Predictive value of night-time heart rate for cardiovascular events in hypertension. the ABP-international study

Paolo Palatini, Gianpaolo Reboldi, Lawrence J. Beilin, Kazuo Eguchi, Yutaka Imai, Kazuomi Kario, Takayoshi Ohkubo, Sante D. Pierdomenico, Francesca Saladini, Joseph E. Schwartz, Lindon Wing, Paolo Verdecchia

研究成果: Article査読

42 被引用数 (Scopus)

抄録

Background: Data from prospective cohort studies regarding the association between ambulatory heart rate (HR) and cardiovascular events (CVE) are conflicting. Methods: To investigate whether ambulatory HR predicts CVE in hypertension, we performed 24-hour ambulatory blood pressure and HR monitoring in 7600 hypertensive patients aged 52±16 years from Italy, U.S.A., Japan, and Australia, included in the 'ABP-International' registry. All were untreated at baseline examination. Standardized hazard ratios for ambulatory HRs were computed, stratifying for cohort, and adjusting for age, gender, blood pressure, smoking, diabetes, serum total cholesterol and serum creatinine. Results: During a median follow-up of 5.0 years there were 639 fatal and nonfatal CVE. In a multivariable Cox model, night-time HR predicted fatal combined with nonfatal CVE more closely than 24 h HR (p=0.007 and =0.03, respectively). Daytime HR and the night:day HR ratio were not associated with CVE (p=0.07 and=0.18, respectively). The hazard ratio of the fatal combinedwith nonfatal CVE for a 10-beats/min increment of the night-time HR was 1.13 (95% CI, 1.04-1.22). This relationship remained significant when subjects taking beta-blockers during the follow-up (hazard ratio, 1.15; 95% CI, 1.05-1.25) or subjects who had an event within 5 years after enrollment (hazard ratio, 1.23; 95% CI, 1.05-1.45) were excluded from analysis. Conclusions: At variance with previous data obtained from general populations, ambulatory HR added to the risk stratification for fatal combined with nonfatal CVE in the hypertensive patients from the ABP-International study. Night-time HR was a better predictor of CVE than daytime HR.

本文言語English
ページ(範囲)1490-1495
ページ数6
ジャーナルInternational Journal of Cardiology
168
2
DOI
出版ステータスPublished - 2013 9 30

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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