Application of assessment of heart rate variability and heart rate turbulence to identify hypertensive patients with an increased risk of adverse cardiovascular events

Abstract

Objective. To develop a method for isolating a group of patients with arterial hypertension of the II degree with an increased risk of the total number of myocardial infarctions, strokes, lethal outcomes from cardiovascular diseases (CVD) in the next 1-3 years, taking into account the assessment of heart rate variability and heart rate turbulence parameters.Materials and methods. In the course of a prospective clinical study 214 patients with arterial hypertension (AH) of the II degree aged 35 to 70 (57,7±7,6) years and 26 practically healthy individuals aged 30-60 (51,7±7,7) years were examined. All were given a comprehensive examination, including Holter monitoring (HM), electrocardiography (ECG), echocardiography (EchoCG). Statistical processing of the results was carried out using the “Statistica 10.0” software.Results. The total number of myocardial infarctions, strokes, and lethal outcomes registered in patients with arterial hypertension of the II degree over a period of 2.6±1.3 years was estimated, the factors associated with their development were determined. A method has been developed to identify a group of patients with arterial hypertension of the II degree who have an increased risk of developing adverse cardiovascular events over the next 1-3 years, it has been shown that its sensitivity is 90.9%; specificity is 95.8%. Conclusion. It is shown that the use of heart rate variability (HRV) and heart rate turbulence (HRT) parameters provides a significant increase in the sensitivity and specificity of the identification of a group with an increased risk of developing the total number of strokes, myocardial infarctions and lethal outcomes in the next 1-3 years.