Liu Ping, Wang Su-jia, Zhang Yun
Department of Cardiovascular Disease, Qilu Hospital, Shandong University, Jinan 250012, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Jan;33(1):49-53.
To investigate the relationship between resting heart rate (RHR)and target organs damage in senile essential hypertension.
All 206 elderly essential hypertensive patients (age: 60 - 85 years) were divided into three groups according to the levels of systolic blood pressure (SBP): SBP < 160 mm Hg, 160 mm Hg </= SBP < 180 mm Hg, SBP >/= 180 mm Hg. Each of the groups mentioned above were divided into five groups according to the levels of RHR [RHR1 group: RHR < 65 beats/minute(bpm); RHR2: 65 bpm </= RHR < 69 bpm; RHR 3: 70 bpm </= RHR < 74 bpm; RHR4: 75 bpm </= RHR < 79 bpm; RHR5: RHR >/= 80 bpm]. Electrocardiography, carotid ultrasonography, echocardiography, creatinine clearance rate (CCr) and quantitative test for 24 hours' urinary microalbuminuria (MAU) were performed.
(1) Compared with RHR1-RHR4 groups, the RHR5 group showed with lower levels of MAU and left ventricular ejection fraction (LVEF) (P < 0.05 or P < 0.01). Compared with RHR1 and RHR2 groups, RHR5 or RHR4 group showed with higher levels of carotid intima-medial thickness (IMT) and carotid arterial diameter (CAD), lower CCr and MAU (P < 0.05 or P < 0.01). (2) The levels of IMT, CAD, LVMI, MAU were positively correlated to RHR (r = 0.312, 0.289, 0.630, 0.563, 0.576 respectively, all P < 0.01), however, the levels of LVEF, CCr were negatively correlated to RHR (r = -0.563, -0.510. all P < 0.01).
Target organ damage (TOD) seems not only related with PP, SBP, DBP, but also related with RHR in senile essential hypertension. RHR may be one of the important risk factors in TOD.
探讨老年原发性高血压患者静息心率(RHR)与靶器官损害之间的关系。
将206例老年原发性高血压患者(年龄60 - 85岁)根据收缩压(SBP)水平分为三组:SBP < 160 mmHg、160 mmHg≤SBP < 180 mmHg、SBP≥180 mmHg。上述每组再根据RHR水平分为五组[RHR1组:RHR < 65次/分钟(bpm);RHR2组:65 bpm≤RHR < 69 bpm;RHR3组:70 bpm≤RHR < 74 bpm;RHR4组:75 bpm≤RHR < 79 bpm;RHR5组:RHR≥80 bpm]。进行心电图、颈动脉超声、超声心动图、肌酐清除率(CCr)及24小时尿微量白蛋白(MAU)定量检测。
(1)与RHR1 - RHR4组相比,RHR5组的MAU和左心室射血分数(LVEF)水平较低(P < 0.05或P < 0.01)。与RHR1和RHR2组相比,RHR5或RHR4组的颈动脉内膜中层厚度(IMT)和颈动脉内径(CAD)水平较高,CCr和MAU较低(P < 0.05或P < 0.01)。(2)IMT、CAD、左心室质量指数(LVMI)、MAU水平与RHR呈正相关(r分别为0.312、0.289、0.630、0.563、0.576,均P < 0.01),然而,LVEF、CCr水平与RHR呈负相关(r分别为 - 0.563、 - 0.510,均P < 0.01)。
在老年原发性高血压中,靶器官损害(TOD)似乎不仅与脉压(PP)、SBP、舒张压(DBP)有关,还与RHR有关。RHR可能是TOD的重要危险因素之一。