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Abstract Objective To investigate the changes of heart rate turbulence (HRT) in hypertensive patients with proteinuria(UP)and spironolactone therapy effect. Methods 75 patients with hypertension were divided into 3 groups:<150mg group ,150~299mg group ,≥ 300mg group according to the 24hour proteinria. They were further divided into subgroups with or without spironolactone therapy. Turbulence onset (TO)and turbulence slope (TS)were calculated based on 24h dynamic ECG recorded before and after 12 weeks of treatment. Results TO decreased and TS increased from≥ 300mg group [(0.78 ±0.31)%、(7.55 ±1.31)ms] to 150~299m group [(0.54 ±0.43)%、(11.12 ±1.25)ms] to <150mg group[(0.25±0.31)%、(18.12±2.34)ms],there was significantly different among each group (al P<0.01).TO and TS changed significantly after treatment and there was a significant difference of these changes between subgroups with and without spironolactone treatment in≥300mg and 150~299mg groups (al P<0.01). TS increased significantly after treatment in<150mg group. Conclusion Autonomic nervous dysfunction may exist in hypertensive patients, especially those with proteinuria. Spironolactone may improve HRT in patients with hypertension and proteinuria.
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