糖尿病: 休息時の心拍数では 心血管疾患のリスクが増加します
Piotr Sobieraj1, Jacek Lewandowski2, Maciej Siński2
1Department of Internal Disease, Hypertension and Vascular Diseases, Medical University of Warsaw, Warszawa, Poland. piotr.sobieraj@wum.edu.pl.
Kardiologia polska
|August 22, 2025
まとめ
休息時の心拍数 (RHR) の上昇は,糖尿病患者の心血管疾患のリスクを高めます. 脳卒中などの リスクの高い患者を より良く特定できるかもしれません
科学分野:
- 心臓病科
- 内分泌学
- 臨床研究
背景:
- 休息時の心拍数 (RHR) の上昇は,心血管疾患および死亡率の既知の危険因子です.
- 現在のガイドラインでは,心血管リスクの上昇の値としてRHRが80bpmであることを示唆しているが,証拠は不確定である.
研究 の 目的:
- 糖尿病 (DM) の患者におけるRHRとCVリスクの関連性を調べる.
- この集団におけるCVリスクの有意な増加を示す特定のRHRの値を決定する.
主な方法:
- ACCORD- BP試験のデータ (DMの4733人の参加者) のポストホック分析.
- 患者をRHRカテゴリーに分類し,制限された立方スラインとセグメンテッド回帰を持つコックス比例リスクモデルを使用します.
- 複合CVエンドポイント (心筋梗塞,脳卒中,死亡) と二次CVエンドポイントとのRHRの評価
主要な成果:
- RHRの上昇とCVリスクの上昇との間には非線形的な関係が見られた.
- セグメンテッド・リグレッションでは,RHR77bpmを超えるCVイベントのリスクが有意に増加していることが判明しました.
- 脳卒中のリスクはRHR上昇と最も強く関連しており,心筋梗塞のリスクは線形的に関連している.
結論:
- DMの患者の心血管リスクの増加を特定するには,RHRの値が80bpmより適切である可能性があります.
- これらの発見は,糖尿病患者のRHRを下げる介入に関する臨床的決定を導くことができる.
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