The Relationship Between β-Receptor Sensitivity and Nocturnal Blood Pressure and Heart Rate Recovery in Normotensive People

Abstract

This study examined the relationship between nocturnal blood pressure (BP) dipping and chronotropic dose₂₅ (CD₂₅) as an indicator of β-adrenergic receptor functioning in normotensive people. In addition, the authors evaluated the influence of β-receptor functioning on heart rate recovery after exercise. The sample consisted of 41 participants (18 men, 23 women). Ambulatory BP monitoring took place in each patient's home. On a separate occasion, β-adrenergic receptor sensitivity was determined by response to isoproterenol infusion. Heart rate (HR) recovery was defined as the change from peak HR to that measured after 1 and 2 minutes of recovery. Relationships between dipping and CD₂₅ were found such that participants with higher CD₂₅ values had less nocturnal decline in systolic BP, diastolic BP, and mean arterial pressure (r =–0.445, –0.533, –0.510, respectively; p<0.004, 0.001, 0.001, respectively). Heart rate recovery at 1 and 2 minutes after exercise was 28.8 ±5 and 49.9 ±6 beats/minute, respectively. Participants with higher CD₂₅ values had more heart rate decline during the first 2 minutes of recovery (r =0.407, p<0.008). In addition, heart rate recovery was inversely related to systolic, diastolic, and mean nocturnal blood pressure dipping (r =–0.348, –0.432, –0.408, respectively, p<0.028, 0.005, 0.009, respectively). Normotensive people with an abnormal circadian pattern of blood pressure may have desensitized β-adrenergic receptors. This desensitization may contribute to blunted nocturnal blood pressure and increased heart rate recovery as measured at 2 minutes following exercise testing.

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