Association of Heart Rate Variability and Baroreflex Sensitivity with Blood Pressure Control in Essential Hypertension: A Hospital-Based Cross-Sectional Study
Autonomic Dysfunction and Blood Pressure Control
DOI:
https://doi.org/10.69750/dmls.02.012.0176Keywords:
Essential hypertension, heart rate variability, baroreflex sensitivity, autonomic dysfunction, blood pressure controlAbstract
Background: The dysfunction of the autonomic nervous system is a major pathophysiologic agent in essential hypertension and potentially a factor in insufficient blood pressure management despite pharmacological therapy. Non-invasive indicators of autonomic cardiovascular regulation include heart rate variability (HRV) and baroreflex sensitivity (BRS); nevertheless, their role in blood pressure management in non-acute clinical life has not been studied well enough.
Objectives: To determine the relationship between heart rate variability and baroreflex sensitivity with blood pressure regulation in essential hypertension patients.
Methods: This was a cross-sectional study that took place between May 2024 and May 2025 and involved 100 adults with essential hypertension. Standardized procedures were employed in measuring blood pressure, and the respondents were divided into two groups, namely controlled and uncontrolled hypertension. HRV measurements were made in both time and frequency domains through short-term electrocardiograph recordings, whereas baroreflex sensitivity was measured under a non-invasive spontaneous sequence approach. These were done by using comparative and correlation analyses in order to explore the relationship between the autonomic parameters and blood pressure levels.
Results: Of the 100 participants, 46% had controlled hypertension and 54% had uncontrolled hypertension. Uncontrolled hypertension patients recorded much lower HRV indices, such as SDNN and RMSSD, as well as high-frequency power, and a much higher LF/HF ratio (p < 0.001). In the state of uncontrolled, baroreflex sensitivity was significantly lower (p < 0.001). There were strong negative relationships between systolic and diastolic blood pressure variables and HRV parameters and baroreflex sensitivity. Multivariate regression analysis has revealed that reduced baroreflex sensitivity and lower SDNN are the independent predictors of poor blood pressure control.
Conclusion: Impaired autonomic regulation, reflected by reduced heart rate variability and baroreflex sensitivity, is strongly associated with uncontrolled essential hypertension. Assessment of autonomic function may enhance risk stratification and support more individualized management of hypertensive patients.
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