Assessing autonomic disturbances of hypertension in the general practitioner's office: a transtelephonic approach to spectral analysis of heart rate variability.
OBJECTIVE
Spectral analysis of heart rate variability (HRV) provides potentially useful information on autonomic disturbances of human hypertension. However, its practical use outside the clinical laboratory is largely unexplored. The aim of this study was to test the feasibility of assessing HRV from the general practitioner's (GP's) office, using a novel transtelephonic approach.


METHODS
Parallel study on two similar groups: 150 subjects (100 hypertensives and 50 normotensives) studied in our hospital clinic and compared with 150 subjects studied in an out-of-hospital practice (100 hypertensive subjects from GPs' surgeries and 50 normotensive subjects participating in a multinational company's health maintenance programme).


METHODS
Spectral analysis of RR interval variability was used to assess autonomic regulation of the sino-atrial (SA) node, both at rest and during standing. For the out-of-hospital practice, strings of continuous electrocardiograms (ECGs), recorded with a microminiature instrument, were fed, off line, through standard telephone lines to our laboratory for subsequent spectral analysis.


RESULTS
RR spectral profiles obtained from healthy controls or hypertensive patients examined in their GPs' surgeries were similar to those obtained in a hospital clinic, both at rest and when standing up.


CONCLUSIONS
The present study shows the feasibility of using a transtelephonic approach to perform spectral analysis of heart rate variability from physicians' surgeries. This method could favour a more widespread use of autonomic assessment in the clinical management of hypertension.
Lucini
Daniela
D
Centro di Ricerca sulla Terapia Neurovegetativa, Dipertimento Scienze Cliniche L. Sacco, University of Milano, Italy.
Porta
Alberto
A
Pagani
Massimo
M
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D001794:Blood Pressure; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services; D010044:Outpatient Clinics, Hospital; D010824:Physicians' Offices; D010821:Physicians, Family; D017216:Telemedicine