Hozawa Atsushi, Ohkubo Takayoshi, Kikuya Masahiro, Ugajin Takashi, Yamaguchi Junko, Asayama Kei, Metoki Hirohito, Ohmori Kaori, Hoshi Haruhisa, Hashimoto Junichiro, Satoh Hiroshi, Tsuji Ichiro, Imai Yutaka
Department of Public Health, Tohoku University Graduate School of Medicine and Pharmaceutical Science, Sendai, Japan.
Am J Hypertens. 2004 Nov;17(11 Pt 1):1005-10. doi: 10.1016/j.amjhyper.2004.06.019.
Recently, the advantages of self-measurement of blood pressure (BP) at home have been recognized. The same advantages could also be applicable to resting heart rate (HR) values assessed at home using a device designed for home BP measurement. However, there have been no studies investigating whether home HR values predict the risk of cardiovascular disease mortality. We therefore investigated the usefulness of HR values in predicting cardiovascular mortality using a device that allowed self-measurement of BP and HR at home.
The association between the home-measured resting HR and the 10-year risk of cardiovascular mortality was examined in 1780 Japanese individuals >/=40 years of age who had no significant arrhythmias. A Cox proportional hazards model that adjusted for major risk factors was used.
An increase of 5 beats/min in the morning home HR measurement was associated with a 17% increase in the risk of cardiovascular mortality (95% confidence interval 5% to 30%). This relationship was also statistically significant after adjustment for home BP values. Even when home-measured systolic BP was within the normal range (<135 mm Hg), subjects with HR >/=70 beats/min had a higher risk of cardiovascular mortality (relative hazard 2.16, 95% confidence interval 1.21 to 3.85) than those with normal systolic BP and HR values.
Self-measurement of HR at home, together with self-measurement of BP, is a simple method of providing useful clinical information for assessing cardiovascular risk.
最近，在家自行测量血压（BP）的优势已得到认可。同样的优势也适用于使用专为家庭血压测量设计的设备在家评估的静息心率（HR）值。然而，尚无研究调查家庭心率值是否能预测心血管疾病死亡率风险。因此，我们使用一种允许在家自行测量血压和心率的设备，研究了心率值在预测心血管死亡率方面的实用性。
在1780名年龄≥40岁且无明显心律失常的日本个体中，研究了家庭测量的静息心率与10年心血管死亡率风险之间的关联。使用了调整主要风险因素的Cox比例风险模型。
早晨家庭心率测量值每增加5次/分钟，心血管死亡率风险增加17%（95%置信区间为5%至30%）。在调整家庭血压值后，这种关系在统计学上也具有显著性。即使家庭测量的收缩压在正常范围内（<135 mmHg），心率≥70次/分钟的受试者比收缩压和心率值正常的受试者具有更高的心血管死亡率风险（相对风险2.16，95%置信区间为1.21至3.85）。
在家自行测量心率以及自行测量血压，是一种为评估心血管风险提供有用临床信息的简单方法。
