State of Autonomic Nervous System in Children with Essential Hypertension

N.M. Gromnatska

Abstract


Objective. To study peculiarities of vegetative function in children with essential hypertension.
Material and Methods. We observed 25 children with essential hypertension (1st group) and 21 children of the control group who did not differ by age and sex. Age of children in the 1st group was 15.0 (12.0–16.0) years, control group — 16.0 (10.0–17.0) years. State of the autonomic nervous system was studied by analyzing the heart rate variability in the background, allowing to estimate initial autonomic tone, and postural, making it possible to assess autonomic reactivity, tests. Cardiointervalogram registration was performed on the computer hardware complex Poly-Spectrum Neurosoft. Hypertension was determined according to the 95th percentile of blood pressure distribution according to age and sex (The Fourth Report on Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents, USA).
Results. Children with essential hypertension are characterized by a decrease in heart rate variability. Temporal and spectral parameters, which characterize the overall heart rate variability, in the background test of children in the 1st group were significantly lower than in controls: thus, RRNN — by 25.0 %, SDNN — by 77.2 %, TR — by 2.3 times less. Parameters responsible for parasympathetic
activity in the 1st group were also significantly lower than in the control group: RMSSD — by 2.83 times, rNN50 — by 14.9 times, HF — by 5.3 times. Activity of the sympathetic autonomic nervous system in children in the 1st group was relatively higher than in children of the control group, as indicated by the decrease in parasympathetic activity and increased autonomic balance index LF/HF by 2.2 times compared with the control group (p = 0.029). Spectral index VLF, which indicates the neurohumoral regulation of cardiac activity, according to the data of power distribution in cardiointervalogram spectrum of children in the 1st group was 1.65 times greater than that of the control group.
Conclusions. 1. Heart rate variability in children with essential hypertension is characterized by a significant reduction of tonic effects of the parasympathetic nervous system and the relative increase in the activity of the sympathetic and neurohumoral influences on the regulation of cardiovascular activity.
2. Increased heart rate rigidity due to the reduction of parasympathetic autonomous influence is a sign of cardiac autonomic neuropathy in children with essential hypertension.


Keywords


essential hypertension; heart rate variability; cardiovascular autonomic neuropathy; children

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DOI: https://doi.org/10.22141/2224-1485.4.36.2014.82739

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