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Respuesta no lineal en el balance autonómico cardiovascular a la prueba de peso sostenido en pacientes hipertensos
Resumen
Objetivo: Determinar la respuesta de los parámetros no lineales del balance autonómico a la hiperreactividad cardiovascular inducida en pacientes hipertensos.
Método: Se realizo un estudio observacional analítico transversal con grupo control no equivalente, realizado en el Laboratorio de Ciencias Básicas Biomédicas de la Universidad de Ciencias Médicas de Santiago de Cuba en 15 pacientes con diagnóstico de hipertensión arterial, pareados en edad y sexo con 30 pacientes normotensos. Se evaluaron parámetros no lineales de la Variabilidad de la Frecuencia Cardiaca (VFC) a través de la señal electrocardiográfica del polígrafo AD Instruments en los estados funcionales de reposo y Prueba del Peso Sostenido (PPS).
Resultados: En individuos sanos los parámetros no lineales de la VFC mostraron diferencias estadísticamente significativas entre el reposo y la PPS. En individuos hipertensos las variables FC (p = 0,001), SD2 (p = 0,001), SD2/SD1 (p = 0,002), α (p = 0,031), α2 (p = 0,031) mostraron diferencias estadísticamente significativas. En el análisis entre los grupos las variables SD1 y SD2/SD1 mostraron diferencias estadísticamente significativas durante el estado de reposo e hiperreactividad cardiovascular. La variable SD2/SD1 discrimina positivamente a los pacientes con hipertensión arterial y además durante la PPS demuestra adecuada validez diagnóstica.
Conclusiones: En el presente estudio se determinó que los pacientes hipertensos presentan cambios en los parámetros no lineales del balance autonómico cardiovascular que reflejan una disminución de la actividad parasimpática, con predominio del tono simpático como factor vegetativo predominante.
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Referencias
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