Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Hypertension. 2013 Sep;62(3):477-84. doi: 10.1161/HYPERTENSIONAHA.113.01605. Epub 2013 Jul 8.
Resting heart rate is an easily measured, noninvasive vital sign that is associated with cardiovascular disease events. The pathophysiology of this association is not known. We investigated the relationship between resting heart rate and stiffness of the carotid (a peripheral artery) and the aorta (a central artery) in an asymptomatic multi-ethnic population. Resting heart rate was recorded at baseline in the Multi-Ethnic Study of Atherosclerosis (MESA). Distensibility was used as a measure of arterial elasticity, with a lower distensibility indicating an increase in arterial stiffness. Carotid distensibility was measured in 6484 participants (98% of participants) using B-mode ultrasound, and aortic distensibility was measured in 3512 participants (53% of participants) using cardiac MRI. Heart rate was divided into quintiles and we used progressively adjusted models that included terms for physical activity and atrioventricular nodal blocking agents. Mean resting heart rate of participants (mean age, 62 years; 47% men) was 63 bpm (SD, 9.6 bpm). In unadjusted and fully adjusted models, carotid distensibility and aortic distensibility decreased monotonically with increasing resting heart rate (P for trend <0.001 and 0.009, respectively). The relationship was stronger for carotid versus aortic distensibility. Similar results were seen using the resting heart rate taken at the time of MRI scanning. Our results suggest that a higher resting heart rate is associated with an increased arterial stiffness independent of atrioventricular nodal blocker use and physical activity level, with a stronger association for a peripheral (carotid) compared with a central (aorta) artery.
静息心率是一种易于测量的、非侵入性的生命体征，与心血管疾病事件有关。其相关的病理生理学尚不清楚。我们在一个无症状的多民族人群中研究了静息心率与颈动脉（外周动脉）和主动脉（中央动脉）僵硬之间的关系。静息心率在动脉粥样硬化多民族研究（MESA）的基线时记录。顺应性被用作动脉弹性的衡量标准，较低的顺应性表明动脉僵硬增加。颈动脉顺应性在 6484 名参与者（98%的参与者）中使用 B 型超声进行测量，主动脉顺应性在 3512 名参与者（53%的参与者）中使用心脏 MRI 进行测量。心率被分为五组，我们使用逐步调整的模型，包括体力活动和房室结阻滞剂的术语。参与者的平均静息心率（平均年龄为 62 岁，47%为男性）为 63 次/分（SD，9.6 次/分）。在未调整和完全调整的模型中，颈动脉顺应性和主动脉顺应性随着静息心率的增加而呈单调下降趋势（趋势 P 值均<0.001 和 0.009）。颈动脉顺应性与主动脉顺应性的关系更强。使用 MRI 扫描时的静息心率也得到了类似的结果。我们的结果表明，静息心率较高与动脉僵硬增加有关，独立于房室结阻滞剂的使用和体力活动水平，与外周（颈动脉）相比，中央（主动脉）动脉的相关性更强。
