Ethnic (Black-White) Contrasts in 24-Hour Heart Rate Variability in Male Adolescents with High and Low Blood Pressure: The Bogalusa Heart Study

Background: Heart rate variability (HRV) has been used to study autonomic effects on the heart. The time-domain measure RMSSD (root mean square of successive differences) represents high frequency (HF) changes in HRV reflecting parasympathetic nervous system activity (PS). The frequency-domain ratio of low to high power (LF/HF) represents sympathetic (SYMP) to PS balance. In adults, increased SYMP tone has been found in hypertensive as compared to normals. The present study was performed to look for differences in HRV by race and between young subjects with high and low levels of diastolic blood pressure (DBP). Methods: Subjects included 34 healthy males age 13–17 years (53% white). Half were selected with K4 DBP < 85th% for height (HT) measured twice, 3–5 years apart. Half had DBP < 15th% for HT. Subjects underwent a physical examination including BP, HT, WT, and ECG prior to Holter monitor application. HRV data was analyzed from 24-hour Holter recordings obtained during normal activity. Results: The RMSSD was lower in whites compared to blacks for day, night, and 24-hour average (P ≥ 0.05) with day-time measurements showing the largest racial difference. This suggests increased PS tone in blacks especially with activity. The LF/HF ratio was higher in whites for all times, reaching significance during the day (all P ≥ 0.05) suggesting SYMP predominance in whites during activity. Subjects with higher levels of DBP had lower RMSSD and higher LF/HF ratio for all times, but these did not reach statistical significance. Conclusions: There is a trend towards SYMP predominance in children with higher DBP. Healthy white adolescents exhibit increased SYMP tone compared to blacks when measured during normal daytime activity.