Left ventricular mass and heart rate variability in middle-aged and elderly salt-sensitive hypertensive subjects

• Published in: Archives of gerontology and geriatrics Vol. 28; no. 2; pp. 159 - 177
• Main Authors: Piccirillo, Gianfranco, Bucca, Carmela, Tarantini, Sabrina, Santagada, Elvira, Viola, Emanuela, Durante, Michele, Raganato, Paolo, Mariano, Antonello, Cacciafesta, Mauro, Marigliano, Vincenzo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 01.03.1999
• Subjects: Autonomic nervous system; Heart rate variability; Hypertension; Myocardial hypertrophy; Salt-sensitive hypertension; Hypertension; VLF, very-low-frequency power; LF, low-frequency power; RR, R–R interval; Myocardial hypertrophy; DBP, diastolic blood pressure; Salt-sensitive hypertension; ECG, electrocardiographic; LVMI, left ventricular mass index; ln, natural logarithm; SBP, systolic blood pressure; HF, high-frequency power; LF:HF ratio, ratio of low- to high-frequency powers of heart rate variability; BMI, body mass index; Autonomic nervous system; TP, total power; NU, normalized unit; Heart rate variability
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/S0167-4943(99)00003-5

Previous reports have shown that in salt-sensitive hypertension a high dietary salt intake can increase sympathetic activity. We evaluated the influence of the autonomic nervous system on myocardial hypertrophy by power spectral analysis of heart rate variability in middle-aged and elderly salt-sensitive hypertensive subjects. We compared autonomic nervous system activity in 32 salt-sensitive hypertensive patients (15 subjects with mean age, 42.4±2.4 years and 17 subjects with mean age, 74.6±1.6 years) and 20 age-matched normotensive controls. Power spectral analysis detects four spectral components: total power (TP), high-frequency (HF), low-frequency (LF) and very-low-frequency (VLF) power. In the elderly subjects we found an association between the left ventricular mass index (LVMI) and the following variables: very-low frequency ( P<0.0001), 24-h urinary sodium excretion ( P<0.0001) and diastolic blood pressure (DBP) ( P<0.0001). In contrast, in middle-aged subjects we found a significant association between the LVMI and LF ( P<0.001). In middle-aged, but not in elderly salt-sensitive hypertensive subjects, increased sympathetic activity correlated with the LVMI ( P<0.0001). Our findings suggest an association between sympathetic hyperactivity and the LVMI in middle-aged subjects with salt-sensitive hypertension.