Global link between heart rate and blood pressure oscillations at rest and during mental arousal in normotensive and hypertensive subjects

Complex phenomena modulate the interplay between heart rate and blood pressure variability, in particular after adjustments induced by stimuli or in pathophysiological conditions. This study sought to investigate in 25 hypertensive and 16 normotensive male subjects whether relationships operating at rest may be preserved after a central nervous system arousal induced by a mental stress test. As a secondary endpoint, we evaluated the potential changes of the components of heart rate and blood pressure variability during stress. Results: A significant correlation was observed between components of RR and systolic blood pressure (SBP) variability (p <0.0001), after controlling for the subject's status (normotensive vs. hypertensive) and for stress-steps (baseline condition, during stress test and recovery). Moreover, the multiple regression model accounted for the potential effects of the baseline alpha _LF value and for the baseline heart rate and systolic blood pressure. The relationship operating between the LF/HF_RR ratio and LF/HF _SBP ratio was not different either at the different steps of stress test (interaction: p = 0.87) or in the two groups of normotensive and hypertensive subjects (interaction: p = 0.76). The variables of RR and SBP variabilities were modified during stress and recovery. In particular, the LF/HF_RR ratio and LF/HF_SBP ratio increased during stress and decreased during recovery. Conclusions: The association between heart rate and blood pressure oscillations was preserved during central nervous system arousal by mental stress both in normotensives and hypertensives. A central integration may account for this constant relationship, the correlation being independent from baseline heart rate, blood pressure and baroreflex sensitivity.