Sympathetic predominance in young male white-collar workers with mild to moderate hypertension.

In order to investigate the difference in diurnal variation of autonomic control between young male mild to moderate hypertensive and normotensive white-collar workers, we accessed heart rate variability with ambulatory blood pressure for over 24 hours including work and sleep periods. Both mean systolic and diastolic blood pressures (SBP and DBP) were significantly (p<0.01) higher in hypertensives (HT, n=11) than normotensives (NT, n=11) in all phases, whereas heart rate was not different between them in any phase. Blood pressures during work period (on-duty) were significantly higher than those during non-work period (off-duty) in both NT and HT. High frequency (HF; 0.15-0.40 Hz) power showed a circadian pattern in phase with the sleep-wake cycle. Both HF and low frequency (LF; 0.05-0.15 Hz) powers in HT were significantly lower than that in NT during the sleep period (p<0.05). LF/HF ratio showed a circadian pattern that was almost opposite of the pattern in HF power. Twenty-four-hour average LF/HF in HT was higher than that in NT (p<0.05). Especially during on-duty, LF/HF in HT was significantly higher than in NT (p<0.05). The increase of SBP and LF/HF from off-duty period to on-duty period (deltaSBP and deltaLF/HF) showed significant positive correlation (r=0.67, P<0.05) in HT group, suggesting that the SBP elevation during on-duty in HT may be coupled with sympathetic activation. These results suggest that HT showed significantly reduced parasympathetic control during sleep and an increased sympathetic activity especially during on-duty as compared with NT. Our findings imply that persistence of sympathodominant states together with reduced vagal activity in young mild to moderate hypertensive workers may be related to future cardiovascular disorders.