Piwońska Aleksandra, Piotrowski Walerian, Broda Grazyna, Drygas Wojciech, Głuszek Jerzy, Zdrojewski Tomasz, Kozakiewicz Krystyna, Stepaniak Urszula, Bandosz Piotr
Institute of Cardiology, Warsaw, Poland.
Kardiol Pol. 2008 Oct;66(10):1069-75; discussion 1076-8.
The imbalance between sympathetic and parasympathetic activity is one of the important factors in pathogenesis of cardiovascular diseases (CVD). There is a relationship between sympathetic activity and some CVD risk factors. Also heart rate (HR) is related to the autonomic nervous system. We analysed the relation of mean resting HR to hypertension, diabetes, obesity and to some risk factors [body mass index (BMI), hsCRP, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL cholesterol (LDL), triglycerides (TG) and glucose (G)].
6977 men and 7792 women, aged 20-74, randomly selected from the Polish population, were screened in 2003-2005 within the framework of the National Multicentre Health Survey (WOBASZ). Resting HR and blood pressure were measured 3 times using an automatic device and for analyses only the mean value of the 2nd and 3rd measurement was used.
Out of screened subjects, HR <60/min was found in 11% of men and 7% of women, and HR >90/min - in 6% and 5% respectively. Medication that influenced HR was taken by 16% of men and 17% of women. Resting HR was correlated (p <0.0001) with BMI, SBP, DBP, hsCRP, LDL and G in men and with SBP, DBP, hsCRP and G in women. After adjustment for medication significantly higher HR was observed both in men and in women with obesity, diabetes, hypertension, high hsCRP and in smoking persons. The prevalence of obesity, diabetes, hypertension, high hsCRP and smoking habit rose with increasing HR and the highest one was found in persons with HR >90/min. In multivariate logistic regression models resting HR was positively associated with hypertension, obesity and diabetes. In men, with every increase in HR by 10 beats/min, OR for hypertension was 1.28 (95% CI: 1.22-1.35), for obesity 1.24 (95% CI 1.17-1.30) and for diabetes 1.36 (95% CI: 1.26-1.48) after adjustment for age, medication and other factors (in women: 1.42 for hypertension, 1.14 for obesity and 1.47 for diabetes).
Resting heart rate is correlated with cardiovascular risk factors (body mass index, blood pressure, glucose and cholesterol level) and with high hsCRP. Heart rate is positively associated with hypertension, obesity and diabetes which indirectly confirms the autonomic nervous system contribution to the pathogenesis of these diseases.
交感神经和副交感神经活动失衡是心血管疾病（CVD）发病机制中的重要因素之一。交感神经活动与一些心血管疾病风险因素之间存在关联。此外，心率（HR）与自主神经系统相关。我们分析了静息平均心率与高血压、糖尿病、肥胖以及一些风险因素[体重指数（BMI）、高敏C反应蛋白（hsCRP）、收缩压（SBP）、舒张压（DBP）、低密度脂蛋白胆固醇（LDL）、甘油三酯（TG）和血糖（G）]之间的关系。
2003年至2005年期间，在全国多中心健康调查（WOBASZ）框架内，从波兰人群中随机选取了6977名男性和7792名年龄在20 - 74岁之间的女性进行筛查。使用自动设备测量静息心率和血压3次，分析时仅采用第2次和第3次测量的平均值。
在筛查对象中，男性静息心率<60次/分钟的占11%，女性占7%；静息心率>90次/分钟的男性占6%，女性占5%。16%的男性和17%的女性服用了影响心率的药物。男性静息心率与BMI、SBP、DBP、hsCRP、LDL和G相关（p<0.0001），女性静息心率与SBP、DBP、hsCRP和G相关。在调整药物因素后，肥胖、糖尿病、高血压、hsCRP升高者以及吸烟者的男性和女性静息心率均显著升高。肥胖、糖尿病、高血压、hsCRP升高和吸烟习惯的患病率随心率升高而上升，心率>90次/分钟者患病率最高。在多因素逻辑回归模型中，静息心率与高血压、肥胖和糖尿病呈正相关。在男性中，校正年龄、药物及其他因素后，心率每增加10次/分钟，高血压的比值比（OR）为1.28（95%可信区间：1.22 - 1.35），肥胖为1.24（95%可信区间1.17 - 1.30），糖尿病为1.36（95%可信区间：1.26 - 1.48）（女性中，高血压为1.42，肥胖为1.14，糖尿病为1.47）。
静息心率与心血管风险因素（体重指数、血压、血糖和胆固醇水平）以及高hsCRP相关。心率与高血压、肥胖和糖尿病呈正相关，这间接证实了自主神经系统在这些疾病发病机制中的作用。
