TY - JOUR
T1 - Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa
AU - Osakwe, Chukwunomso E.
AU - Jacobs, Lotte
AU - Anisiuba, Benedict C.
AU - Ndiaye, Mouhamado B.
AU - Lemogoum, Daniel
AU - Ijoma, Chinwuba K.
AU - Kamdem, Marius M.
AU - Thijs, Lutgarde
AU - Boombhi, Hilaire J.
AU - Kaptue, Joseph
AU - Kolo, Philip M.
AU - Mipinda, Jean B.
AU - Odili, Augustine N.
AU - Ezeala-Adikaibe, Birinus
AU - Kingue, Samuel
AU - Omotoso, Babatunde A.
AU - Ba, Serigne A.
AU - Ulasi, Ifeoma I.
AU - M'buyamba-Kabangu, Jean-Rene
AU - Staessen, Jan A.
PY - 2014/6
Y1 - 2014/6
N2 - Background. 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. Methods. 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. Results. 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 ms(2); p = 0.0038) and low-frequency power (-3.6 nu; p = 0.057), higher high-frequency (+3.3 nu; p = 0.050) and a reduced low-to high-frequency ratio (- 0.08; p = 0.040). With adjustment for heart rate, these differences disappeared, except for the reduced low-frequency power in the R group (-4.67 nu; p = 0.02). Analyses confined to 39 R and 47 E patients with HRV measurements at all visits or based on autoregressive modelling were confirmatory. Conclusion. 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.
AB - Background. 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. Methods. 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. Results. 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 ms(2); p = 0.0038) and low-frequency power (-3.6 nu; p = 0.057), higher high-frequency (+3.3 nu; p = 0.050) and a reduced low-to high-frequency ratio (- 0.08; p = 0.040). With adjustment for heart rate, these differences disappeared, except for the reduced low-frequency power in the R group (-4.67 nu; p = 0.02). Analyses confined to 39 R and 47 E patients with HRV measurements at all visits or based on autoregressive modelling were confirmatory. Conclusion. 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.
KW - Antihypertensive drugs
KW - blacks
KW - heart rate variability
KW - randomized clinical trial
KW - sub-Saharan Africa
U2 - 10.3109/08037051.2013.836810
DO - 10.3109/08037051.2013.836810
M3 - Article
C2 - 24066715
SN - 0803-7051
VL - 23
SP - 174
EP - 180
JO - Blood Pressure
JF - Blood Pressure
IS - 3
ER -