Komai Rie, Obara Taku, Ohkubo Takayoshi, Kato Tetsuo, Kikuya Masahiro, Metoki Hirohito, Inoue Ryusuke, Asayama Kei, Hara Azusa, Tanaka Koji, Gonokami Kenta, Hashimoto Junichiro, Totsune Kazuhito, Imai Yutaka
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
Hypertens Res. 2007 Nov;30(11):1051-7. doi: 10.1291/hypres.30.1051.
We previously reported that a resting heart rate measured at home (home HR) of >or=70 beats per minute was a powerful predictor of the risk of cardiovascular disease mortality, and identified factors affecting home HR in the general Japanese population. The present study examines factors affecting home HR in hypertensive patients treated with antihypertensive medications. Home HR was measured using a home blood pressure (BP) device. Information about the characteristics of the patients was collected using questionnaires administered by a physician. Among 3,400 patients, 3,086 measured home HR both in the morning and evening. The mean values of home HR in the morning and evening were 67.2+/-9.1 and 69.6+/-9.2 beats per minute, respectively. Multivariate linear regression analysis showed that lower age, diabetes mellitus, habitual smoking, higher diastolic BP, and the lack of beta-blocker or angiotensin-converting enzyme inhibitor use were determinants of elevated morning or evening home HR. These results suggest that adequate control of risk factors for cardiovascular disease such as smoking and diabetes mellitus or use of heart rate-lowering agents might help to decrease home HR in treated hypertensive patients.
我们之前报道过,在家测量的静息心率(家庭心率)≥70次/分钟是心血管疾病死亡风险的有力预测指标,并确定了日本普通人群中影响家庭心率的因素。本研究调查了接受抗高血压药物治疗的高血压患者中影响家庭心率的因素。使用家用血压设备测量家庭心率。通过医生发放的问卷收集患者的特征信息。在3400名患者中,3086名患者在早晨和晚上测量了家庭心率。早晨和晚上家庭心率的平均值分别为67.2±9.1次/分钟和69.6±9.2次/分钟。多变量线性回归分析表明,年龄较小、患有糖尿病、习惯性吸烟、舒张压较高以及未使用β受体阻滞剂或血管紧张素转换酶抑制剂是早晨或晚上家庭心率升高的决定因素。这些结果表明,充分控制心血管疾病的危险因素,如吸烟和糖尿病,或使用降低心率的药物,可能有助于降低接受治疗的高血压患者的家庭心率。