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Arrhythmias, hypertension and the elderly: Holter evaluation
A Celentano1, M Galderisi, G F Mureddu
1Department of Cardioangiology, II Medical School, University of Naples, Italy.
Insights
Hypertension significantly increases the risk of arrhythmias, including premature beats, and elevates average heart rate. Advanced age also worsens the severity of premature ventricular beats, independent of blood pressure.
Area of Science:
- Cardiology
- Gerontology
- Hypertension Research
Background:
- Arrhythmias are common cardiac conditions influenced by various factors.
- Hypertension and age are recognized risk factors for cardiovascular diseases.
- The specific impact of hypertension and age on different types of arrhythmias requires further clarification.
Purpose of the Study:
- To investigate the independent and combined roles of age and hypertension in determining the occurrence and severity of arrhythmias.
- To analyze the relationship between hypertension, age, and cardiac parameters like heart rate and premature beats.
Main Methods:
- Utilized 24-hour Holter electrocardiography on 336 patients to assess heart rate, and the number and severity (Lown grade) of supraventricular and ventricular premature beats.
- Excluded patients with prolonged runs of atrial fibrillation or supraventricular tachycardia.
- Employed analysis of variance and multilinear regression to analyze data, stratifying patients by age and blood pressure.
Main Results:
- Hypertensive patients exhibited higher average heart rate and increased supraventricular and premature ventricular beats compared to normotensive individuals.
- The severity of premature ventricular beats was significantly higher in hypertensive patients and in older individuals.
- Mean blood pressure was independently associated with heart rate and the burden/severity of arrhythmias, while age independently correlated with the severity of premature ventricular beats.
Conclusions:
- Hypertension is a significant inducer of cardiac arrhythmias, including premature beats.
- Increasing age exacerbates the severity of premature ventricular beats.
- Both hypertension and age are independent risk factors influencing arrhythmia development and severity.
Abstract:
In order to clarify the role of age and hypertension in determining arrhythmias, we evaluated the average heart rate, and the number of supraventricular and ventricular premature beats and their severity (Lown grade) by 24-h Holter electrocardiography of 336 patients. We excluded 54 patients with prolonged runs of atrial fibrillation or supraventricular tachycardia because these arrhythmias reduce the possibility of determining the number of premature beats. Analysis of variance, carried out after dividing the patients into four different groups according to age and blood pressure (excluding patients aged 60-65 years with diastolic blood pressure of 91-94 mmHg) showed that the hypertensives had a higher average heart rate (P less than 0.01) and more supraventricular (P less than 0.05) and premature ventricular (P less than 0.01) beats than the normotensives; no difference was found among groups of different ages. The severity of premature ventricular beats was higher in hypertensives than in normotensives, and also higher in elderly than in 'young' patients (P less than 0.01). In the evaluation of all 336 patients we found correlations between age and severity of premature ventricular beats in both normotensives (P less than 0.05) and hypertensives (P less than 0.001). Multilinear regression showed that mean blood pressure was independently related to the average heart rate, and supraventricular and premature ventricular beats and their severity, while age was correlated independently only with the severity of premature ventricular beats (P less than 0.001). We conclude that hypertension induces arrhythmias, and that age increases their severity.