Decreasing 24-hour heart rate was independently associated with higher likelihood of left ventricular hypertrophy in untreated hypertension (OR 0.92 per 1 beat/min increase; 95% CI 0.87-0.98; P=0.002).
Cross-Sectional (n=250)
Are 24-hour heart rate and blood pressure additive markers of left ventricular mass in patients with newly diagnosed, untreated hypertension?
Lower 24-hour heart rate is an independent marker of increased left ventricular mass and hypertrophy in untreated hypertensive patients, additive to blood pressure parameters.
Effect estimate: OR 0.92 (95% CI 0.87 to 0.98)
p-value: p=0.002
BACKGROUND: We investigated whether mean heart rate (HR(24)) and blood pressure (BP) parameters during 24-h ambulatory BP monitoring (ABP) are independent or additive markers of left ventricular (LV) mass in subjects with newly diagnosed, untreated hypertension. METHODS: A total of 250 patients (40% women, 60% men; mean age 59.6 +/- 11 years) with essential hypertension who were attending the outpatient Hypertension Unit were studied. All patients underwent 24-h ABP and HR monitoring as well as echocardiography for assessment of left ventricular (LV) dimensions and function. RESULTS: A decreasing HR24 or increasing ABP parameters (ie, systolic, diastolic, mean BP, and pulse pressure) were associated with increasing LV mass (P < .001) and wall thickness (P < .01). In multivariate analysis, after adjusting for age, gender, body surface area, body mass index, hematocrit, glucose, cholesterol, smoking, and each of the measured ABP parameters separately, decreasing HR24 was independently related to increasing LV mass in addition to ABP and body size parameters (P < .001). The addition of HR24 in different multivariate models for prediction of LV mass significantly increased the adjusted model r2 (range of r2 change: 0.039 to 0.064, P for change <.05). Decreasing HR24 or HR during daytime (6 am to 10 pm) was associated with a higher likelihood of LV hypertrophy in addition to ABP parameters (adjusted odds ratio 0.92 (CI 0.87 to 0.98), per 1 beat/min greater HR24 P = .002 and 0.93 (CI: 0.87 to 0.98), per 1 beat/min greater HR in the daytime P = .017). CONCLUSION: The 24-h HR and BP during ABP are independent and additive markers of increased LV mass in untreated hypertensive individuals.
Zakopoulos et al. (Tue,) conducted a cross-sectional in newly diagnosed, untreated essential hypertension (n=250). 24-hour heart rate and blood pressure was evaluated on Likelihood of left ventricular hypertrophy (OR 0.92, 95% CI 0.87 to 0.98, p=0.002). Decreasing 24-hour heart rate was independently associated with higher likelihood of left ventricular hypertrophy in untreated hypertension (OR 0.92 per 1 beat/min increase; 95% CI 0.87-0.98; P=0.002).