Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa. (June 2014)

• Record Type: Journal Article
• Authors: Osakwe, Chukwunomso E.; Jacobs, Lotte; Anisiuba, Benedict C.; Ndiaye, Mouhamado B.; Lemogoum, Daniel; Ijoma, Chinwuba K.; Kamdem, Marius M.; Thijs, Lutgarde; Boombhi, Hilaire J.; Kaptue, Joseph; Kolo, Philip M.; Mipinda, Jean B.; Odili, Augustine N.; Ezeala-Adikaibe, Birinus; Kingue, Samuel; Omotoso, Babatunde A.; Ba, Serigne A.; Ulasi, Ifeoma I.; M'buyamba-Kabangu, Jean-Rene; Staessen, Jan A.; On behalf of the Newer Versus Older Antihypertensive Agents in African Hypertensive Patients Trial (NOAAH) Investigators
• Is Part Of: Blood pressure. Volume 23:Number 3(2014)
• Page Start: 174
• Page End: 180
• Publication Date: 2014-06
• Subjects: Blood pressure -- Periodicals; Hypertension -- Periodicals; Hypertension -- Periodicals; Blood Pressure -- Periodicals; 612.14
• DOI: 10.3109/08037051.2013.836810
• Languages: English
• ISSNs: 0803-7051

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background.</italic> Compared with Caucasians, African Americans have lower heart rate variability (HRV) in the high-frequency domain, but there are no studies in blacks born and living in Africa. <italic>Methods.</italic> In the Newer versus Older Antihypertensive agents in African Hypertensive patients trial (NCT01030458), patients (30–69 years) with uncomplicated hypertension (140–179/90–109 mmHg) were randomized to single-pill combinations of bisoprolol/hydrochlorothiazide (R) or amlodipine/valsartan (E). 72 R and 84 E patients underwent 5-min ECG recordings at randomization and 8, 16 and 24 weeks. HRV was determined by fast Fourier transform and autoregressive modelling. <italic>Results.</italic> Heart rate decreased by 9.5 beats/min in R patients with no change in E patients (− 2.2 beats/min). R patients had reduced total (− 0.13 ms²; <italic>p = </italic>0.0038) and low-frequency power (− 3.6 nu; <italic>p = </italic>0.057), higher high-frequency (+ 3.3 nu; <italic>p = </italic>0.050) and a reduced low- to high-frequency ratio (− 0.08; <italic>p = </italic>0.040). With adjustment for heart rate, these differences disappeared, except for the reduced low-frequency power in the R group (− 4.67 nu; <italic>p = </italic>0.02). Analyses confined to 39 R and 47 E patients with HRV measurements at all visits or based on autoregressive modelling were confirmatory. <italic>Conclusion.</italic> In native black African patients, antihypertensive drugs modulate HRV, an index of autonomous nervous tone. However, these effects were mediated by changes in heart rate except for low-frequency variability, which was reduced on beta blockade independent of heart rate.</p> </abstract>