AIM To assess the association of resting heart rate with allcause and cardiovascular disease(CVD) mortality in the Diabetes Heart Study(DHS).METHODS Out of a total of 1443 participants recruited into the DHS, 1315 par...AIM To assess the association of resting heart rate with allcause and cardiovascular disease(CVD) mortality in the Diabetes Heart Study(DHS).METHODS Out of a total of 1443 participants recruited into the DHS, 1315 participants with type 2 diabetes who were free of atrial fibrillation and supraventricular tachycardia during the baseline exam were included in this analysis. Heart rate was collected from baseline resting electrocardiogram and mortality(all-cause and CVD) was obtained from state and national death registry. Kaplan-Meier(K-M) and Cox proportional hazard analyses were used to assess the association.RESULTS The mean age, body mass index(BMI) and systolic blood pressure(SBP) of the cohort were 61.4 ± 9.2 years, 32.0 ± 6.6 kg/m2, and 139.4 ± 19.4 mmHg respectively. Fiftysix percent were females, 85% were whites, 15% were blacks, 18% were smokers. The mean ± SD heart rate was 69.8(11.9) beats per minute(bpm). After a median follow-up time of 8.5 years(maximum follow-up time is 14.0 years), 258 participants were deceased. In K-M analysis, participants with heart rate above the median had a significantly higher event rate compared with those below the median(log-rank P = 0.0223). A one standard deviation increase in heart rate was associated with allcause mortality in unadjusted(hazard ratio 1.16, 95%CI: 1.03-1.31) and adjusted(hazard ratio 1.20, 95%CI: 1.05-1.37) models. Similar results were obtained with CVD mortality as the outcome of interest.CONCLUSION Heart rate is an independent predictor of all-cause mortality in this population with type 2 diabetes. In this study, a 1-SD increase in heart rate was associated with a 20% increase in risk suggesting that additional prognostic information may be gleaned from this ubiquitously collected vital sign.展开更多
Background:Resting heart rate(RHR)is considered as a strong predictor of total mortality and hospitalization due to heart failure in hypertension patients.Bisoprolol fumarate,a second-generation beta-adrenoreceptor bl...Background:Resting heart rate(RHR)is considered as a strong predictor of total mortality and hospitalization due to heart failure in hypertension patients.Bisoprolol fumarate,a second-generation beta-adrenoreceptor blockers(β-blocker)is commonly prescribed drug to manage hypertension.The present study was to retrospectively evaluate changes in the average RHR and its association with cardiovascular outcomes in bisoprolol-treated coronary artery disease(CAD)patients from the CAD treated with bisoprolol(BISO-CAD)study who had comorbid hypertension.Methods::We performed ad-hoc analysis for hypertension sub-group of the BISO-CAD study(n=866),which was a phase IV,multination,multi-center,single-arm,observational study carried out from October 2011 to July 2015 across China,South Korea,and Vietnam.Multivariate regression analysis was used to identify factors associated with incidence of composite cardiac clinical outcome(CCCO),the results were presented as adjusted odds ratio(OR)along with 95%confidence interval(CI)and adjusted P value.Results::A total of 681 patients(mean age:64.77±10.33 years)with hypertension from BISO-CAD study were included in the analysis.Bisoprolol improved CCCOs in CAD patients with comorbid hypertension,with RHR<65 and<70 beats/min compared with RHR≥65 and≥75 beats/min,respectively,in the efficacy analysis(EA)set.In addition,it lowered RHR in both intent-to-treat(ITT)and EA groups after 6,12,and 18 months of treatment.Further,RHR 70 to 74 beats/min resulted in significantly higher risk of CCCOs EA set of patients(adjusted OR:4.34;95%CI:1.19-15.89;P=0.03).Also,events of hospitalization due to acute coronary syndrome were higher when RHR 69 to 74 beats/min compared to RHR<69 beats/min in ITT patients.Conclusion::Bisoprolol can effectively reduce RHR in Asian CAD patients with comorbid hypertension and hence,improve CCCO without affecting their blood pressure.展开更多
文摘AIM To assess the association of resting heart rate with allcause and cardiovascular disease(CVD) mortality in the Diabetes Heart Study(DHS).METHODS Out of a total of 1443 participants recruited into the DHS, 1315 participants with type 2 diabetes who were free of atrial fibrillation and supraventricular tachycardia during the baseline exam were included in this analysis. Heart rate was collected from baseline resting electrocardiogram and mortality(all-cause and CVD) was obtained from state and national death registry. Kaplan-Meier(K-M) and Cox proportional hazard analyses were used to assess the association.RESULTS The mean age, body mass index(BMI) and systolic blood pressure(SBP) of the cohort were 61.4 ± 9.2 years, 32.0 ± 6.6 kg/m2, and 139.4 ± 19.4 mmHg respectively. Fiftysix percent were females, 85% were whites, 15% were blacks, 18% were smokers. The mean ± SD heart rate was 69.8(11.9) beats per minute(bpm). After a median follow-up time of 8.5 years(maximum follow-up time is 14.0 years), 258 participants were deceased. In K-M analysis, participants with heart rate above the median had a significantly higher event rate compared with those below the median(log-rank P = 0.0223). A one standard deviation increase in heart rate was associated with allcause mortality in unadjusted(hazard ratio 1.16, 95%CI: 1.03-1.31) and adjusted(hazard ratio 1.20, 95%CI: 1.05-1.37) models. Similar results were obtained with CVD mortality as the outcome of interest.CONCLUSION Heart rate is an independent predictor of all-cause mortality in this population with type 2 diabetes. In this study, a 1-SD increase in heart rate was associated with a 20% increase in risk suggesting that additional prognostic information may be gleaned from this ubiquitously collected vital sign.
基金This study was funded by Merck Serono Co.,Ltd,an affiliate of Merck KGaA,Darmstadt,Germany.
文摘Background:Resting heart rate(RHR)is considered as a strong predictor of total mortality and hospitalization due to heart failure in hypertension patients.Bisoprolol fumarate,a second-generation beta-adrenoreceptor blockers(β-blocker)is commonly prescribed drug to manage hypertension.The present study was to retrospectively evaluate changes in the average RHR and its association with cardiovascular outcomes in bisoprolol-treated coronary artery disease(CAD)patients from the CAD treated with bisoprolol(BISO-CAD)study who had comorbid hypertension.Methods::We performed ad-hoc analysis for hypertension sub-group of the BISO-CAD study(n=866),which was a phase IV,multination,multi-center,single-arm,observational study carried out from October 2011 to July 2015 across China,South Korea,and Vietnam.Multivariate regression analysis was used to identify factors associated with incidence of composite cardiac clinical outcome(CCCO),the results were presented as adjusted odds ratio(OR)along with 95%confidence interval(CI)and adjusted P value.Results::A total of 681 patients(mean age:64.77±10.33 years)with hypertension from BISO-CAD study were included in the analysis.Bisoprolol improved CCCOs in CAD patients with comorbid hypertension,with RHR<65 and<70 beats/min compared with RHR≥65 and≥75 beats/min,respectively,in the efficacy analysis(EA)set.In addition,it lowered RHR in both intent-to-treat(ITT)and EA groups after 6,12,and 18 months of treatment.Further,RHR 70 to 74 beats/min resulted in significantly higher risk of CCCOs EA set of patients(adjusted OR:4.34;95%CI:1.19-15.89;P=0.03).Also,events of hospitalization due to acute coronary syndrome were higher when RHR 69 to 74 beats/min compared to RHR<69 beats/min in ITT patients.Conclusion::Bisoprolol can effectively reduce RHR in Asian CAD patients with comorbid hypertension and hence,improve CCCO without affecting their blood pressure.
