Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa

Chukwunomso E. Osakwe, Lotte Jacobs, Benedict C. Anisiuba, Mouhamado B. Ndiaye, Daniel Lemogoum, Chinwuba K. Ijoma, Marius M. Kamdem, Lutgarde Thijs, Hilaire J. Boombhi, Joseph Kaptue, Philip M. Kolo, Jean B. Mipinda, Augustine N. Odili, Birinus Ezeala-Adikaibe, Samuel Kingue, Babatunde A. Omotoso, Serigne A. Ba, Ifeoma I. Ulasi, Jean-Rene M'buyamba-Kabangu, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.
Original languageEnglish
Pages (from-to)174-180
JournalBlood Pressure
Issue number3
Publication statusPublished - Jun 2014


  • Antihypertensive drugs
  • blacks
  • heart rate variability
  • randomized clinical trial
  • sub-Saharan Africa

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