Nocturnal nondipping of heart rate predicts cardiovascular events in hypertensive patients.
Nocturnal nondipping of heart rate predicts cardiovascular events in hypertensive patients.
复制标题
心率的夜间非心率预测高血压患者的心血管事件。
DOI：
10.1097/hjh.0b013e328330a938
复制
发表时间：
2009-11
影响因子：
4.9
通讯作者：
Kario K
中科院分区：
文献类型：
--
作者：
Eguchi K;Hoshide S;Ishikawa J;Pickering TG;Schwartz JE;Shimada K;Kario K
It is not established whether nocturnal non-dipping of heart rate predicts future cardiovascular disease. We performed this study to test the hypothesis that nocturnal non-dipping of heart rate predicts the risk of incident cardiovascular disease (CVD) independent of nocturnal BP dipping pattern. Ambulatory blood pressure monitoring was performed in 457 uncomplicated patients, who were being treated or evaluated for hypertension. They were followed for an average of 72 ± 26 months. Non-dipping heart rate was defined as a night/day heart rate ratio greater than 0.90. We chose two outcomes for this analysis: CVD events (defined as stroke, myocardial infarction, or sudden cardiac death), and all-cause mortality. Cox regression analyses (stepwise method) were used to estimate hazard ratios and their 95%CI, after adjusting for covariates. In univariate analysis, increased sleep heart rate and non-dipping of heart rate were associated with increased risk of CVD and all-cause mortality, but awake heart rate was not. In multivariable analyses, heart rate non-dipping status significantly predicted an increased risk of CVD events (hazard ratio=2.37, 95%CI=1.22–4.62, P=0.01), but not for all-cause mortality. Increased 24-hour heart rate was significantly associated with increased risk of all cause mortality (hazard ratio=1.67, 95%CI=1.11–2.51, P=0.01). The risk of future CVD was shown to be 2.4 times as great in those whose heart rate does not exhibit the typical nocturnal decline. The relationship was independent of non-dipping of SBP and did not dependent on diabetes status or BP level.
