Role of autonomic dysfunction and its relationship with inflammation in the cases of high - normal blood pressure

Aim and Rationale: At the moment, it is shown that high ? normal blood pressure is as common as hypertensive status and related to cardiovascular risk factors. The factors which can lead to high ? normal blood pressure and their relationship with cardiovascular risk markers have to be exerted for taking effective measures and for preventing possible cardiovascular events in the future. In our research, we aim to investigate the association between otonomic dysfunction, especially sympathic predominance and its relationship with inflammatory response.Method: Cases in the research were selected from the persons whom admitted to Dokuz Eylül University Cardiology Department in the time between September 2007 and October 2008. 40 cases with high- normal blood pressure and as control group, 50 cases with normal blood pressure based on three seperate arterial blood pressure measurements at rest were included in research. Cases were compared against each other in terms of age and body mass index (BMI). Rhytm analysis in every case was obtained from the electrocardiography (ECG) recordings which was done by 24 hour rhytm holter devices. Mean heart rate, mean RR time, 24 hour triangle index, SDNN, SDNNi, SDANN and RMSSD values were obtained from the time domain analysis at 24 hour ECG recordings. Also, high sensitive CRP (hsCRP) and interleukin ? 6 (IL-6) analyses were done from the blood samples taken from the venous route. Time domain heart rate variability analyses and the levels of inflammatory markers were compared between the groups of high ? normal blood pressure and control. At the same time, time domain heart rate variability analyses and the levels of inflammatory markers were compared in each group seperatelyResults: Mean BMI level was detected about 27.5 ± 4.3 kg/m2 in high ? normal blood pressure group and 25.4 ± 4.8 kg/m2 in control group and the difference was statistically significant (p= 0.03). Mean heart rate was detected about 74 ± 10.6 /min in high ? normal blood pressure group and 73 ± 9.4 /min in control group and the difference was not statistically significant (p= 0.64). Mean RR time was detected about 819.7 ± 128 msn in high ? normal blood pressure group and 827.7 ± 117 msn in control group and the difference was not statistically significant (p= 0.75). SDNN was detected about 142.5 ± 49.2 in high ? normal blood pressure group and 143.5 ± 33.4 in control group and the difference was not statistically significant (p= 0.91). SDNNi was detected about 58.9 ± 25.3 in high ? normal blood pressure group and 58.8 ± 16.2 in control group and the difference was not statistically significant (p= 0.97). SDANN was detected about 127 ± 49.3 in high ? normal blood pressure group and 130 ± 33.3 in control group and the difference was not statistically significant (p= 0.74). rMSSD was detected about 42.7 ± 28.8 in high ? normal blood pressure group and 39.8 ± 18.8 in control group and the difference was not statistically significant (p= 0.58). Mean hsCRP level was detected about 11.5 ± 20.1 ng/ml in high ? normal blood pressure group and 4.3 ± 4.5 ng/ml in control group and the difference was not statistically significant (p= 0.9). In corelation analysis for each group, there was no significant relationship between heart rate variability values and levels of inflammatory markersConclusion: In our research BMI values in high ? normal blood pressure group was detected higher than control group. The difference of heart rate variability values and levels of inflammatory merkers was not statistically significant between two groups. Also there was no significant relationship between heart rate variability values and levels of inflammatory markers in each group. These results were exerted that otonomic dysfunction was not present and levels of inflammatory markers were not elevated in high ? normal blood pressure cases and also there was no relationship between otonomic process and inflammation.Key words: High ? normal blood pressure, otonomic dysfunction