A study on changes in autonomic nervous system function in elderly coronary heart disease patients with hypertension / 中华老年医学杂志

ABSTRACT

Objective:To investigate changes in autonomic nervous system function in elderly coronary heart disease patients with hypertension.Methods:Clinical data of 186 patients with coronary heart disease(CHD)from January 2017 to January 2021 in our hospital were retrospectively collected.Patients were divided into the CHD group(n=93)and the CHD with hypertension group(n=93)according to whether they had hypertension.All subjects underwent 24-hour dynamic electrocardiogram, and differences in heart rate variability(HRV)were analyzed and compared between the groups.Results:Values from time-domain parameters for HRV included the standard deviation of the normal-to-normal R-R intervals( SDNN)[(77.4±15.1)ms vs.(114.6±25.9)ms, t=11.97, P<0.05], the standard deviation of sequential five-minute R-R interval means( SDANN)[(66.8±14.5)ms vs.(97.4±25.0)ms, t=10.21, P<0.05], the SDNN index[(34.1±11.4)ms vs.(51.9±18.0)ms, t=8.07, P<0.05], the root mean square successive difference( rMSSD)[(26.1±13.9)ms vs.(36.1±27.2)ms, t=3.18, P<0.05], and the percentage of successive normal interbeat intervals greater than 50 milliseconds(PNN50)[(5.0±6.4)% vs.(8.3±11.0)%, t=2.53, P<0.05], and were lower in the CHD with hypertension group than in the CHD group.Values from frequency-domain parameters for HRV included low frequency(LF)[(168.9±202.8)ms vs.(443.6±663.6)ms, t=3.78, P<0.05], high frequency(HF)[(203.3±202.5)ms vs.(499.5±1222.7)ms, t=2.28, P<0.05], and the LF/HF ratio(1.0±0.7 vs.1.3±0.8, t=3.18, P<0.05), and were lower in the CHD with hypertension group than in the CHD group. Conclusions:Impairment of cardiac autonomic nervous system function is more serious in elderly CHD patients with hypertension than in elderly CHD patients.Heart rate variability is a valuable clinical indicator and may be used for treatment targets in evaluating dysfunction of the autonomic nervous system in CHD patients with hypertension.