静息心率与臂踝脉搏波传导速度的关系

Relationship between resting heart rate and brachial-ankle pulse wave velocity in healthy Chinese population

目的 探讨静息心率（RHR）与臂踝脉搏波传导速度（baPWV）的关系.方法 采用横断面研究设计,在2006至2007年参加健康体检的101 510例开滦集团职工中,以分层随机抽样方法抽取5 852例作为研究对象,进行统一问卷调查、血液生化及baPWV检查.符合入选标准的研究对象（年龄≥40岁、既往无卒中、短暂性脑缺血发作、心肌梗死者）共5 440例,将其中资料完整的5 153例纳入统计分析.依据2010至201 1年健康体检时RHR的四分位数,将研究对象分为第一分位组（RHR＜ 63次/min,n=1 405）、第二分位组（63次/min≤RHR＜ 69次/min,n=1 176）、第三分位组（69次/min≤RHR＜ 76次/min,n=1 322）、第四分位组（RHR≥76次/min,n=1 250）.采用多因素logistic回归分析RHR与baPWV的关系.结果 （1）研究对象的年龄为（55.1±11.8）岁;男性3 110例,女性2 043例;baPWV为（1 586±400） cm/s;baPWV≥1 400 cm/s的检出率为61.8％（3 185/5 153）.（2）第一、二、三、四分位组的baPWV分别为（1 511±338） cm/s、（1 533±329） cm/s、（1 574±368） cm/s、（1 734±462） cm/s;baPWV≥1 400 cm/s的检出率分别为54.7％ （769/1 405）、56.0％ （658/1 176）、63.1％ （834/1 322）、74.3％ （929/1 150）.（3）多因素logistic回归分析显示：校正年龄、性别、收缩压、体质指数、空腹血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、高敏C反应蛋白、是否服用降压药、吸烟和体育锻炼后,与第一分位组比较,第二、三和四分位组baPWV≥1 400 cm/s的检出率均增加,OR值分别为1.37（95％ CI：1.11 ～1.69）、1.96（95％ CI：1.59 ～2.41）和2.60（95％ CI：2.07 ～3.25）.结论 RHR加快与baPWV增加独立相关.

Objective To investigate the relationship between resting heart rate （RHR） and brachial-ankle pulse wave velocity （baPWV） in healthy Chinese population.Methods This was a retrospective cohort study,and a total of 5 852 participants were selected with stratified random sampling from the 101 510 workers of Tangshan Kailuan company who received the health examination during 2010-2011 including epidemiological investigation,biochemical indicators measurement and baPWV measurement.A total of 5 440 participants met the inclusion criteria （aged 40 years or older,without stroke,transient ischemic attack and myocardial infarction） and 5 153 participants （3 110 males,mean age （55.1 ± 11.8） years old） with integral data were finally recruited into the final analysis.The observation population was divided into four groups according to RHR collected during health examinations：quartile 1 （RHR≤63 beats/min,n =1 405） ; quartile 2 （63 beats/min ＜ RHR≤69 beats/min,n =1 176） ; quartile 3 （69 beats/min ＜ RHR ≤76 beats/min,n =1 322） ; quartile 4 （RHR ＞ 76 beats/min,n =1 250）.Multivariate logistic regression analysis was used to analyze the relationship between RHR and baPWV.Results （1） The mean baPWV was （1 586 ± 400） cm/s,and the detection rates of baPWV ≥1 400 cm/s was 61.8％ （3 185/5 153）.（2）The baPWV of quartile 1,2,3 and 4 were （1 511 ±338） cm/s,（1 533 ±329） cm/s,（1 574 ±368） cm/s and （1 734 ±462） cm/s,respectively,and the detection rates of baPWV≥ 1 400 cm/s were 54.7％ （769/1 405）,56.0％ （658/1 176）,63.1％ （834/1 322） and 74.3％（929/1 150）,respectively.（3） Multiple logistic regression analysis showed that the detection rates of baPWV were significantly higher in quartile 2,3 and 4 compared to quartile 1,and the OR values were 1.37 （95 ％ CI：1.11-1.69）,1.96 （95 ％ CI：1.59-2.41） and 2.60 （95 ％ CI：2.07-3.25）,respectively,after adjusting for age,gender and systolic blood pressure,body mass index,fasting blood glucose,triglyceride,total cholesterol,high density lipoprotein cholesterol,hs-CRP,antihypertensive agents,smoking and exercise status.Conclusion RHR is positively associated with baPWV in healthy Chinese population.