Heart Rate and Blood Pressure: “Connecting the Dots” in Epidemiology and Pathophysiology

Kouvas, Nikos; Tsioufis, Costas; Vogiatzakis, N.; Sanidas, Elias; Konstantinidis, D.; Kintis, Konstantinos; Dimitriadis, Kyriakos; Kakosaiou, Zoi; Tsioufis, Panagiotis; Kouremeti, M.; Katsiki, Niki; Tousoulis, Dimitrios

doi:10.1177/0003319717746524

Cited by 6 publications

(3 citation statements)

References 55 publications

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“…22 These results may be partially explained by HR being inversely related to central SBP. 28,29 Although SBP in our current and abovementioned studies was measured peripherally, the near-linear relationship between peripheral SBP and central SBP may also affect the relationship between HR and peripheral SBP. 30 In addition, as observed in this study, their relationship may also be affected by confounding factors such as triglyceride levels.…”

Section: Discussionmentioning

confidence: 80%

Potential Mediators of Causal Associations of Circulating Triglycerides With Blood Pressure: Evidence From Genetic and Observational Data

Liu

et al. 2022

Hypertension

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Background: Existing evidence indicates that elevated triglycerides may affect blood pressure, but the underlying mechanisms are not fully understood. Herein, we aim to identify the intermediaries of associations of triglyceride with systolic blood pressure and diastolic blood pressure using the Mendelian randomization (MR) framework. Methods: Triglyceride-associated single nucleotide polymorphisms were extracted and used to match phenotypes in PhenoScanner. From the broad spectrum of possible triglyceride-associated traits, potential mediators linking triglyceride to blood pressure were screened out by MR and MR-based mediation analysis. Moreover, cross-sectional observational data of 206 341 adults were used to validate the mediators identified at the genetic level. Results: Among the nearly 100 raw phenotypes matched by 313 triglyceride-associated single nucleotide polymorphisms, 39 traits were filtered and integrated into subsequent analysis. By further filtering using MR analysis, only pulse rate and lymphocyte count (LC) were identified as independent mediators. MR-based mediation analysis showed that genetically predicted LC could mediate 9.2% of the association of triglyceride with systolic blood pressure; genetically predicted pulse rate and LC could mediate 18.3% and 17.6% of the association of triglyceride with DBP, respectively. Observational data also support the mediating role of pulse rate and LC. Conclusions: The current findings highlighted the mediating role of pulse rate and LC on the causal pathway from triglyceride to blood pressure and may contribute to a better understanding of the pathogenic mechanism by which high triglyceride affects other cardiometabolic factors.

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Section: Discussionmentioning

confidence: 80%

Potential Mediators of Causal Associations of Circulating Triglycerides With Blood Pressure: Evidence From Genetic and Observational Data

Liu

et al. 2022

Hypertension

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“… 36 HR is independently correlated with arteriolar lesion sclerosis and cohort studies have shown that hypertensive patients with a high resting HR have an increased risk of all-cause and cardiovascular death. 37 , 38 Apart from age, MHR was the second most important factor in our prediction model. A possible explanation for our optimized model was that influencing factors associated with high blood pressure also led to pathological manifestations.…”

Section: Discussionmentioning

confidence: 99%

A Nomogram for Predicting the Risk of Critical Limb Ischemia in Adults with Hypertension: A Retrospective Study

Xu¹,

Zhu²,

Huo³

et al. 2022

IJGM

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Purpose Peripheral arterial disease (PAD) presenting with underlying hypertension (HTN) poses a higher risk of bilateral lower limb amputation than PAD patients without HTN. While the role of HTN management of PAD patients has received limited attention. We analyzed the clinical characteristics of PAD in adults with HTN and explored risk factors for PAD to construct a nomogram for evaluating critical limb ischemia (CLI) and lesion severity. Methods Patients and Methods Between January 2014 and December 2019, we retrospectively evaluated 1886 patients with peripheral artery disease with coexisting HTN. Patients were randomly divided into training (n = 1320, 70%) and validation cohorts (n = 566, 30%), and according to the subjective experience of PAD [Fontaine classification (I–II vs III–IV)], patients were further classified into intermittent claudication (IC) and CLI groups. LASSO regression and multivariate Cox proportional hazard analyses were used to construct a nomogram using variables defined in the training cohort, which was validated in the validation cohort. The evaluation of the predictive discriminative, accuracy and clinical application are further analyzed. Results In the training cohort, optimal independent factors included age, male sex, body mass index, diabetes mellitus, heart rate, triglyceride, and uric acid (AM-BDHTU), which were included in the nomogram predicting the CLI risk (all P < 0.05). The C-index values for CLI risk in PAD with HTN patients were 0.729 (95% CI: 0.704–0.807) and 0.728 (95% CI: 0.652–0.744) in the training and validation sets, respectively. Calibration curves indicated good consistency between predicted and actual outcomes. DCA confirmed the clinical utility of the diagnostic model. Conclusion The AM-BDHTU nomogram, constructed and validated using simple to obtain clinical variables, when combined with the Fontaine classification, effectively predicts the risk of CLI among PAD patients with HTN.

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“…HTN is one of the major risk factors that contribute to cardiovascular and kidney diseases, also being a leading cause of premature mortality [ 3 ]. The poor prognosis of hypertensive patients is not only related to poor-controlled blood pressure, but also closely related to an increased heart rate [ 4 ]. An increased heart rate is associated with new heart failure [ 5 ] and all-cause and cardiovascular deaths [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Dietary Fiber (Oat Bran) Supplement in Heart Rate Lowering in Patients with Hypertension: A Randomized DASH-Diet-Controlled Clinical Trial

Zhang

et al. 2022

Nutrients

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(1) Background: The management goal for patients with essential hypertension (HTN) is not only to lower blood pressure (BP), but also to control increased heart rate (HR). In a previous study, it was found that dietary fiber (DF) supplementation can effectively reduce BP in patients with HTN. The aim of this study was to determine whether a DF supplement can lower HR in patients with HTN. (2) Methods: Seventy patients who met the inclusion and exclusion criteria were randomly allocated into the control group (n = 34) and the intervention group (n = 36). The regular DASH dietary care was delivered to both groups of patients. In addition, one bag of oat bran (30 g/d, containing DF 8.9 g) was delivered to the intervention group. The 24 h ambulatory heart rate was measured at baseline and 3 months. (3) Results: At 3 months, the 24 h maximum heart rate (24h maxHR) in the intervention group was significantly lower than that in the control group. After the intervention, within-group comparisons in the intervention group revealed that there were significant reductions in the 24 h average heart rate (24h aveHR), 24h maxHR, average heart rate during day time (D-aveHR), minimum heart rate during day time (D-minHR), and maximum heart rate during day time (D-maxHR). Similar differences were not found in the control group. (4) Conclusions: Dietary fiber (oat bran) supplementation might be beneficial in lowering HR in patients with HTN.

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Heart Rate and Blood Pressure: “Connecting the Dots” in Epidemiology and Pathophysiology

Cited by 6 publications

References 55 publications

Potential Mediators of Causal Associations of Circulating Triglycerides With Blood Pressure: Evidence From Genetic and Observational Data

Potential Mediators of Causal Associations of Circulating Triglycerides With Blood Pressure: Evidence From Genetic and Observational Data

A Nomogram for Predicting the Risk of Critical Limb Ischemia in Adults with Hypertension: A Retrospective Study

Effect of Dietary Fiber (Oat Bran) Supplement in Heart Rate Lowering in Patients with Hypertension: A Randomized DASH-Diet-Controlled Clinical Trial

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