Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study
Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study
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DOI：
10.1136/bmjopen-2019-032699
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发表时间：
2020-03-01
期刊：
影响因子：
2.9
通讯作者：
Wu, Shouling
中科院分区：
文献类型：
--
作者：
Zhao, Mao Xiang;Zhao, Quanhui;Wu, Shouling
目的以往研究表明，心率升高与心血管事件的风险增加有关。本研究旨在前瞻性地研究中国高血压患者静息心率（RHR）与全因死亡率之间的关系。前瞻性和基于人群的队列研究。设置开滦队列研究在中国北方的唐山市进行。参与者我们招募了46561例未接受β-2006年和2008年在开滦集团进行的员工健康检查中首次被诊断为高血压。结果本研究的主要结局是所有患者-方法本研究中的患者随访9.25 +/- 1.63年。所有患者每2年随访一次。根据RHR在研究人群中的分布，将RHR按五分位数分为五组：Q1：RHR 68和>72 bpm; Q3：RHR >72和76和82 bpm。采用考克斯比例风险模型，对传统的危险因素进行调整。校正潜在混杂因素后，限制性三次样条回归显示全因死亡率的风险随心率增加而增加。多因素考克斯回归分析结果显示，高血压患者全因死亡的危险比（HR）为1.31（95%CI 1.27 ~ 1.33）。
Objective Previous studies have shown that an elevated heart rate is associated with a higher risk of cardiovascular events. This study aimed to prospectively examine the relationship between resting heart rate (RHR) and all-cause mortality in Chinese patients with hypertension.Design An observational, prospective and population-based cohort study.Setting The Kailuan cohort study was conducted in Tangshan City in northern China.Participants We enrolled 46 561 patients who did not receive beta-blocker treatment and were diagnosed with hypertension for the first time during an employee health examination in Kailuan Group in 2006 and 2008.Outcome The primary outcome of this study was all-cause mortality.Methods The patients in this study were followed for 9.25 +/- 1.63 years. All patients were followed up face to face every 2 years. According to the distribution of RHR in the study population, RHR was categorised into five groups on the basis of quintiles: Q1: RHR 68 and >72 bpm; Q3: RHR >72 and 76 and 82 bpm. Cox proportional hazards model, which was adjusted for traditional risk factors, was used.Results During follow-up, 4751 deaths occurred. After adjustment for potential confounders, restricted cubic spline regression showed that the risk of all-cause mortality increased with heart rate. In multivariate Cox regression analyses adjusted for age, sex and major covariates, the HR for all-cause mortality was 1.31 (95% CI 1.27 to 1.33) in the highest quintile group (Q5) compared with the lowest quintile group (Q1).Conclusion An increase in RHR is a long-term risk factor of all-cause mortality in Chinese patients with hypertension.