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Breathing variability at rest is positively associated with 24-h blood pressure level.

ABSTRACT: BACKGROUND:Previous research has reported that inhibition of breathing can be observed in hypertensive patients at rest during the daytime, as well as in sleep at night. The present study hypothesized that the variability of breathing and end-tidal CO(2) (PetCO(2)) in seated women at rest is positively associated with their 24-h blood pressure level. METHODS:Breath-to-breath measures of breathing rate and tidal volume were recorded via inductive plethysmography in each of 54 women during two 20-min sessions of seated rest, and in 32 women during night time sleep. PetCO(2) was also recorded during these sessions via a respiratory gas monitor. Ambulatory blood pressure was recorded for 24 h between the two clinic sessions via oscillometry. RESULTS:Breath pauses >10 s were observed significantly more often in women in the upper than the lower tertile of 24-h systolic blood pressure. Breath-to-breath variability in breathing rate, tidal volume, and minute ventilation were greater in the higher blood pressure tertile women. Variability in PetCO(2) was also greater in high blood pressure tertile. These associations were independent of age, weight, and body surface area (BSA). Breathing variability was inversely correlated with heart rate variability (HRV). CONCLUSION:Greater variability in breathing at rest that is independent of metabolic activity characterizes women with elevated blood pressure. The linear association of breathing variability with 24-h blood pressure level is consistent with the hypothesis that intermittent breathing inhibition may predispose to the development of some forms of hypertension.

SUBMITTER: Anderson DE

PROVIDER: S-EPMC2752321 | biostudies-literature | 2008 Dec

REPOSITORIES: biostudies-literature

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Breathing variability at rest is positively associated with 24-h blood pressure level.

Anderson David E DE McNeely Jessica D JD Chesney Margaret A MA Windham Beverly G BG

American journal of hypertension 20080925 12

<h4>Background</h4>Previous research has reported that inhibition of breathing can be observed in hypertensive patients at rest during the daytime, as well as in sleep at night. The present study hypothesized that the variability of breathing and end-tidal CO(2) (PetCO(2)) in seated women at rest is positively associated with their 24-h blood pressure level.<h4>Methods</h4>Breath-to-breath measures of breathing rate and tidal volume were recorded via inductive plethysmography in each of 54 women ...[more]

PMID: 18820654

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Project description:Spontaneous baroreflex sensitivity (BRS) is a widely used tool for the quantification of the cardiovascular regulation. Numerous groups use the xBRS method, which calculates the cross-correlation between the systolic beat-to-beat blood pressure and the R-R interval (resampled at 1 Hz) in a 10 s sliding window, with 0-5 s delays for the interval. The delay with the highest correlation is selected and, if significant, the quotient of the standard deviations of the R-R intervals and the systolic blood pressures is recorded as the corresponding xBRS value. In this paper we test the hypothesis that the xBRS method quantifies the causal interactions of spontaneous BRS from non-invasive measurements at rest. We use the term spontaneous BRS in the sense of the sensitivity curve is calculated from non-interventional, i.e., spontaneous, baroreceptor activity. This study includes retrospective analysis of 1828 measurements containing ECG as well as continues blood pressure under resting conditions. Our results show a high correlation between the heart rate - systolic blood pressure variability (HRV/BPV) quotient and the xBRS (r = 0.94, p < 0.001). For a deeper understanding we conducted two surrogate analyses by substituting the systolic blood pressure by its reversed time series. These showed that the xBRS method was not able to quantify causal relationships between the two signals. It was not possible to distinguish between random and baroreflex controlled sequences. It appears xBRS rather determines the HRV/BPV quotient. We conclude that the xBRS method has a potentially large bias in characterizing the capacity of the arterial baroreflex under resting conditions. During slow breathing, estimates for xBRS are significantly increased, which clearly shows that measurements at rest only involve limited baroreflex activity, but does neither challenge, nor show the full range of the arterial baroreflex regulatory capacity. We show that xBRS is exclusively dominated by the heart rate to systolic blood pressure ratio (r = 0.965, p < 0.001). Further investigations should focus on additional autonomous testing procedures such as slow breathing or orthostatic testing to provide a basis for a non-invasive evaluation of baroreflex sensitivity.

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Breathing variability at rest is positively associated with 24-h blood pressure level.

Publications

Breathing variability at rest is positively associated with 24-h blood pressure level.

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