Dipartimento di Medicina, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Curr Hypertens Rep. 2013 Jun;15(3):253-9. doi: 10.1007/s11906-013-0342-7.
Resting heart rate is a well recognized marker of autonomic nervous system tone, and in many population studies has been found to be a significant correlate of blood pressure, increased body mass index, and metabolic disturbances. This association is particularly striking in patients with hypertension or diabetes, and cardiovascular morbidity related to high heart rate in these conditions seems to depend mainly on the clustering of these risk factors. The prospective relationship between tachycardia and metabolic abnormalities found in longitudinal studies indicates that the adrenergic overdrive is the cause rather than the consequence of the insulin resistance state. Findings from observational studies and clinical trials have shown that heart rate measured during the follow-up provides prognostic information over and above heart rate measured at baseline, whereas the predictive value of heart rate measured out of the office is still debated. Antihypertensive drugs that decrease blood pressure and heart rate through a reduction of the sympathetic outflow may be more beneficial in clinical situations characterized by heightened sympathetic activity associated to insulin resistance.
静息心率是自主神经系统张力的一个公认标志物，在许多人群研究中，它被发现与血压、体重指数增加和代谢紊乱有显著相关性。这种相关性在高血压或糖尿病患者中尤为明显，而这些情况下与高心率相关的心血管发病率似乎主要取决于这些危险因素的聚集。在纵向研究中发现的心动过速与代谢异常之间的前瞻性关系表明，肾上腺素能亢进是胰岛素抵抗状态的原因而不是后果。观察性研究和临床试验的结果表明，在随访期间测量的心率提供了比基线时测量的心率更有预后价值的信息，而在办公室外测量的心率的预测价值仍存在争议。通过减少交感神经输出来降低血压和心率的降压药物在与胰岛素抵抗相关的交感神经活动增强的临床情况下可能更有益。
