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Resting heart rate in relation to blood pressure: Results from the World Health Organization—Cardiovascular Disease and Alimentary Comparison Study

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Abstract

Background

Epidemiological studies have reported that increased heart rate (HR) is associated with cardiovascular mortality. We aimed in assessing the hypothesis that HR may influence the outcomes of cardiovascular disease via a pathway related to increases in blood pressure (BP).

Methods

Data from the World Health Organization—Cardiovascular Disease and Alimentary Comparison (CARDIAC) Study were analyzed to examine the association between resting HR and BP in a sample of 8541 adults aged 48–56 participating in the CARDIAC baseline surveys.

Results

Increased heart rates were significantly correlated with both systolic and diastolic BP (SBP and DBP) in men and women. The overall results (e.g. the pooled regression coefficients) suggest that an increase in each unit of heart rate (beat per minute) was associated with 0.27 mmHg increase in SBP, and 0.09 mmHg in DBP in the total study population sample, and 0.203 mmHg increase in SBP, and 0.252 mmHg increase in DBP in the sub-sample in which subjects with anti-hypertensive medication use were excluded in the analysis.

Conclusion

The study, by using a large population-based sample, indicates that increased resting heart rates are associated with increased blood pressure. The result supports the hypothesis that the influence of heart rates on cardiovascular mortality may be mediated by elevated blood pressure.

Introduction

Epidemiological studies have reported that increased heart rate (HR) is associated with cardiovascular mortality and even non-cardiovascular disease [1], [2], [3], [4]. However, only in recent years, has interest been aroused by an awareness that the HR–CVD association may be explained by the association between heart rate and blood pressure (BP) [4], [5]. Despite these observations, the importance of associations between HR and BP is still poorly recognized in research and clinical practice [5]. Furthermore, few studies that have tested this association applied a sample size big enough from an international cooperative study. The World Health Organization—Cardiovascular Disease and Alimentary Comparison (CARDIAC) Study provides an opportunity with us to examine this association between HR and BP in middle-aged populations [6], [7], [8], [9], [10].

Section snippets

Study design and populations

The CARDIAC Study, with a multi-center cross-sectional study design, started in mid 1985, and continues at its phase II stage (e.g., MONALISA Study) [6], [10]. The CARDIAC Study was designed to examine the association between various dietary markers and BP (“Core study”) and between these factors and cardiovascular disease mortality rates (“Complete study”). We have published a series which reports on dietary biomarkers and BP, and dietary biomarkers in relation to deaths from coronary heart

Results

Table 1 shows the basic characteristics of 8541 (M: 4288, F: 4253) participants aged 48–56 years old by sex in 54 centers of the CARDIAC Study. Males had higher mean systolic and diastolic blood pressure (SBP and DBP) than females (p < 0.01). However, females had higher mean body mass index (BMI), resting heart rate (HR) and prevalence of anti-hypertensive medication use than males (p < 0.01).

Participants with hypertension had significantly higher mean (SD) heart rates than those with normal blood

Discussion

The present study observes that elevated resting heart rates were significantly associated with increases in BP in a sample of more than 8500 participants aged 48–56 years old. Several prospective studies have reported resting heart rate be a risk predictor for certain specific-cause deaths, including CVD and non-CVD deaths including the Framingham Study, the NHANES I Epidemiologic Follow-up Study, the NIPPONDATA80 Study, and others [4], [13], [14], [15], [16]. The mechanisms by which increased

Acknowledgement

The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [17].

References (17)

There are more references available in the full text version of this article.

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