Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Tangshan People's Hospital, Tangshan, Hebei, China.
Heart. 2015 Jan;101(1):44-9. doi: 10.1136/heartjnl-2014-305685. Epub 2014 Sep 1.
Although higher resting heart rate (RHR) has emerged as a predictor for lifespan, the underlying mechanisms remain obscure. The present study investigates whether a positive relationship exists between RHR and metabolic syndrome (MetS) and whether RHR predicts future MetS.
A cohort of 89,860 participants were surveyed during 2006-2007 in Kailuan/Tangshan, China. MetS was diagnosed when a participant presented at least three of the following: abdominal adiposity, low high density lipoprotein-cholesterol, high triglycerides, hypertension or impaired fasting glucose. RHR was derived from ECG recordings and subjects were stratified based on RHR. Some participants without MetS at baseline were followed-up for 4 years.
At baseline, 23,150 participants (25.76%) had MetS. There was a positive association between RHR and MetS. The OR of having MetS was 1.49 (95% CI 1.32 to 1.69) in subjects with RHR at 95-104 compared with those at 55-64 beats per minute (bpm) (reference), after adjusting for variables including age, sex, education, cigarette smoking, alcohol drinking, physical activities, body mass index, hypertension, diabetes, hyperlipidaemia, inflammatory biomarkers and renal function. More importantly, when 43,725 individuals from the original study without MetS at baseline were followed-up, higher RHR was found to predict greater risk of MetS incidence. The OR of developing MetS 4 years later was 1.41 (95% CI 1.21 to 1.65) in subjects with RHR at 95-104 bpm compared with reference, after all adjustments.
Our cross-sectional and longitudinal findings provide evidence that RHR is an independent risk factor for existing MetS and a powerful predictor for future incidence of MetS.
尽管较高的静息心率(RHR)已成为预测寿命的指标,但潜在机制尚不清楚。本研究旨在探讨 RHR 与代谢综合征(MetS)之间是否存在正相关关系,以及 RHR 是否可预测未来 MetS 的发生。
在中国开滦/唐山地区,于 2006-2007 年对 89860 名参与者进行了调查。当参与者至少存在以下三种情况时,即可诊断为 MetS:腹部肥胖、低高密度脂蛋白胆固醇、高甘油三酯、高血压或空腹血糖受损。RHR 源自心电图记录,参与者根据 RHR 进行分层。一些基线时无 MetS 的参与者进行了 4 年的随访。
基线时,23150 名参与者(25.76%)患有 MetS。RHR 与 MetS 呈正相关。与 RHR 在 55-64 次/分钟(参考)的参与者相比,RHR 在 95-104 次/分钟的参与者发生 MetS 的 OR 为 1.49(95%CI 1.32-1.69),调整了年龄、性别、教育程度、吸烟、饮酒、体力活动、体重指数、高血压、糖尿病、高脂血症、炎症生物标志物和肾功能等变量后,结果仍然具有统计学意义。更重要的是,当对原始研究中基线时无 MetS 的 43725 名参与者进行随访时,发现较高的 RHR 预示着发生 MetS 的风险更高。与参考相比,RHR 在 95-104 次/分钟的参与者在 4 年后发生 MetS 的 OR 为 1.41(95%CI 1.21-1.65),调整所有因素后,结果仍然具有统计学意义。
本研究的横断面和纵向研究结果均表明,RHR 是现有 MetS 的独立危险因素,也是未来 MetS 发生的有力预测指标。