静息心率与新发高血压的关系  

Relationship between resting heart rate and new-onset hypertension

作　　者：高竞生[1] 刘小雪[2] 王安心[3] 郑晓明[1] 吴云涛[1] 赵海燕[1] 赵晓红[1] 魏国清[1] 吴寿岭[1] 

机构地区：[1]河北联合大学附属开滦医院心内科,河北唐山063000 [2]河北联合大学研究生学院 [3]首都医科大学附属北京天坛医院神经内科

出　　处：《中华高血压杂志》2014年第4期347-352,共6页Chinese Journal of Hypertension

摘　　要：目的探讨中国北方非糖尿病人群中静息心率与新发高血压(NOH)的关系。方法采用前瞻性队列研究方法,以参加2006-2007年度开滦集团职工健康体检的职工101 510人中收缩压<140 mm Hg(1 mm Hg=0.133kPa)和舒张压<90mm Hg、无高血压病史、未使用降压药物且血压测量资料完整及空腹血糖<7.0mmol/L、无糖尿病病史、未使用降糖药物及静息心率测量资料完整的职工49 290人作为观察队列。排除未参加2008-2009或2010-2011年度体检以及血压资料缺失者,最终纳入统计分析29 680人。依据2006-2007年度静息心率测量值将观察对象分为静息心率<67、67~<71、71~<78、≥78次/min共4组,采用多因素Cox风险回归模型分析静息心率与NOH的关系。结果入选者平均随访(3.5±0.9)年。静息心率<67、67~<71、71~<78、≥78次/min组高血压的发病密度分别为102.2、107.2、112.1、120.3/1000人年。4组男性和女性高血压发病密度分别为116.3、124.5、132.5、139.4/1000人年和60.5、63.6、65.1、68.9/1000人年。影响NOH的多因素Cox回归模型分析显示,校正了年龄、性别、收缩压、舒张压、体质量指数、空腹血糖、三酰甘油、总胆固醇、高敏C反应蛋白、高密度脂蛋白胆固醇、吸烟、饮酒、高血压家族史后,与静息心率<67次/min组比较,67~<71、71~<78、≥78次/min组NOH发病风险增加,HR值(95%CI)分别为1.07(1.01~1.13)、1.08(1.02~1.14)、1.15(1.09~1.22)。在不同性别人群校正上述因素后,心率对女性NOH的影响不再有统计学意义,但仍增加男性NOH的发病风险。结论静息心率加快者未来发生高血压的风险增加,在男性中更加显著。Objective To investigate the relationship between resting heart rate（RHR） and new-onset hypertension （NOH） in the non-diabetic population in northern China. Methods There were 101 510 employees in the Kailuan Group who took part in the 2006--2007 health examination. In this prospective cohort study, 49 290 subjects from the above employees with no history of hypertension and diabetes, without the administration of hypoglycemic agents or anti-hypertension drugs, with complete data from physical examinations of systolic blood pressure, diastolic blood pressure and RHR, and with a fasting blood glucose level^7.0 retool/L, systolic blood pressure^140 mm Hg, and diastolic blood pressure^90 mm Hg were selected. A total of 29 680 participants were enrolled for the ultimate a- nalysis after those were excluded who did not participate in the 2008--2009 or 2010--2011 health examination and had no complete information on blood pressure. According to the RHR data collected in the 2006-- Z007 health ex- amination, those subjects were divided into 4 groups： RHR〈67, 67-〈71, 71-〈78 and ≥78 beat/rain group, respectively. Multivariate Cox proportional hazard regression model was assumed for analyzing the relationship be- tween RHR and NOH. Results The mean follow-up period for all the cases was （3.5±0.9） years. The inci- dence density of NOH in RHR〈67, 67-〈71, 71-〈78 and ≥78 beat/min group were 102.2, 107.2, 112.1 and 120.3 per 1000 person-years, respectively. Furthermore, the corresponding incidence density for men and women in the four groups were 116.3, 124.5, 132.5, 139.4 and 60.5, 63.6, 65.1, 68.9 per 1000 person-years, respec- tively. Multivariate Cox regression model analysis showed that compared with RHR^67 beat/min group, the other three RHR groups had an increased risk of NOH after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, body mass index, fastingblood glucose and other risk factors. The hazard ratios （95% CI） for 67-〈71, 71- 〈78 and ≥78 beat/m

关 键 词：静息心率 新发高血压 交感神经活性 

分 类 号：R544.1[医药卫生—心血管疾病]