Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa Chukwunomso E. Osakwe Lotte Jacobs Benedict C. Anisiuba Mouhamado B. Ndiaye Daniel Lemogoum Chinwuba K. Ijoma Marius M. Kamdem Lutgarde Thijs Hilaire J. Boombhi Joseph Kaptue Philip M. Kolo Jean B. Mipinda Augustine N. Odili Birinus Ezeala-Adikaibe Samuel Kingue Babatunde A. Omotoso Serigne A. Ba Ifeoma I. Ulasi Jean-Rene M’buyamba-Kabangu Jan A. Staessen 10.6084/m9.figshare.11806755.v1 https://tandf.figshare.com/articles/journal_contribution/Heart_rate_variability_on_antihypertensive_drugs_in_black_patients_living_in_sub-Saharan_Africa/11806755 <p><i>Background.</i> Compared with Caucasians, African Americans have lower heart rate variability (HRV) in the high-frequency domain, but there are no studies in blacks born and living in Africa. <i>Methods.</i> In the Newer versus Older Antihypertensive agents in African Hypertensive patients trial (NCT01030458), patients (30–69 years) with uncomplicated hypertension (140–179/90–109 mmHg) were randomized to single-pill combinations of bisoprolol/hydrochlorothiazide (R) or amlodipine/valsartan (E). 72 R and 84 E patients underwent 5-min ECG recordings at randomization and 8, 16 and 24 weeks. HRV was determined by fast Fourier transform and autoregressive modelling. <i>Results.</i> Heart rate decreased by 9.5 beats/min in R patients with no change in E patients (− 2.2 beats/min). R patients had reduced total (− 0.13 ms²; <i>p =</i> 0.0038) and low-frequency power (− 3.6 nu; <i>p =</i> 0.057), higher high-frequency (+ 3.3 nu; <i>p =</i> 0.050) and a reduced low- to high-frequency ratio (− 0.08; <i>p =</i> 0.040). With adjustment for heart rate, these differences disappeared, except for the reduced low-frequency power in the R group (− 4.67 nu; <i>p =</i> 0.02). Analyses confined to 39 R and 47 E patients with HRV measurements at all visits or based on autoregressive modelling were confirmatory. <i>Conclusion.</i> In native black African patients, antihypertensive drugs modulate HRV, an index of autonomous nervous tone. However, these effects were mediated by changes in heart rate except for low-frequency variability, which was reduced on beta blockade independent of heart rate.</p> 2020-02-05 10:12:12 Antihypertensive drugs blacks heart rate variability randomized clinical trial sub-Saharan Africa