Autonomic response to change of posture among normal and mild-hypertensive adults: investigation by time-dependent spectral analysis.

In this study, we applied the time-dependent spectral analysis approach (SDA) to investigate the autonomic changes occurring during a transition from supine to standing position (CP), in normal and unmedicated mild hypertensive subjects. The SDA method enables an accurate follow-up of the instantaneous changes in autonomic activity, even during the unsteady phase of the transition, where sudden changes in heart rate (HR) and arterial blood pressure (ABP) are observed. We were able to quantify the vagal withdrawal (reflected in the high frequency component of the time-dependent spectrum of HR fluctuations) in the immediate response to CP and the more slowly following sympathetic increase (reflected in the low frequency component of ABP). This general pattern was observed in both groups. In addition, our results identified an altered sympathetic response to CP in mild-hypertensives, as compared to normal adults. Their basal sympathetic activity is enhanced (higher mean HR and increased low frequency fluctuations in ABP) and their response to CP is reduced, as reflected only in the LF content of ABP fluctuations, relative to normals. No difference was observed in HR fluctuations, showing that there is no parasympathetically mediated alteration of the baroreflex control of HR in mild-hypertension.