Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a “tool” to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD).
18 September 2025 in Arquivos Brasileiros de Cardiologia
Table of contents Updates and modifications to the Brazilian Guidelines for In-Office and Out-of-Office Blood Pressure Measurement 10 Part 1 – Blood pressure measurement 10 […] Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023 Table of contents Updates and modifications to the Brazilian Guidelines for In-Office and Out-of-Office Blood Pressure Measurement 10 Part 1 – Blood pressure measurement 10 […] Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
1 January 2024 in Arquivos Brasileiros de Cardiologia
Sumário Atualizações e Mudanças nas Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório 10 Parte 1 – Medidas da Pressão Arterial 10 […] Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023 Sumário Atualizações e Mudanças nas Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório 10 Parte 1 – Medidas da Pressão Arterial 10 […] Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023
Background: There are still discrepancies in the literature as to whether COVID-19 infection could impact biochemical, anthropometric, and cardiovascular markers. The purpose of this study was firstly to observe the effects of COVID-19 infection over 12 months on Type 2 diabetes (T2D) and obesity. Secondarily, we analyzed the individual influence of COVID-19 infection on changes in biochemical, anthropometric, and cardiovascular markers. Methods: This study is part of a secondary analysis of a recently published article. The research involved 84 participants with T2D, divided into two groups: the control group (40 participants) received only medical care, while the intervention group (44 participants) received both medical care and nutritional assessment. Consultations were held quarterly over 12 months, with a follow-up after 3 months. Data Analysis: For influence analysis, non-normal variables were compared using the Mann–Whitney test, and normal variables were compared using unpaired t-tests. For all cases, α = 0.05 and p < 0.05 were considered significant. Results: The analysis revealed a high percentage of patients in both groups who had a COVID-19 infection (70% control and 72.7% intervention) over 12 months. Regarding the influence analysis, participants in the intervention group who were infected with COVID-19 showed smaller reductions in glycated hemoglobin (HbA1c) (p = 0.0120) and systolic blood pressure (SBP) (p = 0.0460). For the other biochemical, anthropometric, and cardiovascular markers, in both groups, no significant differences were found (p > 0.05). Conclusion: COVID-19 possibly influenced SBP and HbA1c levels over 12 months in people with T2D and obesity. However, caution should be exercised in generalizing these results due to the limitations of this study. Additionally, influence analysis does not establish a causal relationship, and more clinical trials in different populations are needed to fully analyze this topic.