Heart rate as marker of sympathetic activity
Abstract
OBJECTIVE: To determine the value of the supine heart rate as a marker of sympathetic tone by assessing, in a large group of subjects, the relationships between this parameter and two other indices of sympathetic activity, plasma norepinephrine and sympathetic nerve traffic. PATIENTS AND METHODS: We studied 243 subjects aged 50.0+/-12.1 years (mean +/- SD). Of these, 38 were normotensive healthy controls, 113 subjects had untreated essential hypertension, 27 were obese normotensives and 65 had congestive heart failure. In each subject, over a 10 min supine period, we measured mean arterial pressure (Finapres), heart rate (electrocardiogram), venous plasma norepinephrine (high-performance liquid chromatography) and efferent postganglionic muscle sympathetic nerve activity (microneurography at a peroneal nerve). RESULTS: In the whole study group, supine heart rate was correlated with both plasma norepinephrine (r = 0.32, P < 0.0001) and muscle sympathetic nerve activity (r = 0.38, P < 0.0001). This was also the case in the normotensive obese subjects and the heart failure subjects considered separately. Heart rate values were greater in the obese and the heart failure patients than in controls (75.1+/-13.0 and 78.2+/-13.0 versus 69.2+/-11.6 beats/min; P < 0.05 and P < 0.001, respectively), as were plasma norepinephrine (362.7+/-202 and 400.3+/-217 versus 230.4+/-126 pg/ml; P < 0.01 and P < 0.001, respectively) and muscle sympathetic nerve activity (44.1+/-14.7 and 55.3+/-14.3 versus 27.8+/-11.0 bursts/min; P < 0.001 for both). In contrast, in the essential hypertensive subjects, no significant relationship was found between these three indices of sympathetic activity. Furthermore, in the hypertensives, the heart rate was not increased, at variance with the sympathetic nerve traffic, which was greater than in controls (36.2+/-10.0 versus 27.8+/-11.0 bursts/min, P < 0.001). CONCLUSIONS: These data suggest that the supine heart rate can be regarded as a marker of intersubject differences in sympathetic tone, and that this is the case both in the general population and in those with cardiovascular diseases. Its value for this purpose is limited, however, and the limitations may be more evident in essential hypertension than in conditions such as obesity and heart failure.
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There is no such thing as 'overall' or 'generalized' sympathetic nerve activity or tone, and no single method can provide an overall assessment of the sympathetic nervous system.
“As a result of these complexities, there is no such thing as “overall” or “generalized” sympathetic nerve activity or tone, and one cannot obtain an overall assessment of the sympathetic nervous system with any single method.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [23]
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- Authors
- Grassi, G., Vailati, S., Bertinieri, G., Seravalle, G., Stella, M. L., DellʼOro, R., & Mancia, G.
- Affiliations
- University of Milan (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Corresponding author
- Mancia, Giuseppe
- Venue
- Journal of Hypertension
- Published
- 1998-11
- Volume
- 16
- Issue
- 11
- Pages
- 1635-1639
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W1989096354
- Cited by
- 279
- References
- 17
- Citations by year
- 2026: 5 · 2025: 17 · 2024: 9 · 2023: 10 · 2022: 13 · 2021: 20 · 2020: 16 · 2019: 11 · 2018: 16 · 2017: 13 · 2016: 15 · 2015: 14 · 2014: 13 · 2013: 10 · 2012: 7
- FWCI
- 5.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- heart rate, sympathetic activity, plasma norepinephrine, muscle sympathetic nerve activity, essential hypertension, congestive heart failure, obesity, autonomic function
- MeSH terms
- Adult, Blood Pressure, Electrocardiography, Female, Heart Failure, Heart Rate, Humans, Hypertension, Male, Middle Aged, Norepinephrine, Obesity, Sympathetic Nervous System, Supine Position, Muscle, Skeletal
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