Parameters of heart rate and blood pressure variability in adolescents with neuropsychiatric disorders during functional tests

Abstract

The aim of this study was to assess characteristics of heart rate (HR) and blood pressure (BP) variability in adolescents with clinically confirmed neuropsychiatric pathology in the conditions of a functional test.
Methods. The method of spiroarteriocardiorhythmography was used to test cardiovascular parameters during a functional stress test (voluntary breathing with a spirometric mask, a model of mild hypercapnia / hypoxia), in students of a specialized school for patients of psychiatric clinics (in remission) (n = 61) and students of a regular school (n = 197). Adolescents from a specialized school were divided into two groups: 1) patients with neurological diagnoses and consequences of organic brain damage (n = 35) and 2) patients with psychiatric disorders without organic brain damage (n = 26). The age of students from both schools was 12.0–17.7 years; samples of both schools were divided into 5 age ranges (12.0-13.5, 13.6-14.5, 14.6-15.5, 15.6-16.5 and 16.6-17.7 years). The adolescents from the control school were additionally subdivided by gender.

Results. In the age ranges of 12.0–13.5, 13.6–14.5, and 14.6–15.5 years, no statistically significant differences were found between students from different schools in any parameters. In the age range of 15.6–16.5 years, adolescents with neurological diagnoses and consequences of organic brain damage had higher values of systolic and diastolic BP compared to the control groups. In the age range of 16.6-17.7 years, adolescents with psychiatric disorders without organic brain damage had higher values of the stress index than in the control groups, and a tendency towards lower values of spontaneous arterial baroreflex sensitivity compared to patients with neurological diagnoses (p = 0.056).
Conclusion. Adolescents with neuropsychiatric pathologies did not significantly differ from students of regular schools in parameters of HR and BP variability. The increased stress index in adolescents with psychopathology without organic brain damage aged 16.6–17.7 years can be interpreted as a correlate of elevated sympathetic activity. Adolescents with neurological diseases apparently had an earlier onset of juvenile prehypertension (at 15.6-16.5 years) compared to the control.