Qian-Hui Guo, Dong-Yan Zhang, Ying Wang, De-Wei An, Qi-Fang Huang, Yan Li & Ji-Guang Wang

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Sheng, CS., Li, FK., Cheng, YB. et al. Blood pressure and heart rate variability and baroreflex sensitivity in white-coat, masked, and sustained hypertension. Hypertens Res 43, 772–780 (2020). https://doi.org/10.1038/s41440-020-0413-5

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