Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Obesity (Silver Spring). 2011 Mar;19(3):618-23. doi: 10.1038/oby.2010.191. Epub 2010 Sep 2.
We did a prospective study to investigate whether clinic heart rate (HR) and 24-h ambulatory HR were independent predictors of subsequent increase in body weight (BW) in young subjects screened for stage 1 hypertension. The study was conducted in 1,008 subjects from the Hypertension and Ambulatory Recording Venetia Study (HARVEST) followed for an average of 7 years. Ambulatory HR was obtained in 701 subjects. Data were adjusted for lifestyle factors and several confounders. During the follow-up BW increased by 2.1 ± 7.2 kg in the whole cohort. Both baseline clinic HR (P = 0.007) and 24-h HR (P = 0.013) were independent predictors of BMI at study end. In addition, changes in HR during the follow-up either measured in the clinic (P = 0.036) or with 24-h recording (P = 0.009) were independent associates of final BMI. In a multivariable Cox regression, baseline BMI (P < 0.001), male gender (P < 0.001), systolic blood pressure (BP) (P = 0.01), baseline clinic HR (P = 0.02), and follow-up changes in clinic HR (P < 0.001) were independent predictors of overweight (Ov) or obesity (Ob) at the end of the follow-up. Follow-up changes in ambulatory HR (P = 0.01) were also independent predictors of Ov or Ob. However, when both clinic and ambulatory HRs were included in the same Cox model, only baseline clinic HR and its change during the follow-up were independent predictors of outcome. In conclusion, baseline clinic HR and HR changes during the follow-up are independent predictors of BW gain in young persons screened for stage 1 hypertension suggesting that sympathetic nervous system activity may play a role in the development of Ob in hypertension.
我们进行了一项前瞻性研究,旨在探讨在筛查出 1 期高血压的年轻人群中,诊所心率(HR)和 24 小时动态 HR 是否为随后体重增加(BW)的独立预测因子。该研究在 Hypertension and Ambulatory Recording Venetia 研究(HARVEST)的 1008 名受试者中进行,平均随访 7 年。在 701 名受试者中获得了动态 HR 数据。数据调整了生活方式因素和几个混杂因素。在随访期间,整个队列的 BW 增加了 2.1 ± 7.2kg。基线诊所 HR(P = 0.007)和 24 小时 HR(P = 0.013)均为研究结束时 BMI 的独立预测因子。此外,随访期间诊所测量的 HR 变化(P = 0.036)或 24 小时记录的 HR 变化(P = 0.009)与最终 BMI 独立相关。在多变量 Cox 回归中,基线 BMI(P < 0.001)、男性(P < 0.001)、收缩压(BP)(P = 0.01)、基线诊所 HR(P = 0.02)和随访期间诊所 HR 的变化(P < 0.001)是随访结束时超重(Ov)或肥胖(Ob)的独立预测因子。动态 HR 的随访变化(P = 0.01)也是 Ov 或 Ob 的独立预测因子。然而,当诊所和动态 HR 均包含在同一个 Cox 模型中时,只有基线诊所 HR 及其在随访期间的变化是结局的独立预测因子。总之,基线诊所 HR 和随访期间的 HR 变化是筛查出 1 期高血压的年轻人 BW 增加的独立预测因子,提示交感神经系统活动可能在高血压中 Ob 的发展中起作用。