EVAluation of the prognostic value of BARoreflex sensitivity in hypertensive patients: the EVABAR study.
OBJECTIVE
The prognostic value of baroreflex sensitivity in hypertensive patients has not much been studied.


METHODS
A cohort of 451 hypertensive patients without cardiovascular history was studied for an average of 6.2 +/- 2.8 years follow-up. Each patient had a baroreflex sensitivity measurement by the sequence method, which is represented by the slope of up-sequences (systolic blood pressure+/pulse interval+) and down-sequences (systolic blood pressure-/pulse interval-) of spontaneous fluctuations in systolic blood pressure and pulse interval.


RESULTS
During the follow-up, there were 20 deaths from any cause and 30 patients presented a major adverse cardiovascular event. Deaths and major adverse cardiovascular events were associated with a reduction in baroreflex sensitivity (systolic blood pressure+/pulse interval+ and systolic blood pressure-/pulse interval-). In multivariate analysis, the reduction in baroreflex sensitivity systolic blood pressure+/pulse interval+ was associated with an increased risk of deaths from any cause (Odds ratio 1.23; 95% confidence interval 1.02-1.67, P = 0.04). A baroreflex sensitivity systolic blood pressure+/pulse interval+ under 4.5 ms/mmHg was associated with a 2.5-increased relative risk of major adverse cardiovascular event (95% confidence interval 1.11-5.93, P = 0.03). However, multivariate analysis showed that baroreflex sensitivity systolic blood pressure-/pulse interval- was not associated either with death or major adverse cardiovascular events.


CONCLUSIONS
Reduction in baroreflex sensitivity marked by a reduction in vagal reflexes is an independent marker of the risk of mortality and major adverse cardiovascular events in hypertensive patients.
Ormezzano
Olivier
O
Cardiology and Hypertension Department, Michallon University Hospital, Grenoble, France. OOrmezzano@chu-grenoble.fr
Cracowski
Jean-Luc
JL
Quesada
Jean-Louis
JL
Pierre
Hélène
H
Mallion
Jean-Michel
JM
Baguet
Jean-Philippe
JP
D000328:Adult; D017704:Baroreflex / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis