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Resting heart rate and its dynamic change and the risk of hypertension: The Rural Chinese Cohort Study

Journal of Human Hypertension volume 34, pages 528–535 (2020)Cite this article

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Abstract

The sex- and age-specific relation in the association of resting heart rate (RHR) and its change and risk of hypertension remains unclear. We prospectively estimated the incidence of hypertension among 9969 nonhypertensive adults participating in The Rural Chinese Cohort Study. Self-reported questionnaires and anthropometric and laboratory measurements were collected at baseline (2007–2008) and follow-up (2013–2014). The modified Poisson regression model was used to calculate relative risk (RR) values and 95% confidence intervals (CIs) for incident hypertension associated with RHR and its dynamic change. During follow-up (median, 6.01 years), 797 (20.28%) men, and 1178 (19.51%) women developed hypertension. Risk of hypertension was increased for women with the highest versus lowest RHR tertile after adjusting for confounding factors (RR: 1.19 [95%CI: 1.04–1.36]) and was associated with increased RHR for women with young age (RR per 10-beat/min RHR increase, 1.25 [95%CI: 1.09–1.43]), middle age (1.06 [0.99–1.14]), and older age (1.11 [1.01–1.23]). Risk of developing hypertension was significantly higher (RR: 1.22 [95%CI: 1.04–1.42]) in women with high RHR (≥80-beat/min) throughout the study period than those with normal RHR (<80-beat/min). No significant association of RHR and hypertension was found in men. RHR is an independent predictor of hypertension in rural Chinese women. Persistently high RHR is associated with increased hypertension risk in women. The dose–response association between RHR and hypertension could be affected by sex and age status.

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References

  1. Palatini P, Benetos A, Julius S. Impact of increased heart rate on clinical outcomes in hypertension: implications for antihypertensive drug therapy. Drugs. 2006;66:133–44.

    Article  CAS  Google Scholar 

  2. Palatini P, Julius S. Elevated heart rate: a major risk factor for cardiovascular disease. Clin Exp Hypertens. 2004;26:637–44.

    Article  CAS  Google Scholar 

  3. Poulter NR, Dobson JE, Sever PS, Dahlof B, Wedel H, Campbell NR, et al. Baseline heart rate, antihypertensive treatment, and prevention of cardiovascular outcomes in ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial). J Am Coll Cardiol. 2009;54:1154–61.

    Article  CAS  Google Scholar 

  4. Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet. 2015;386:801–12.

    Article  Google Scholar 

  5. Aladin AI, Al Rifai M, Rasool SH, Keteyian SJ, Brawner CA, Michos ED, et al. The association of resting heart rate and incident hypertension: the henry ford hospital exercise testing (FIT) project. Am J Hypertens. 2016;29:251–7.

    Article  Google Scholar 

  6. Inoue T, Iseki K, Iseki C, Kinjo K, Ohya Y, Takishita S. Higher heart rate predicts the risk of developing hypertension in a normotensive screened cohort. Circ J. 2007;71:1755–60.

    Article  Google Scholar 

  7. Conti S, Szklo M, Menotti A, Pasquini P. Risk factors for definite hypertension: cross-sectional and prospective analyses of two Italian rural cohorts. Preventive Med. 1986;15:403–10.

    Article  CAS  Google Scholar 

  8. Oda E, Aizawa Y. Resting heart rate predicts metabolic syndrome in apparently healthy non-obese Japanese men. Acta Diabetol. 2014;51:85–90.

    Article  Google Scholar 

  9. Shigetoh Y, Adachi H, Yamagishi S, Enomoto M, Fukami A, Otsuka M, et al. Higher heart rate may predispose to obesity and diabetes mellitus: 20-year prospective study in a general population. Am J Hypertens. 2009;22:151–5.

    Article  Google Scholar 

  10. Dyer AR, Liu K, Walsh M, Kiefe C, Jacobs DR, Bild DE. Ten-year incidence of elevated blood pressure and its predictors: the CARDIA study. J Hum Hypertens. 1999;13:13–21.

    Article  CAS  Google Scholar 

  11. Gu DF, Wildman RP, Wu XQ, Reynolds K, Huang JF, Chen CS, et al. Incidence and predictors of hypertension over 8 years among Chinese men and women. J Hypertens. 2007;25:517–23.

    Article  CAS  Google Scholar 

  12. Wang AX, Liu XX, Guo XH, Dong Y, Wu YT, Huang Z, et al. Resting heart rate and risk of hypertension: results of the Kailuan cohort study. J Hypertens. 2014;32:1600–5.

    Article  CAS  Google Scholar 

  13. Valentini M, Parati G. Variables influencing heart rate. Prog Cardiovasc Dis. 2009;52:11–9.

    Article  Google Scholar 

  14. Zhao Y, Zhang M, Luo X, Yin L, Pang C, Feng T, et al. Association of obesity categories and high blood pressure in a rural adult Chinese population. J Hum Hypertens. 2016;30:613–8.

    Article  CAS  Google Scholar 

  15. Zhao Y, Zhang M, Luo X, Wang C, Li L, Zhang L, et al. Association of 6-year waist circumference gain and incident hypertension. Heart. 2017;103:1347–52.

    Article  Google Scholar 

  16. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.

    Article  Google Scholar 

  17. Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, et al. Human blood pressure determination by sphygmomanometry. Circulation. 1993;88:2460–70.

    Article  CAS  Google Scholar 

  18. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.

    Article  CAS  Google Scholar 

  19. Weng J, Ji L, Jia W, Lu J, Zhou Z, Zou D, et al. Standards of care for type 2 diabetes in China. Diabetes/Metab Res Rev. 2016;32:442–58.

    Article  Google Scholar 

  20. Post WS, Larson MG, Levy D. Hemodynamic predictors of incident hypertension. The Framingham Heart Study. Hypertension. 1994;24:585–90.

    Article  CAS  Google Scholar 

  21. Kim DI, Yang HI, Park JH, Lee MK, Kang DW, Chae JS, et al. The association between resting heart rate and type 2 diabetes and hypertension in Korean adults. Heart. 2016;102:1757–U81.

    Article  Google Scholar 

  22. Yang HI, Kim HC, Jeon JY. The association of resting heart rate with diabetes, hypertension, and metabolic syndrome in the Korean adult population: The fifth Korea National Health and Nutrition Examination Survey. Clin Chim Acta. 2016;455:195–200.

    Article  CAS  Google Scholar 

  23. Palatini P, Julius S. Heart rate and the cardiovascular risk. J Hypertens. 1997;15:3–17.

    Article  CAS  Google Scholar 

  24. Kouvas N, Tsioufis C, Vogiatzakis N, Sanidas E, Konstantinidis D, Kintis K, et al. Heart rate and blood pressure: “Connecting the Dots” in epidemiology and pathophysiology. Angiology. 2018;69:660–5.

  25. Jamerson KA, Julius S, Gudbrandsson T, Andersson O, Brant DO. Reflex sympathetic activation induces acute insulin resistance in the human forearm. Hypertension. 1993;21:618–23.

    Article  CAS  Google Scholar 

  26. Giannoglou GD, Chatzizisis YS, Zamboulis C, Parcharidis GE, Mikhailidis DP, Louridas GE. Elevated heart rate and atherosclerosis: an overview of the pathogenetic mechanisms. Int J Cardiol. 2008;126:302–12.

    Article  Google Scholar 

  27. Palatini P, Benetos A, Grassi G, Julius S, Kjeldsen SE, Mancia G, et al. Identification and management of the hypertensive patient with elevated heart rate: statement of a European Society of Hypertension Consensus Meeting. J Hypertens. 2006;24:603–10.

    Article  CAS  Google Scholar 

Download references

Funding

Funding

This work was supported by the National Natural Science Foundation of China (grant nos. 81373074, 81402752, and 81673260); the Natural Science Foundation of Guangdong Province (grant no. 2017A030313452); the Medical Research Foundation of Guangdong Province (grant no. A2017181); and the Science and Technology Development Foundation of Shenzhen (grant nos. JCYJ20140418091413562, JCYJ20160307155707264, JCYJ20170302143855721, and JCYJ20170412110537191).

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Authors and Affiliations

  1. The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China

    Yang Zhao, Pei Qin, Zhaoxia Yin, Honghui Li, Xizhuo Sun, Feiyan Liu, Xu Chen, Cheng Cheng, Qionggui Zhou, Ming Zhang, Yu Liu & Dongsheng Hu

  2. Study Team of Shenzhen’s Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China

    Yang Zhao, Pei Qin, Zhaoxia Yin, Honghui Li, Xizhuo Sun, Feiyan Liu, Xu Chen, Qionggui Zhou, Ming Zhang, Yu Liu & Dongsheng Hu

  3. Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China

    Pei Qin, Feiyan Liu, Qionggui Zhou & Ming Zhang

  4. Cardiovascular Department, Zhengzhou Yihe Hospital, Zhengzhou, Henan, PR China

    Haohang Sun

  5. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China

    Yongcheng Ren, Dechen Liu & Leilei Liu

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  1. Yang Zhao
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  16. Dongsheng Hu
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Correspondence to Yu Liu or Dongsheng Hu.

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Zhao, Y., Qin, P., Sun, H. et al. Resting heart rate and its dynamic change and the risk of hypertension: The Rural Chinese Cohort Study. J Hum Hypertens 34, 528–535 (2020). https://doi.org/10.1038/s41371-019-0259-y

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