Change of 24 Hours Heart Rate Variablity in Older Healthy Subjects and Older Hypertensive Patients

Kwak, Hyun Jin

Original Article

Journal of the Korean Geriatrics Society 1999;3(1):41-49.
Published online March 31, 1999.

Change of 24 Hours Heart Rate Variablity in Older Healthy Subjects and Older Hypertensive Patients

Hyun Jin Kwak

연령 증가와 고혈압으로 인한 심박동수 변이의 변화

Abstract

BACKGROUND
: Heart rate variability informed us to diagnose impairment of autonomic nervous system in patient with diabetes, hypertension, ischemic heart disease, chronic renal disease, arrhythmia. Change of autonomic nervous system is related to circadian rhythm, stress, physical activity, age and so on. Especially, impairment of vagal nervous system with age help us to expect sudden cardiac death, myocardial infarction, arrhythmia. So we survey heart rate variability by using 24 hours Holter monitoring to expect impairment of autonomic nervous system in elderly hypertensive patients.
METHODS
: In order to assess 24 hours heart rate variability, we used Del Mar Avionics 563 Holter monitoring on 15 older hypertensive patient (>or=65 years), 15 older hypertensive patient(<64 years), 15 younger healthy subjects (<64 years), and 15 older healthy subjects (>or=65 years). The following frequency domain variables were considered: low frequency(LF), high frequency(HF) power spectral parameter, and LF/HF ratio.
Results
: 1) There was significant decrease in LF power spectral parameter in older groups compared with younger groups 394.0+/-237.8 vs 127.7+/-96.3, p<0.05, 171.8+/-173.5 vs 40.8+/-33.8, p<0.05). 2) In hypertensive patients, there was significant decrease in HF power spectral parameter compared with healthy subjects(989.2+/-553.8 vs 526.0+/-364.7, p<0.05, 804.2+/-404.5 vs 368.8+/-241.2, p<0.05). 3) Although there was no significant difference, L/H ratio decreased in older groups compared with younger gourps. 4) In circadian rhythm, control subjects had low HF power spectral parameter at morning. LF/HF ratio was high at morning in younger groups.
CONCLUSION
: L/H ratio was depressed in older groups. HF was blunted in hypertensive groups. Thus, impairment of autonomic nervous system was accelerated by age and hypertension.

Key Words: Keyword Heart rate variability, Age, Hypertension

초 록

최근 심박동수 변이를 이용하여 여러 질환에 의한 자율신경계 변화에 대한 유용한 정보를 얻어왔다. 이에 본 저자들은 연령의 증가와 함께 고혈압 동반 시 자율신경계에 미치는 영향을 알아보기 위해 24시간 Holter monitoring을 시행하고 파우어 스펙트럼 분석으로 분석하여 연령에 따라 심박동수 변이를 측정하였고, 노인 고혈압 환자의 심박동수 변이를 성인 고혈압 환자와 비교 분석하였다.