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Deriving heart period variability from blood pressure waveforms

Departments of ¹Psychiatry and ⁴Rehabilitation Medicine, College of Physicians and Surgeons, and ²Department of Biostatistics, Mailman School of Public Health, Columbia University, New York 10032; ³Division of Developmental Psychobiology, New York State Psychiatric Institute, New York, New York 10032; and ⁵Department of Psychiatry, University of California, San Diego 92093, and Veterans Affairs Healthcare System, San Diego, California 92169

Submitted 4 December 2002 ; accepted in final form 20 June 2003

International standards for calculating heart period variability (HPV) from a series of R-wave intervals (R-R) in an electrocardiographic (ECG) recording have been widely accepted. It is possible, and potentially useful in various settings, to use systolic blood pressure waveform intervals to estimate HPV, but the validity of HPV derived from blood pressure (BP) waveforms has not been established. To test the reliability between BP- and ECG-derived HPV indexes, we evaluated data from 234 healthy adults in four studies of HPV reactivity to stress. Study conditions included resting baseline, arithmetic, Stroop test, speech presentation, and orthostatic tilt. Continuous ECG and BP recordings were sampled at a rate of 500 Hz, scored by the same methods, and used to calculate heart rate and time- and frequency-domain measures of HPV. Overall, reliability between the two methods was very high for computing heart rate and HPV indexes. High-frequency HPV indexes were somewhat less reliably computed. In conclusion, in healthy adults, with the use of appropriate methods, BP waveforms can produce reliable indexes of HPV.

psychophysiology; methodology; cardiovascular reactivity

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