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Heart rate and blood pressure variability in cardiac diseases: pharmacological implications

Summary— Even at rest, blood pressure and heart rate fluctuate continuously around their mean values. Considerable interest has recently focused on the assessment of spontaneous fluctuations in heart rate and blood pressure, ie, heart rate and blood pressure variability, using time or frequency domain indexes. Heart rate variability has been extensively studied in cardiovascular disease and has emerged as a valuable parameter for detecting abnormalities in autonomic cardiovascular control, evaluating the prognosis and assessing the impact of drug therapy on the autonomic nervous system in patients with myocardial infarction, congestive heart failure or a heart transplant. In contrast, until the recent development of noninvasive methods for continuous blood pressure recording, blood pressure variability received little attention, and this parameter remains to be evaluated in cardiovascular disease.