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Prevalence and factors associated with fast resting heart rate in hypertensive and normotensive patients
Xiaofei Li1, Tao Kong1, Yan Yao1
1State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Fast resting heart rate (RHR) is more prevalent in hypertensive individuals. Factors associated with fast RHR differ between hypertensive and normotensive groups, though stroke and diabetes are common links.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Fast resting heart rate (RHR) is often overlooked in hypertension management.
- Understanding RHR prevalence and associated factors is crucial for cardiovascular health.
- Hypertension treatment guidelines do not consistently address RHR.
Purpose of the Study:
- To determine the prevalence of fast RHR in hypertensive and normotensive individuals.
- To identify factors associated with fast RHR in both groups.
- To highlight the clinical significance of RHR in hypertension.
Main Methods:
- Retrospective analysis of two cross-sectional studies in China.
- Inclusion of 6763 hypertensive and 2807 normotensive subjects.
- Definition of fast RHR as >85 bpm based on resting electrocardiogram data.
Main Results:
- Fast RHR prevalence was higher in hypertensive patients (14.4%) versus normotensives (7.1%).
- Associated factors in hypertensives included younger/older age, low BMI, and hypercholesterolemia.
- Associated factors in normotensives included female sex, pre-hypertension, and rural origin.
- Stroke and diabetes history were significantly associated with fast RHR in both groups.
Conclusions:
- Fast RHR is common in hypertensive patients and warrants clinical attention.
- Prior stroke and diabetes are key factors associated with fast RHR.
- Distinct demographic and clinical factors are linked to fast RHR in hypertensive versus normotensive individuals.
Abstract:
Background: Fast resting heart rate (RHR) is easily neglected in clinical practice of hypertension treatment.Aims: We aimed to investigate the prevalence of fast RHR and associated factors in hypertensive and normotensive individuals.Methods: We retrospectively analyzed data from two cross-sectional studies conducted in China. A total of 6763 hypertensive patients and 2807 age and sex-matched normotensive subjects with complete data on resting electrocardiogram and medical history were included. Fast RHR was defined as RHR > 85 bpm.Results: The prevalence of fast RHR was higher in hypertensive patients as compared with the normotensives (14.4% vs 7.1%, P < 0.01). In both hypertensive and normotensive subjects, fast RHR appeared as a "U-type" distribution as aging and a "inverted J type" trend as body mass index (BMI) increasing. Multivariate regression analysis showed that fast RHR was associated with age >65 or <25 years old (OR = 1.32, 95% CI 1.08-1.61), BMI <18.5 kg/m2 (OR = 2.94, 95%CI 1.47-5.87) and hypercholesterolemia (OR = 1.30, 95%CI 1.10-1.53) in hypertensive patients. Fast RHR in the normotensives was associated with female (OR = 1.78, 95%CI 1.27-2.48), pre-hypertensive state (OR = 2.38, 95%CI 1.61-3.52), and rural area origin (OR = 1.50, 95%CI 1.01-2.42). Stroke and diabetes conferred closer relevance to fast RHR in both hypertensive (OR = 1.31, 95%CI 1.02-1.69 and OR 2.26, 95%CI 1.60-3.21) and normotensive individuals (OR = 2.67, 95%CI 1.36-5.21 and OR = 2.77, 95%CI 1.47-5.23).Conclusion: Fast RHR might be common in patients with hypertension. Prior stroke and diabetes history is common associated with fast RHR. Other factors associated with fast RHR seem to be different between hypertensive patients and normotensive subjects.Abbreviations: BMI: body mass index; CI: Confidence Interval; DBP: diastolic blood pressure; ECG: electrocardiogram; OR: odd ratio; RHR: resting heart rate; SBP: systolic blood pressure.
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