Arq. Bras. Cardiol. 2018; 111(1): 73-74
Heart Rate Variability in Coexisting Diabetes and Hypertension
DOI: 10.5935/abc.20180118
This Short Editorial is referred by the Research article "Effects of Coexistence Hypertension and Type II Diabetes on Heart Rate Variability and Cardiorespiratory Fitness".
The autonomic nervous system regulates heart rate through sympathetic and parasympathetic response to different stimuli. The resultant fluctuation between intervals of consecutive heart beats, called heart rate variability (HRV), is a valuable tool to assess autonomic nervous system activity. A decrease in HRV is a marker of reduced parasympathetic and increased sympathetic tone and has long been considered to negatively impact the prognosis in cardiovascular disease.
In 1996, the European Society of Cardiology and the North American Society of Pacing and Electrophysiology suggested standards for evaluation, physiological interpretation, and clinical use for time- and frequency-domain HRV analysis in short- and long-term recordings. Some nonlinear measures have been suggested to work better than traditional measures in predicting future adverse events in several patient groups. More recently, newer computational tools have been derived from nonlinear dynamics and complex systems. Although the physiological background of nonlinear measures of HRV is less understood than the conventional measures, it is speculated that nonlinear dynamics could provide better understanding on nonlinear behavior commonly occurring within human systems due to their complex dynamic nature., In accordance, a good agreement between some non-linear HRV measures and the Framingham cardiovascular risk score was observed, suggesting that they could be used for screening cardiovascular risk. In 2015, the e-Cardiology Working Group of the European Society of Cardiology and the European Heart Rhythm Association launched a critical review of new methodologies for analyzing HRV, including entropy rate, fractal scaling and Poincaré plot, and their application in different physiological and clinical studies.
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