Holter Monitoring Parameters in Assessment of Cardiovascular Risk in Patients with Hypertension and Obesity

Abstract

The purpose of the study was to analyze the features of the Holter monitoring parameters and their significance in the evaluation of cardiovascular risk in patients with hypertension and obesity. The Holter’s was performed by 82 patients with hypertension aged 38 to 76 years (34 men and 48 women). The investigation was carried out on the diagnostic complex SDM 23 "X-TECHNO" in 24-hour. There were 4 groups of patients depending on the body mass index (BMI): 1st with normal body weight, 2nd - with overweight, 3rd - with obesity I degree, 4th - with obesity II-III degree. Based on the results obtained, a combination of hypertension and overweight or obesity is characterized by changes in heart rate variability. This indicates a vegetative imbalance with a weakened activity of the parasympathetic part of the autonomic nervous system. These changes are manifested by a decrease in SDNN 24 and rMSSD, total spectrum power (TF) due to the HF component, an increase in the mean daily heart rate, and statistically significantly higher values of the vagosympathetic interaction index (LF/HF). Smoothing of the circadian rhythm of the heart in patients with hypertension depends on the presence and degree of obesity. The prolongation of the QT interval corrected for heart rate and the presence of ventricular rhythm disturbances of high grades recorded a statistically significantly larger number of individuals in the group of patients with obesity. These rhythm disturbances can be regarded as potentially malignant or malignant according to the risk stratification of J.T. Bigger.