Higher Heart Rate Predicts the Risk of Developing Hypertension in a Normotensive Screened Cohort

Abstract

ypertension is the most prevalent disorder that affects a vast majority of adults in Japan and is an important risk factor for myocardial infarction and cerebrovascular disease. 1 Among the metabolic syndrome components, hypertension is the strongest predictor for cardiovascular events 2 or carotid atherosclerosis. 3 Moreover, high blood pressure (BP) is a useful predictor for excess medical costs. 4 Therefore, the prevention of hypertension is an important public health issue. Patients with prehypertension are at an increased risk for progression to hypertension over a short period; those with a BP ranging 130-139/80-89 mmHg (systolic/diastolic) have twice the risk of developing hypertension as those with lower values. 5 Accordingly, identifying subjects with a high risk of developing hypertension will enable us to better target cost-effective interventions.The heart rate (HR) is easily obtained biologic information that requires no special instruments or techniques, in contrast to other recently developed biometric techniques. As HR fluctuates according to the method of measurement or condition, HR is an unreliable biometric marker to use for epidemiologic research. Furthermore, the significance of a higher HR tends to be underestimated in the clinical setting. Nonetheless, some studies report an association Circulation Journal Vol.71, November 2007 between HR and cardiovascular morbidity or mortality [6][7][8][9][10][11][12][13] and all causes of mortality. [7][8][9][10][11]14,15 A few studies report that HR is a predictor of developing hypertension. [16][17][18][19][20][21] We hypothesized that a high resting HR predicts the development of hypertension or BP progression, even after adjusting for risk factors such as metabolic syndrome or proteinuria. The aim of the present study was to evaluate whether a high HR predicts the development of hypertension and BP progression over a short period in normotensive, screened subjects. Methods SubjectsThis was a retrospective longitudinal study. The subjects were the participants of a 1-day health evaluation held by the Okinawa General Health Maintenance Association (OGHMA), which is one of the largest screening centers in Okinawa, Japan. 22 The OGHMA offers a 1-day health evaluation program throughout the year. This program provides thorough anthropometric measurements, a physical examination, laboratory tests and electrocardiography, both for individuals and health maintenance programs of companies and public organizations.Of 9,914 participants in the health screening program in 1997, 5,923 participated in this program in 2000. In the present analysis, 1,592 participants were excluded for the following reasons: prevalent hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, or use of antihypertensive medications; n=1,408), no electrocardiogram (ECG) recording, or a record of ectopic beats or atrial fibrillation (n=780) or heart disease (history of heart disease or the use of medication for heart disease; n=46). ParticiCirc J 2007; 71: 1755 -1760 (Re...

The haemodynamic response to propranolol in cirrhosis with arterial hypertension: a comparative analysis with normotensive cirrhotic patients

“…23 Moreover, a higher heart rate predicts the risk of developing hypertension in a normotensive screened cohort. 24,25 Cirrhosis is also associated with increased heart rate and blood pressure and heart rate obtained during the 24-h monitoring were positively and closely correlated. 26 Combination of cirrhosis and hypertension may have an additive effect on heart rate.…”

Effect of heart rate on the risk of developing metabolic syndrome

“…[20][21][22] Many patients with tachycardia have the characteristic features of insulin resistance syndrome, namely high blood pressure, obesity, increased blood glucose and insulin and an abnormal lipid profile. 7 Accordingly, it is likely that tachycardic patients are at a high risk for cardiovascular events 8,23 and metabolic syndrome.…”

Significance of Heart Rate in the Prevalence of Metabolic Syndrome and Its Related Risk Factors in Japanese

“…28 In regard to Japanese, a study reported that HR was the strongest predictor of all-cause death among SBP and DBP, antihypertensive medication, HR, uric acid, VC, and serum cholesterol after adjustment for age. 29 Another epidemiological study in Japanese reported that a higher HR was independently associated with the development of hypertension in a logistic regression analysis adjusted for gender, age, alcohol consumption, exercise, atherosclerotic risk factors, and lifestyle. 30 Pathophysiological studies indicate that a relatively high HR has direct detrimental effects on the progression of coronary atherosclerosis, on the occurrence of myocardial ischemia and ventricular arrhythmias, and on left ventricular function.…”