Maloberti Alessandro, Tognola Chiara, Fumagalli Stefano, Garofani Ilaria, Algeri Michela, Shkodra Atea, Bellomare Marco, Campana Marta, Busti Andrea, Riccio Alfonso, Facchetti Rita, Grassi Guido, Bombelli Michele, Giannattasio Cristina
School of Medicine and Surgery, University of Milano-Bicocca.
Cardiology 4, ASST GOM Niguarda, Milan.
J Hypertens. 2025 Oct 1;43(10):1686-1694. doi: 10.1097/HJH.0000000000004106. Epub 2025 Jul 24.
The role of resting heart rate (HR) and of its changes over time on the progression of pulse wave velocity (PWV) has not been extensively evaluated. The aim of this study was to investigate this relationship in a population of hypertensive patients in a longitudinal study.
We enrolled 572 hypertensive outpatients aged 18-80, followed by the Hypertension Unit of St. Gerardo Hospital (Monza, Italy). Anamnestic, clinical and laboratory data, BP and PWV were assessed at baseline and after a median follow-up of 3.7 ± 0.5 years.
At baseline, mean age was 53.9 ± 12.7 years, SBP and DBP were 141.2 ± 17.8 and 86.5 ± 10.5 mmHg, HR was 65.6 ± 10.9 bpm and PWV was 8.6 ± 2.0 m/s. Despite an improvement in BP and therapies, at follow-up, a PWV increase (ΔPWV 0.5 ± 2.2 m/s). In patients with higher ΔHR, ΔPWV was significantly higher (0.82 ± 2.22 vs. 0.27 ± 2.25 m/s, P = 0.003). At multivariable stepwise regression, baseline HR showed a significant association with baseline PWV. However, neither HR nor ΔHR was significantly associated with ΔPWV. Same results were confirmed by mediation analysis.
The main result of our study was that despite the presence of a significant association between baseline HR and baseline PWV, neither HR nor ΔHR was significantly associated with PWV progression (ΔPWV). On the contrary, baseline PWV and baseline BP (SBP, DBP, MBP and PP) and their changes during follow-up present significant association with an accelerated process of arterial stiffening.
静息心率（HR）及其随时间的变化对脉搏波速度（PWV）进展的作用尚未得到广泛评估。本研究的目的是在一项纵向研究中调查高血压患者群体中的这种关系。
我们纳入了572名年龄在18 - 80岁的高血压门诊患者，由圣杰拉尔多医院（意大利蒙扎）高血压科进行随访。在基线时以及中位随访3.7±0.5年之后，评估患者的既往史、临床和实验室数据、血压及脉搏波速度。
基线时，平均年龄为53.9±12.7岁，收缩压和舒张压分别为141.2±17.8和86.5±10.5 mmHg，心率为65.6±10.9次/分钟，脉搏波速度为8.6±2.0 m/s。尽管血压和治疗有所改善，但随访时脉搏波速度仍有增加（脉搏波速度变化量为0.5±2.2 m/s）。在心率变化量较高的患者中，脉搏波速度变化量显著更高（0.82±2.22 vs. 0.27±2.25 m/s，P = 0.003）。在多变量逐步回归分析中，基线心率与基线脉搏波速度显著相关。然而，心率及心率变化量均与脉搏波速度变化量无显著关联。中介分析证实了相同的结果。
我们研究的主要结果是，尽管基线心率与基线脉搏波速度之间存在显著关联，但心率及心率变化量均与脉搏波速度进展（脉搏波速度变化量）无显著关联。相反，基线脉搏波速度和基线血压（收缩压、舒张压、平均血压和脉压）及其随访期间的变化与动脉僵硬度加速进程显著相关。
