静息心率与新发高血压的关系

Relationship between resting heart rate and new-onset hypertension

  • 摘要: 目的探讨中国北方非糖尿病人群中静息心率与新发高血压(NOH)的关系。方法采用前瞻性队列研究方法,以参加2006-2007年度开滦集团职工健康体检的职工101 510人中收缩压<140 mm Hg(1 mm Hg=0.133kPa)和舒张压<90mm Hg、无高血压病史、未使用降压药物且血压测量资料完整及空腹血糖<7.0mmol/L、无糖尿病病史、未使用降糖药物及静息心率测量资料完整的职工49 290人作为观察队列。排除未参加2008-2009或2010-2011年度体检以及血压资料缺失者,最终纳入统计分析29 680人。依据2006-2007年度静息心率测量值将观察对象分为静息心率<67、67~<71、71~<78、≥78次/min共4组,采用多因素Cox风险回归模型分析静息心率与NOH的关系。结果入选者平均随访(3.5±0.9)年。静息心率<67、67~<71、71~<78、≥78次/min组高血压的发病密度分别为102.2、107.2、112.1、120.3/1000人年。4组男性和女性高血压发病密度分别为116.3、124.5、132.5、139.4/1000人年和60.5、63.6、65.1、68.9/1000人年。影响NOH的多因素Cox回归模型分析显示,校正了年龄、性别、收缩压、舒张压、体质量指数、空腹血糖、三酰甘油、总胆固醇、高敏C反应蛋白、高密度脂蛋白胆固醇、吸烟、饮酒、高血压家族史后,与静息心率<67次/min组比较,67~<71、71~<78、≥78次/min组NOH发病风险增加,HR值(95%CI)分别为1.07(1.01~1.13)、1.08(1.02~1.14)、1.15(1.09~1.22)。在不同性别人群校正上述因素后,心率对女性NOH的影响不再有统计学意义,但仍增加男性NOH的发病风险。结论静息心率加快者未来发生高血压的风险增加,在男性中更加显著。

     

    Abstract: Objective To investigate the relationship between resting heart rate(RHR)and new-onset hypertension(NOH)in the non-diabetic population in northern China. Methods There were 101 510employees in the Kailuan Group who took part in the 2006-2007health examination. In this prospective cohort study,49 290subjects from the above employees with no history of hypertension and diabetes,without the administration of hypoglycemic agents or anti-hypertension drugs,with complete data from physical examinations of systolic blood pressure,diastolic blood pressure and RHR,and with a fasting blood glucose level<7.0mmol/L,systolic blood pressure<140mm Hg,and diastolic blood pressure<90mm Hg were selected. A total of 29 680participants were enrolled for the ultimate analysis after those were excluded who did not participate in the 2008-2009or 2010-2011health examination and had no complete information on blood pressure. According to the RHR data collected in the 2006-2007health examination,those subjects were divided into 4groups:RHR<67,67-<71,71-<78and≥78beat/min group, respectively. Multivariate Cox proportional hazard regression model was assumed for analyzing the relationship between RHR and NOH. Results The mean follow-up period for all the cases was(3.5±0.9)years. The incidence density of NOH in RHR<67,67-<71,71-<78and≥78beat/min group were 102.2,107.2,112.1and 120.3per 1000person-years,respectively. Furthermore,the corresponding incidence density for men and women in the four groups were 116.3,124.5,132.5,139.4and 60.5,63.6,65.1,68.9per 1000person-years,respectively. Multivariate Cox regression model analysis showed that compared with RHR<67beat/min group,the other three RHR groups had an increased risk of NOH after adjustment for age,gender,systolic blood pressure,diastolic blood pressure,body mass index,fastingblood glucose and other risk factors. The hazard ratios(95% CI)for 67-<71,71-<78and ≥78beat/min group were 1.07(1.01-1.13),1.08(1.02-1.14)and 1.15(1.09-1.22),respectively. After adjustment for the above factors in men and women,the influence of heart rate on NOH in women was not significant,but it was still a risk factor for NOH in men. Conclusion Increased RHR can indicate a higher risk of hypertension,particularly in men.

     

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