Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China.
Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Hypertens Res. 2023 Feb;46(2):321-329. doi: 10.1038/s41440-022-01076-y. Epub 2022 Oct 24.
The joint effect of blood pressure (BP) and heart rate (HR) on cardiovascular disease is unclear. Rate pressure product (RPP), the product of systolic BP and HR, is assessed in this study. This study aimed to determine the longitudinal patterns of RPP from childhood to adulthood and to explore the relationship between RPP trajectories in early life and left ventricular hypertrophy (LVH) in midlife. We included individuals with 3 or more RPP values from 7 visits over a 30-year follow-up period in the Hanzhong Adolescent Hypertension Study cohort to fit trajectory groups and performed logistic regression to evaluate the relative risk of developing LVH. Three discrete trajectories in RPP were identified among 2412 participants assessed from childhood to middle-aged adulthood, which were tagged as "low stable," "moderate stable," and "moderate increasing". A higher waist-to-hip ratio, smoking, alcohol consumption, hypertension, diabetes, and hyperlipidemia were associated with increased RPP trajectories. The Cornell voltage product was positively correlated with RPP in 2017 and was higher in the moderate-stable and moderate-increasing groups than in the low-stable group in RPP trajectories. Compared with the low-stable group, the ORs of LVH were 1.65 (1.13, 2.92) for the moderate-stable and 3.56 (2.26, 5.44) for the moderate-increasing group. Subjects with moderate-stable and moderate-increasing trajectories showed higher probabilities of LVH at an elderly age than those in the low stable trajectory group even after adjusting for multiple cardiovascular risk factors. RPP trajectories are identifiable from childhood and are associated with LVH in midlife. Monitoring RPP trajectories from early life may be an effective approach to predict cardiovascular health status later in life.
血压（BP）和心率（HR）对心血管疾病的联合影响尚不清楚。本研究评估了收缩压（BP）和 HR 的乘积——心率血压乘积（RPP）。本研究旨在确定 RPP 从儿童期到成年期的纵向变化模式，并探讨生命早期 RPP 轨迹与中年左心室肥厚（LVH）之间的关系。我们纳入了汉中青少年高血压研究队列中 30 年随访期间有 3 次或以上 RPP 值的 2412 名参与者，以拟合轨迹组，并进行逻辑回归评估发生 LVH 的相对风险。在从儿童期到成年中期评估的 2412 名参与者中，确定了 3 种离散的 RPP 轨迹，分别标记为“低稳定”、“中稳定”和“中升高”。较高的腰围-臀围比、吸烟、饮酒、高血压、糖尿病和高脂血症与 RPP 轨迹增加相关。2017 年，康奈尔电压乘积与 RPP 呈正相关，在 RPP 轨迹中，中稳定组和中升高组高于低稳定组。与低稳定组相比，中稳定组的 LVH 比值比（OR）为 1.65（1.13，2.92），中升高组为 3.56（2.26，5.44）。与低稳定轨迹组相比，中稳定和中升高轨迹组的受试者在老年时发生 LVH 的可能性更高，即使在调整了多个心血管危险因素后也是如此。从儿童时期开始，RPP 轨迹是可识别的，与中年时的 LVH 相关。从生命早期开始监测 RPP 轨迹可能是预测生命后期心血管健康状况的有效方法。
