Predictive value of ambulatory heart rate in the Japanese general population: the Ohasama study
Predictive value of ambulatory heart rate in the Japanese general population: the Ohasama study
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DOI：
10.1097/hjh.0b013e3283041172
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发表时间：
2008-08-01
影响因子：
4.9
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Hozawa, Atsushi;Inoue, Ryusuke;Imai, Yutaka
静息心率可以预测心血管疾病死亡率或全因死亡率。由于警惕性反应的影响，在办公室外测量的心率应该比在诊所获得的心率具有更好的预测能力。然而，只有少数研究描述了动态血压监测装置测量的心率与心血管疾病预测之间的关系。方法我们研究了1444名日本普通人群，他们没有心血管疾病史，包括心律失常。我们使用多重校正Cox比例风险来计算白天心率、夜间心率和昼夜心率下降比[昼夜心率下降比=（白天心率-夜间心率）/白天心率× 100]的死亡风险。经过12年的随访，分别有101名、195名和296名参与者死于心血管疾病、非心血管疾病和所有原因。其他研究表明，白天和夜间的心率都不能预测心血管疾病的死亡率，而两者都能预测非心血管疾病的死亡率。昼夜心率下降比与全因死亡率显著相关。当夜间心率和昼夜心率下降比同时纳入同一Cox模型时，只有夜间心率能显著且独立地预测全因死亡率（每10 bpm增加的相对危险度= 1.29,95%可信区间为1.07 - 1.54）。结论夜间心率值似乎是该人群动态心率参数中最重要的全因死亡率预测指标。
Background Resting heart rate can predict cardiovascular disease mortality or all-cause mortality. Because of the effect of the alert reaction, heart rates measured out-of-office should have better predictive power than those obtained at clinics. However, only a few studies have described the relationship between heart rate measured by ambulatory blood pressure monitoring devices and cardiovascular disease prediction.Methods We studied 1444 individuals from the Japanese general population who did not have a history of cardiovascular diseases including arrhythmia. We used multiple adjusted Cox proportional hazards to calculate the mortality risk of daytime heart rate, night-time heart rate, and the day - night heart rate dip ratio [ day - night heart rate dip ratio=(daytime heart rate-night-time heart rate)/daytime heart rate x 100].Results After 12 years of follow-up, 101, 195, and 296 participants died due to cardiovascular diseases, noncardiovascular diseases, and all causes, respectively. As shown by others, neither daytime nor night-time heart rate predicted cardiovascular disease mortality, whereas both predicted noncardiovascular disease mortality. The day night heart rate dip ratio was significantly related to all-cause mortality. When night-time heart rate and day-night heart rate dip ratio were simultaneously included into the same Cox model, only night-time heart rate significantly and independently predicted all-cause mortality ( relative hazard per 10 bpm increase = 1.29, 95% confidence interval, 1.07 - 1.54).Conclusion Night-time heart rate value seems to have the most important predictor of all-cause mortality among ambulatory heart rate parameters in this population.