Association of heart rate variability disorders and daily blood pressure 

profile in patients with hypertension and diabetes mellitus 2 type with different 

body weight 
Yuliya Shaposhnikova 

1
 , Irina Ilchenko

 1
 , Lesya Bobronnikova

 1
 , Victoriia Pligovka

 2
 

1 Kharkiv national medical university, Kharkiv, Ukraine, 

2 Government Institution: L.T.Malaya Therapy National Institute of the NAMS of 

Ukraine, Kharkiv, Ukraine 

Objective:  To establish the relationship between impaired heart rate 

variability (HRV) and blood pressure (BP) daily profile in patients with arterial 

hypertension (AH) and diabetes mellitus 2 type  (DM-2) with different body 

weight. 

Material and methods. This study was performed on 27 patients with 

hypertension and type 2 diabetes mellitus with the body mass index (BMI) 34,4 ± 

1,5 kg / m² (group 1) and 25 patients with hypertension and type 2 diabetes with 

BMI of 23,7 ± 1,3 kg / m² (group 2). Demographic characteristics recorded at the 

first visit included age, sex, height, weight, medication, smoking history, and other 

diseases. Were estimated the 24-hour blood pressure monitoring (ABPM) and 24 

hour Holter ECG monitoring (HMEKG) with an estimate of spectral parameters of 

HR. The analysis of HRV included time parameters: normal-to-normal (NN) 

intervals, standard deviation of the NN intervals (SDNN), the square root of the 

mean squared differences of successive NN intervals (RMSSD), the number of 

interval differences of successive NN intervals greater than 50 ms (NN50), and 

pNN50-the proportion derived by dividing NN50 by the total number of NN 

intervals, SDNN - estimate of overall HRV, HRV triangular index - estimate  

overall HRV, SDANN - estimate of long-term components of HRV, and RMSSD-

estimate of short-term components of HRV, and HRV triangular index. The 

analysis of  HRV also included the spectral parameters: TP, LF and HF, LFn, HFn, 

ratio LF/HF and their circadian fluctuation. The following parameters were 

assessed: LF – low frequency [ms²] range 0.5 - 0.05 Hz: component of sympathetic 

nervous system activity; HF – high frequency [ms²] range 0.15 - 0.5 Hz: 

component of parasympathetic nervous system activity; VLF – very low frequency 

[ms²] range < 0.05 Hz – component expressing the activity of renin – angiotensin 

system and thermoregulation; LF/HF – temporary activity of ANS (sympathovagal 

balance); TP – total power [ms²]. 

Results. Patients of first group RRNN indicators, RMSSD, LF and VLF 

were significantly lower (p <0.05), BP variability higher (p <0.05), and abnormal 

circadian blood pressure profile is more common than in patients of second groups. 

The lowest values of the LF and HF indices, characterizing the tone of the 

parasympathetic and sympathetic nervous system, have been observed in patients 

of 1st group. LF indicators have been also reduced in patients of 1
st
 group, but the 

LF / HF values were not significantly different between groups 1 and 2. In patients 

with type 2 diabetes mellitus and hypertension in both groups showed a decrease as 

the tone of the parasympathetic (HF), and sympathetic (LF) divisions of the 

autonomic nervous system. The results of presented investigation did not show any 

differences between HRV parameters and the degree of blood pressure increment. 



It has been proved to significant correlation between the high BMI, HRV 

parameters and circadian blood pressure profile. 

Conclusions. Hypertensive patients with type 2 diabetes mellitus with 

increasing BMI is more significant decrease in HRV, increased blood pressure 

variability and violation of diurnal blood pressure profile. Such patients in addition 

to therapy of hypertension and type 2 diabetes mellitus need body mass correction 

to reduce cardiovascular risk.