Study of sympathovagal imbalance by spectral analysis of heart rate variability in young prehypertensives.

ABSTRACT

Though prehypertension has recently been considered as a risk factor for cardiovascular accidents, the pathophysiological mechanism that causes the development of prehypertension in normotensive subjects has not been fully elucidated. Therefore, the present study was conducted to assess the sympathovagal imbalance in prehypertensives and normotensives by spectral analysis of heart rate variability (HRV) to understand the nature of change in autonomic balance in this dysfunction. Body mass index (BMI), waist-hip ratio (WHR), basal heart rate (BHR), blood pressure (BP), rate-pressure product (RPP) and spectral indices of HRV such as total power (TP), normalized low frequency power (LFnu), normalized high frequency power (HFnu), ratio of low frequency power to high frequency power (LF-HF ratio), mean heart rate (mean RR), square root of the mean squared differences of successive normal to normal intervals; (RMSSD), the number of interval differences of successive NN intervals greater than 50 ms (NN50) and the proportion derived by dividing NN50 by the total number of NN intervals (pNN50) were assessed in two groups of young subjects: normotensives (n=68) and prehypertensives (n=66). Sympathovagal balance (SVB) was analyzed and correlated with BMI, WHR, BHR, BP and RPP in both the groups. It was observed that autonomic imbalance in prehypertensives was due to increase in both sympathetic activity and vagal inhibition. LF-HF ratio, the sensitive indicator of SVB was significantly correlated with BMI, WHR, BHR, BP and RPP in prehypertensive subjects. It was concluded that vagal inhibition might be important in the critical alteration of sympathovagal balance in the development of prehypertension in young normotensive subjects.