title: Heart rate variability and target organ damage in hypertensive patients.
abstract: BACKGROUND
  We evaluated the association between linear standard Heart Rate Variability (HRV) measures and vascular, renal and cardiac target organ damage (TOD).
  
  
  METHODS
  A retrospective analysis was performed including 200 patients registered in the Regione Campania network (aged 62.4 ± 12, male 64%). HRV analysis was performed by 24-h holter ECG. Renal damage was assessed by estimated glomerular filtration rate (eGFR), vascular damage by carotid intima-media thickness (IMT), and cardiac damage by left ventricular mass index.
  
  
  RESULTS
  Significantly lower values of the ratio of low to high frequency power (LF/HF) were found in the patients with moderate or severe eGFR (p-value < 0.001). Similarly, depressed values of indexes of the overall autonomic modulation on heart were found in patients with plaque compared to those with a normal IMT (p-value <0.05). These associations remained significant after adjustment for other factors known to contribute to the development of target organ damage, such as age. Moreover, depressed LF/HF was found also in patients with left ventricular hypertrophy but this association was not significant after adjustment for other factors.
  
  
  CONCLUSIONS
  Depressed HRV appeared to be associated with vascular and renal TOD, suggesting the involvement of autonomic imbalance in the TOD. However, as the mechanisms by which abnormal autonomic balance may lead to TOD, and, particularly, to renal organ damage are not clearly known, further prospective studies with longitudinal design are needed to determine the association between HRV and the development of TOD.
authors.affiliation: Multidisciplinary Department of Medical Sciences, Second University of Naples, Via Pansini, 5, Naples, Italy. paolo.melillo@unina2.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Melillo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Izzo
authors.forename: Nicola
authors.initials: N
authors.lastname: De Luca
authors.forename: Leandro
authors.initials: L
authors.lastname: Pecchia
mesh_terms: D000328:Adult; D000368:Aged; D059168:Carotid Intima-Media Thickness; D005260:Female; D005919:Glomerular Filtration Rate; D006331:Heart Diseases / Q000209:etiology*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000209:etiology*