{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:00:48Z","timestamp":1792440048945,"version":"4.5.0"},"reference-count":41,"publisher":"IOP Publishing","issue":"1","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Biomed. Phys. Eng. Express"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The study of inter-beat intervals (IBI) and systolic blood pressure (SBP) fluctuations is of public health importance. Here we obtain insights about their underlying dynamics by means of an innovative study of the distribution of their rank-ordered registers, provided by fits to the Discrete Generalized Beta Distribution (DGBD), for healthy subjects and patients with end-stage renal disease (ESRD), under an active standing maneuver. SBP and IBI non-invasive time series were recorded during supine position followed by active standing for nine ESRD patients and eighteen age-matched healthy subjects. Once the data were rank ordered, the three parameter DGBD function was fitted through the Levenberg\u2013Marquardt non-linear algorithm. Taking into consideration the statistical interpretations of the parameters, the quantitative exploration of their dependence with regard to the cases examined and changes in body position provided new insights: (i) Evidence for the presence of regulatory mechanisms that preserve the tail symmetry of the IBI distributions in healthy subjects, which are not evident in ESRD patients; (ii) The identification of a more pronounced weight of low-magnitude fluctuations at active standing in the SBP time series, manifested as a broader statistical dispersion of blood pressure values; (iii) A quantitative determination of a more undermined SBP regulation in ESRD. Overall, a better understanding of the statistical behavior of IBI and SBP time series is achieved by means of the DGBD function. Through the variation of its parameters, the DGBD approach has the potential to become a marker for assessing or even predicting the impairment of cardiovascular control mechanisms.<\/jats:p>","DOI":"10.1088\/2057-1976\/ae250e","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T22:47:48Z","timestamp":1764283668000},"page":"015012","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Insights from a discrete generalized beta distribution analysis of heart rate and blood pressure variability: an integrated approach to study end-stage renal disease"],"prefix":"10.1088","volume":"12","author":[{"given":"Alejandro","family":"Aguado-Garc\u00eda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-7751","authenticated-orcid":true,"given":"Claudia","family":"Lerma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5625-1949","authenticated-orcid":true,"given":"Juan C","family":"Echeverr\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8187-8573","authenticated-orcid":false,"given":"Gertrudis Hortensia","family":"Gonz\u00e1lez-G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1192-9769","authenticated-orcid":false,"given":"Gustavo","family":"Mart\u00ednez-Mekler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"bpexae250ebib1","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1109\/TBME.1982.324972","type":"journal-article","article-title":"1\/f fluctuation of heartbeat period","volume":"BME-29","author":"Kobayashi","year":"1982","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"bpexae250ebib2","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1113\/jphysiol.2010.196428","type":"journal-article","article-title":"Scale exponents of blood pressure and heart rate during autonomic blockade as assessed by detrended fluctuation analysis","volume":"589","author":"Castiglioni","year":"2011","journal-title":"J. Physiol."},{"key":"bpexae250ebib3","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1161\/01.CIR.101.1.47","type":"journal-article","article-title":"Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction","volume":"101","author":"Huikuri","year":"2000","journal-title":"Circulation"},{"key":"bpexae250ebib4","doi-asserted-by":"publisher","first-page":"3730","DOI":"10.1103\/PhysRevE.47.3730","type":"journal-article","article-title":"Finite-size effects on long-range correlations: implications for analyzing DNA sequences","volume":"47","author":"Peng","year":"1993","journal-title":"Phys. Rev. E"},{"key":"bpexae250ebib5","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevE.65.041107","type":"journal-article","article-title":"Effect of nonstationarities on detrended fluctuation analysis","volume":"65","author":"Chen","year":"2002","journal-title":"Phys. Rev. E"},{"key":"bpexae250ebib6","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1063\/1.1562051","type":"journal-article","article-title":"Interpretation of heart rate variability via detrended fluctuation analysis and \u03b1\u03b2 filter","volume":"13","author":"Echeverr\u0131\u0301a","year":"2003","journal-title":"Chaos"},{"key":"bpexae250ebib7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004791","type":"journal-article","article-title":"Universality of rank-ordering distributions in the arts and sciences","volume":"4","author":"Mart\u00ednez-Mekler","year":"2009","journal-title":"PLoS One"},{"key":"bpexae250ebib8","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.physa.2010.07.037","type":"journal-article","article-title":"Order\u2013disorder transition in conflicting dynamics leading to rank\u2013frequency generalized beta distributions","volume":"390","author":"Alvarez-Martinez","year":"2011","journal-title":"Physica A"},{"key":"bpexae250ebib9","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2020.102031","type":"journal-article","article-title":"Continuous wavelet transform based processing for estimating the power spectrum content of heart rate variability during hemodiafiltration","volume":"62","author":"Cartas-Rosado","year":"2020","journal-title":"Biomed. Signal Process. Control"},{"key":"bpexae250ebib10","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1093\/oxfordjournals.eurheartj.a014868","type":"journal-article","article-title":"Heart rate variability. Standards of measurement, physiological interpretation, and clinical use","volume":"17","author":"Malik","year":"1996","journal-title":"Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur. Heart J."},{"key":"bpexae250ebib11","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1063\/1.166141","type":"journal-article","article-title":"Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series","volume":"5","author":"Peng","year":"1995","journal-title":"Chaos"},{"key":"bpexae250ebib12","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1152\/japplphysiol.00364.2019","type":"journal-article","article-title":"Dynamical interaction between heart rate and blood pressure of end-stage renal disease patients evaluated by cross recurrence plot diagonal analysis","volume":"128","author":"Gonz\u00e1lez","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"bpexae250ebib13","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1111\/j.1475-097X.2008.00813.x","type":"journal-article","article-title":"Recurrences in heart rate dynamics are changed in patients with diabetes mellitus","volume":"28","author":"Javorka","year":"2008","journal-title":"Clin. Physiol. Funct. Imaging."},{"key":"bpexae250ebib14","doi-asserted-by":"publisher","first-page":"469","DOI":"10.3390\/e25030469","type":"journal-article","article-title":"Nonlinear dynamics of heart rate variability after acutely induced myocardial ischemia by percutaneous transluminal coronary angioplasty","volume":"25","author":"Calder\u00f3n-Ju\u00e1rez","year":"2023","journal-title":"Entropy"},{"key":"bpexae250ebib15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-40385-1","type":"journal-article","article-title":"Revisiting nonlinearity of heart rate variability in healthy aging","volume":"13","author":"Calder\u00f3n-Ju\u00e1rez","year":"2023","journal-title":"Sci Rep."},{"key":"bpexae250ebib16","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevE.71.021906","type":"journal-article","article-title":"Multiscale entropy analysis of biological signals","volume":"71","author":"Costa","year":"2005","journal-title":"Phys. Rev. E"},{"key":"bpexae250ebib17","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1093\/ndt\/gfm634","type":"journal-article","article-title":"Heart rate variability (HRV) in kidney failure: measurement and consequences of reduced HRV","volume":"23","author":"Ranpuria","year":"2008","journal-title":"Nephrol. Dial Transplant"},{"key":"bpexae250ebib18","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s10157-014-0990-1","type":"journal-article","article-title":"Preserved autonomic heart rate modulation in chronic renal failure patients in response to hemodialysis and orthostatism","volume":"19","author":"Lerma","year":"2015","journal-title":"Clin. Exp. Nephrol."},{"key":"bpexae250ebib19","doi-asserted-by":"publisher","first-page":"3147","DOI":"10.3390\/nu12103147","type":"journal-article","article-title":"Understanding development of malnutrition in hemodialysis patients: a narrative review","volume":"12","author":"Sahathevan","year":"2020","journal-title":"Nutrients"},{"key":"bpexae250ebib20","doi-asserted-by":"publisher","DOI":"10.1063\/1.5024685","type":"journal-article","article-title":"Analysis of diagonals in cross recurrence plots between heart rate and systolic blood pressure during supine position and active standing in healthy adults","volume":"28","author":"Gonz\u00e1lez-G\u00f3mez","year":"2018","journal-title":"Chaos"},{"key":"bpexae250ebib21","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s10286-012-0173-7","type":"journal-article","article-title":"Baroreflex sensitivity estimation by the sequence method with delayed signals","volume":"22","author":"Mart\u00ednez-Garc\u00eda","year":"2012","journal-title":"Clinical Autonomic Research"},{"key":"bpexae250ebib22","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1152\/japplphysiol.00245.2016","type":"journal-article","article-title":"Effects of different stresses on cardiac autonomic control and cardiovascular coupling","volume":"122","author":"Xie","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"bpexae250ebib23","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1209\/epl\/i1998-00366-3","type":"journal-article","article-title":"Stochastic feedback and the regulation of biological rhythms","volume":"43","author":"Ivanov","year":"1998","journal-title":"Europhysics Letters (EPL)"},{"key":"bpexae250ebib24","doi-asserted-by":"publisher","first-page":"93","DOI":"10.2174\/1573402115666190301144316","type":"journal-article","article-title":"The adaptive value and clinical significance of allostatic blood pressure variation","volume":"15","author":"James","year":"2019","journal-title":"Curr. Hypertens Rev."},{"key":"bpexae250ebib25","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1161\/HYPERTENSIONAHA.114.03782","type":"journal-article","article-title":"Biophysical characterization of the underappreciated and important relationship between heart rate variability and heart rate","volume":"64","author":"Monfredi","year":"2014","journal-title":"Hypertension"},{"key":"bpexae250ebib26","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1038\/s41467-022-29256-x","type":"journal-article","article-title":"Dynamics of ranking","volume":"13","author":"I\u00f1iguez","year":"2022","journal-title":"Nat. Commun."},{"key":"bpexae250ebib27","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/BFb0067700","type":"book","article-title":"The levenberg-marquardt algorithm: implementation and theory. Numerical analysis","volume":"630","author":"Mor\u00e9","year":"1977"},{"key":"bpexae250ebib28","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.physa.2014.01.036","type":"journal-article","article-title":"Birth and death master equation for the evolution of complex networks","volume":"402","author":"Alvarez-Mart\u00ednez","year":"2014","journal-title":"Physica A"},{"key":"bpexae250ebib29","doi-asserted-by":"publisher","DOI":"10.1063\/1.5027784","type":"journal-article","article-title":"Rank ordered beta distributions of nonlinear map symbolic dynamics families with a first-order transition between dynamical regimes","volume":"28","author":"Alvarez-Martinez","year":"2018","journal-title":"Chaos"},{"key":"bpexae250ebib30","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1038\/335405a0","type":"journal-article","article-title":"Multifractal phenomena in physics and chemistry","volume":"335","author":"Stanley","year":"1988","journal-title":"Nature"},{"key":"bpexae250ebib31","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevE.72.041904","type":"journal-article","article-title":"Model for complex heart rate dynamics in health and diseases","volume":"72","author":"Kotani","year":"2005","journal-title":"Phys. Rev. E"},{"key":"bpexae250ebib32","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1186\/s12882-020-02196-8","type":"journal-article","article-title":"Heart rhythm complexity as predictors for the prognosis of end-stage renal disease patients undergoing hemodialysis","volume":"21","author":"Liu","year":"2020","journal-title":"BMC Nephrol"},{"key":"bpexae250ebib33","first-page":"S29","type":"journal-article","article-title":"Baroreflex control of regional vascular resistances during simulated orthostatism","volume":"37","author":"Berdeaux","year":"1992","journal-title":"Kidney Int. Suppl."},{"key":"bpexae250ebib34","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1111\/j.1469-7793.1999.0617t.x","type":"journal-article","article-title":"Human responses to upright tilt: a window on central autonomic integration","volume":"517","author":"Cooke","year":"1999","journal-title":"J. Physiol."},{"key":"bpexae250ebib35","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1111\/aor.12887","type":"journal-article","article-title":"Effects of orthostatism and hemodialysis on mean heart period and fractal heart rate properties of chronic renal failure patients","volume":"41","author":"Echeverr\u00eda","year":"2017","journal-title":"Artif. Organs"},{"key":"bpexae250ebib36","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1140\/epjs\/s11734-022-00682-8","type":"journal-article","article-title":"Recurrence plot analysis of heart rate variability in end-stage renal disease treated twice-weekly by hemodialysis with or without intradialytic hypotension","volume":"232","author":"Calder\u00f3n-Ju\u00e1rez","year":"2023","journal-title":"Eur. Phys. J. Spec. Top."},{"key":"bpexae250ebib37","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/nrcardio.2013.1","type":"journal-article","article-title":"Assessment and management of blood-pressure variability","volume":"10","author":"Parati","year":"2013","journal-title":"Nat. Rev. Cardiol."},{"key":"bpexae250ebib38","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.cjca.2013.02.012","type":"journal-article","article-title":"Blood pressure variability: a novel and important risk factor","volume":"29","author":"Floras","year":"2013","journal-title":"Can. J. Cardiol."},{"key":"bpexae250ebib39","first-page":"S19","type":"journal-article","article-title":"Analysis of ambulatory blood pressure data","volume":"9","author":"Coats","year":"1991","journal-title":"J. Hypertens. Suppl."},{"key":"bpexae250ebib40","doi-asserted-by":"publisher","DOI":"10.1115\/1.4050458","type":"journal-article","article-title":"A brief on biological thermodynamics for human physiology","volume":"143","author":"Dutta","year":"2021","journal-title":"J. Biomech. Eng."},{"key":"bpexae250ebib41","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1038\/s41371-023-00888-w","type":"journal-article","article-title":"Individual versus integration of multiple components of central blood pressure and aortic stiffness in predicting cardiovascular mortality in end-stage renal diseases","volume":"38","author":"C\u00f4t\u00e9","year":"2024","journal-title":"J. Hum. Hypertens"}],"container-title":["Biomedical Physics &amp; Engineering Express"],"original-title":[],"link":[{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T10:58:06Z","timestamp":1765277886000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae250e"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12,9]]},"published-print":{"date-parts":[[2026,2,1]]}},"URL":"https:\/\/doi.org\/10.1088\/2057-1976\/ae250e","relation":{},"ISSN":["2057-1976"],"issn-type":[{"value":"2057-1976","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]},"assertion":[{"value":"Insights from a discrete generalized beta distribution analysis of heart rate and blood pressure variability: an integrated approach to study end-stage renal disease","name":"article_title","label":"Article Title"},{"value":"Biomedical Physics & Engineering Express","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2025 The Author(s). Published by IOP Publishing Ltd","name":"copyright_information","label":"Copyright Information"},{"value":"2025-05-16","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-11-27","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-12-09","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}