Heart rate variability in patients with essential hyperhidrosis: dynamic influence of sympathetic and parasympathetic maneuvers.

BACKGROUND: Essential hyperhidrosis has been associated with an increased activity of the sympathetic system. In this study, we investigated cardiac autonomic function in patients with essential hyperhidrosis and healthy controls by time and frequency domain analysis of heart rate variability (HRV).

METHOD: In this study, 12 subjects with essential hyperhidrosis and 20 healthy subjects were included. Time and frequency domain parameters of HRV were obtained from all of the participants after a 15-minute resting period in supine position, during controlled respiration (CR) and handgrip exercise (HGE) in sitting position over 5-minute periods in each stage.

RESULTS: Baseline values of HRV parameters including RR interval, SDNN and root mean square of successive R-R interval differences, low frequency (LF), high frequency (HF), normalized unit of high frequency (HFnu), normalized unit of low frequency (LFnu), and LF/HF ratio were identical in two groups. During CR, no difference was detected between the two groups with respect to HRV parameters. However, the expected increase in mean heart rate (mean R-R interval) did not occur in hyperhidrotic group, whereas it did occur in the control group (Friedman's P = 0.000). Handgrip exercise induced significant decrease in mean R-R interval in both groups and no difference was detected between the two groups with respect to the other HRV parameters. When repeated measurements were compared with two-way ANOVA, there was statistically significant difference only regarding mean heart rate in two groups (F = 6.5; P = 0.01).

CONCLUSION: Our overall findings suggest that essential hyperhidrosis is a complex autonomic dysfunction rather than sympathetic overactivity, and parasympathetic system seems to be involved in pathogenesis of this disorder.