Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all-cause mortality in men with diabetes
Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all-cause mortality in men with diabetes
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DOI：
10.2337/diacare.26.7.2052
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发表时间：
2003-07-01
期刊：
影响因子：
16.2
通讯作者：
Blair, SN
中科院分区：
文献类型：
--
作者：
Cheng, YLJ;Lauer, MS;Blair, SN
目的：心率恢复(HRR)是健康男性心血管疾病(CVD)和全因死亡率的独立预后指标。研究设计和方法：在这项队列研究中，我们检查了2333名有病史的糖尿病患者(平均年龄49.4岁)，他们在德克萨斯州达拉斯的库珀诊所进行了极量运动后5分钟的HRR基线测量(心率(峰值)-心率(5分钟恢复))。我们确定HRR四分位数为每分钟175次四分位。心血管疾病和全因死亡的危险比(HR)根据年龄、心肺健康状况、静息心率、空腹血糖、体重指数、吸烟习惯、饮酒、总胆固醇、甘油三酯和心血管病病史进行了调整。结果：在14.9年的中位随访期内，142例死亡被认为与心血管疾病相关，287例死亡。与HRR最高四分位数的男性相比，调整后的第一、第二和第三四分位数的心血管死亡比率分别为2.0(95%Cl1.1-3.8)15(0.8-2.7)和1.5(0.9-2.8)(P为Trend<；0.001)。同样，对于全因死亡，调整后的第一、第二和第三四分位数的HR分别为2.01.3-3.21.5(1.0-2.3)和1.5(1.1-2.3)(趋势与趋势0.001)。结论--在糖尿病患者中，即使在恢复后5分钟测量的HRR降低，也可以独立地预测心血管疾病和全原因死亡。
OBJECTIVE - Heart rate recovery (HRR) is an independent prognostic indicator for cardiovascular disease (CVD) and all-cause mortality in healthy men. We examined the association of HRR to CVD-related and all-cause mortality in men with diabetes.RESEARCH DESIGN AND METHODS - in this cohort study we examined 2,333 men with documented diabetes (mean age 49.4 years) that had baseline 5-min HRR measurement following maximal exercise (heart rate(peak) - heart rate(5) min of recovery) at The Cooper Clinic, Dallas, TX. We identified HRR quartiles as quartile 1 75 bpm. Hazard ratios (HRs) for cardiovascular and all-cause death were adjusted for age, cardiorespiratory fitness, resting heart rate, fasting blood glucose, BMI, smoking habit, alcohol consumption, total cholesterol, triglyceride, and history of CVD at baseline.RESULTS - During a median of 14.9 years follow-up, there were 142 deaths that were considered CVD related and 287 total deaths. Compared with men in the highest quartile of HRR, adjusted HRs in the first, second, and third quartiles were 2.0 (95% Cl 1.1-3.8) 1 5 (0.8-2.7), and 1.5 (0.9-2.8), respectively, for cardiovascular death (P for trend < 0.001). Similarly, for all-cause death, adjusted HRs in the first, second, and third quartiles were 2.0 (1.3-3.2), 1.5 (1.0-2.3), and 1.5 (1.1-2.3) (P for trend < 0.001).CONCLUSIONS - Among men with diabetes, a decreased HRR, even measured as long as 5 min after recovery, was independently predictive of cardiovascular and all-cause death.