Resting heart rate, mortality and future coronary heart disease in the elderly: the 3C study
Resting heart rate, mortality and future coronary heart disease in the elderly: the 3C study
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DOI：
10.1177/1741826710389365
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发表时间：
2011-06-01
影响因子：
--
通讯作者：
Empana, J. P.
中科院分区：
文献类型：
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作者：
Legeai, C.;Jouven, X.;Empana, J. P.
目的：探讨老年人静息心率(RHR)与死亡率和冠心病(CHD)发生率之间的关系。方法：数据来源于法国三城市研究，该研究包括9294名居住在社区的老年受试者，年龄在1999-2001年间，年龄在基线检查时为65岁。研究人群包括7147名参与者(61%的女性)，他们在基线时没有安装起搏器或任何心律失常。使用电子张力计在基线位置用电子张力计测量两次RHR。然后对参与者进行为期6年的血管发病率和死亡率两年一次的跟踪调查。结果：经过6年随访，615例患者死亡，其中17.9%死于心血管疾病。RHR最高五分之一(>；79 bpm)的受试者与最低五分之一(0.10)的受试者相比，总、心血管和非心血管死亡的风险分别增加74%(95%CI，1.3-2.3)、87%(95%CI：0.98-3.6，p=0.06)和72%(95%CI，1.3-2.3)。相反，RHR不能预测冠心病事件(n=228个事件；最高和最低五分之一：HR：1.0；95%CI：0.6-1.5)。结论：在社区老年人中，RHR是死亡率的独立危险标记，但不是发生CHD事件的独立危险标记。它的常规测量可能有助于识别那些在短期内死亡风险增加的人。
Objectives: To investigate the association between resting heart rate (RHR) and mortality and incident coronary heart disease (CHD) in the elderly.Methods: Data derived from the Three-City Study, a French multicentre prospective study including 9294 community-dwelling elderly subjects aged >= 65 years at baseline examination between 1999 and 2001. The study population comprised 7147 participants (61% women) who were free of a pacemaker or any cardiac arrhythmias at baseline. RHR was measured twice at baseline in a seated position using an electronic tensiometer. Participants were then followed up bi-annually for vascular morbidity and mortality over 6 years. CHD events and cardiovascular death were adjudicated by an independent expert committee.Results: After 6 years of follow-up, 615 subjects died including 17.9% from cardiovascular causes. Subjects from the top quintile of RHR (>79 bpm) had respectively a 74% (95% CI, 1.3-2.3), a 87% (95% CI: 0.98-3.6, p=0.06) and a 72% (95% CI, 1.3-2.3) increased risk of total, cardiovascular and non-cardiovascular mortality compared to those from the lowest quintile (0.10). Conversely, RHR was not predictive of incident CHD (n=228 events; top vs lowest quintile: HR: 1.0; 95% CI: 0.6-1.5).Conclusions: RHR is an independent risk marker of mortality but not of incident CHD events in community-dwelling elderly. Its routine measurement may help identify those who are at increased risk of mortality in the short term.