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Title of Journal: Am J Hypertens

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Abbravation: American Journal of Hypertension

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Narnia

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0895-7061

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P238 Heart rate variability and ECG changes in 1

Authors: Pedersen Ole L Refsgaard Jens Nielsen Eric S
Publish Date: 2005/05/01
Volume: 18, Issue: S4, Pages: 91A-91A
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Abstract

Ole L Pedersen Jens Refsgaard Eric S Nielsen P238 Heart rate variability and ECG changes in 148 Danish patients after two years in the VALUE trial American Journal of Hypertension Volume 18 Issue S4 May 2005 Page 91A https//doiorg/101016/jamjhyper200503255Modulation of the autonomic nervous system through an increase in heart rate variability HRV with potential benefits in reducing the risk of ventricular arrhythmias has been demonstrated earlier in ischaemic heart disease with drugs affecting the reninangiotensin system The VALUEtrial explored the possible cardiac benefits of a valsartanbased VAL regimen compared to treatment with amlodipine AML in highrisk hypertensive patients The purpose of the present substudy was to evaluate the treatment effects on the ECG and HRV calculated from ambulatory electrocardiographic recordings obtained by Holter technique during 24 hoursNine Danish VALUEcentres with a total of 148 patients participated in this substudy Holterrecordings 2channel Tracker Reynolds Pathfinder analysis were obtained after two years of maintained randomized therapy From Holter data ventricular arrhythmias were classified according to severity and from 2hours periods during day and night time domain HRV measures were derivedThe demographics showed two wellbalanced groups with equal blood pressure reduction to 140/80 mmHg Potassium levels were equal VAL 41 ±04 vs 39 ±04 mmol/L ns Betablockers were given as addon to 37 in both groups After 2 years the measured ECG criteria for left ventricular hypertrophy and the levels of QTc VAL 406 ±25 vs 413 ±27 msec ns and QTdispersion VAL 35 ±17 vs 38 ±15 msec ns were equalin the two groups The long term HRV measured as the standard deviation of the average normal to normal intervals SDANN was significantly higher in VAL compared with AML during the night 38 ±17 vs 32 ±13 msec P=0019 whereas the SDANN did not differ between the two groups in the daytime The 24 hour triangular index was significantly higher in VAL compared with AML 32 ±11 vs 28 ±9 P=002 The prevalence of all categories of ventricular arrhythmia as well as the prevalence of atrial fibrillation was equal in the two groupsTwo indices of longterm HRV showed differences in favour of the VAL regimen Although baseline HRV data were not obtained the findings in this study substantiate correlation between a treatment regimen based on valsartan and alteration of the autonomic cardiovascular control through an increase of HRV

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