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Association of resting heart rate and hypertension stages on all-cause and car- diovascular mortality among elderly Koreans： the Kangwha Cohort Study

引用

Journal of Geriatric Cardiology 2016年第7期13卷 573-579页

作者： mikyung ryu Gombojav Bayasgalan Heejin Kimm Chung Mo Nam Heechoul Ohrr Institute on Aging Ajou University Medical Center Suwon South Korea College of Physical Education Kyonggi University Suwon South Korea Department of Public Health the Graduate School Yonsei University Seoul South Korea Department of Epidemiology and Health Promotion Institute for Health Promotion Graduate School of Public Health Yonsei University Seoul South Korea Department of Preventive Medicine Yonsei University College of Medicine Seoul South Korea

Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.

关键词： Cardiovascular diseases Heart rate Hypertension Mortality Prehypertension

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