title: Autonomic cardiovascular control and diastolic dysfunction in hypertensive subjects.
abstract: BACKGROUND
  Early hypertension is associated with left ventricular diastolic dysfunction due to increased end-diastolic pressure. This increase, through the cardiopulmonary reflexes, can influence autonomic cardiovascular control.
  
  
  METHODS
  We assessed autonomic nervous system modulation of cardiovascular signals by power spectral analysis of RR interval and systolic arterial pressure variabilities in subjects with recently diagnosed hypertension with or without diastolic dysfunction and in normotensive control subjects.
  
  
  RESULTS
  Both hypertensive groups had higher low-frequency (LF) power expressed in normalized units (NUs) than normotensive controls (p < 0.05; p < 0.001) during controlled breathing at rest. The LF spectral index measured after tilt was greater in hypertensive subjects with diastolic dysfunction than in those without (p < 0.05). LF NUs measured at rest correlated significantly with the E/A wave ratio and after tilt with the E-wave deceleration time.
  
  
  CONCLUSIONS
  These results seem to indicate that in subjects with recently diagnosed hypertension sympathetic modulation of the sinus node prevails. During tilt, a maneuver designed to stimulate systemic arterial and cardiopulmonary baroreceptor reflexes, hypertensive subjects with diastolic dysfunction, who presumably also have higher end-diastolic pressures, seem to have greater sympathetic modulation of the sinus node than hypertensive subjects without diastolic dysfunction.
authors.affiliation: Dipartimento di Scienze dell'Invecchiamento, Policlinico Umberto I, Università La Sapienza, Rome, Italy. gianfranco.piccirillo@uniroma1.it
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Piccirillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Germanò
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitarelli
authors.forename: Maddalena
authors.initials: M
authors.lastname: Ragazzo
authors.forename: Silvia
authors.initials: S
authors.lastname: di Carlo
authors.forename: Tiziana
authors.initials: T
authors.lastname: De Laurentis
authors.forename: Alessia
authors.initials: A
authors.lastname: Torrini
authors.forename: Sabrina
authors.initials: S
authors.lastname: Matera
authors.forename: Marzia
authors.initials: M
authors.lastname: Magnanti
authors.forename: Nicola
authors.initials: N
authors.lastname: Marchitto
authors.forename: Livia
authors.initials: L
authors.lastname: Bonanni
authors.forename: Damiano
authors.initials: D
authors.lastname: Magrì
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012119:Respiration; D012146:Rest / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D018667:Tilt-Table Test; D013997:Time Factors