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[静息心率对高血压前期患者进展为高血压的影响]

[Impact of resting heart rate on the progression to hypertension in prehypertension patients].

作者信息

Ji Chunpeng, Zheng Xiaoming, Chen Shuohua, Dong Yan, Yang Guang, Gao Xinying, Tao Jie, Wu Shouling

机构信息

Hebei United University Graduate School, Tangshan 063000, China.

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出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Oct;42(10):860-5.

Abstract

OBJECTIVE

To observe the effect of resting heart rate (RHR) on the progression to hypertension in patients with prehypertension.

METHODS

People who participated the physical examination between 2006 and 2007 at Kailuan medical group and diagnosed as prehypentension were selected as the observation cohort. The second and the third physical examination were conducted between 2008 and 2009 and between 2010 and 2011. The observation population was divided into five groups according to the different levels of RHR at baseline: the first group ( ≤69 beats/min), the second group (70-74 beats/min), the third group (75-79 beats/min), the fourth group (80-84 beats/min) and the fifth group ( ≥85 beats/min). The rate of the progression to hypertension was compared among five groups, and the relationship between RHR and the progression to hypertension was estimated using Cox proportional hazard analysis.

RESULTS

A total of 34 512 patients with prehypentension were recruited and 25 392 patients were involved in the final statistics after excluding patients who died or were lost to follow-up. A total of 13 228 (52.1%) patients with prehypentension developed hypertension during follow-up. The rate of the progression to hypertension increased with the RHR (first group: 51.2%, second group: 50.1%, third group: 52.9%, fourth group: 53.5%, fifth group: 57.5%). Multiple Cox regression models showed that the risk of the progression to hypertension increased with the RHR levels. Patients in the fifth group carried 1.25 times higher risk for developing hypertension than patients in the second group after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood glucose, serum uric acid, C-reactive protein, smoking, drinking, physical exercise and family history of hypertension at baseline.

CONCLUSION

Elevated RHR is an independent risk factor for the progression to hypertension in patients with prehypertension.

摘要

目的

观察静息心率(RHR)对高血压前期患者进展为高血压的影响。

方法

选取2006年至2007年在开滦医疗集团参加体检且被诊断为高血压前期的人群作为观察队列。在2008年至2009年以及2010年至2011年进行第二次和第三次体检。根据基线时不同的RHR水平将观察人群分为五组:第一组(≤69次/分钟)、第二组(70 - 74次/分钟)、第三组(75 - 79次/分钟)、第四组(80 - 84次/分钟)和第五组(≥85次/分钟)。比较五组中进展为高血压的发生率,并使用Cox比例风险分析评估RHR与进展为高血压之间的关系。

结果

共招募了34512例高血压前期患者,排除死亡或失访患者后,25392例患者纳入最终统计。共有13228例(52.1%)高血压前期患者在随访期间进展为高血压。进展为高血压的发生率随RHR升高而增加(第一组:51.2%,第二组:50.1%,第三组:52.9%,第四组:53.5%,第五组:57.5%)。多重Cox回归模型显示,进展为高血压的风险随RHR水平升高而增加。在对年龄、性别、收缩压、舒张压、腰围、体重指数、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、血尿酸、C反应蛋白、吸烟、饮酒、体育锻炼和高血压家族史进行基线调整后,第五组患者发生高血压的风险比第二组患者高1.25倍。

结论

RHR升高是高血压前期患者进展为高血压的独立危险因素。

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