糖尿病:休息心率有多高,心血管疾病的风险会增加?
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
概括
在糖尿病患者中,静止心率升高会增加心血管风险. 一个每分钟77次的值, 而不是每分钟80次的值,
科学领域:
- 心脏病学
- 内分泌学
- 临床研究
背景情况:
- 静止心率升高是心血管事件和死亡的已知危险因素.
- 目前的指导方针表明,心血管风险增加的门是每分钟80的RHR,但证据不确定.
研究的目的:
- 在糖尿病患者中研究RHR与心血管风险之间的关联.
- 确定特定的RHR值,表明该人群中心血管风险显著增加.
主要方法:
- 对ACCORD- BP试验数据的后期分析 (4733名患有DM的参与者).
- 将患者分为RHR类别并使用具有限制立方线和细分回归的Cox比例危险模型.
- 评估RHR与复合心血管终点 (心肌梗塞,中风,死亡) 和二次心血管终点的关系.
主要成果:
- 在较高的RHR和心血管风险之间观察到非线性关系.
- 分段回归发现心血管事件风险显著增加,超过77bpm的RHR.
- 脑卒中风险与RHR升高的关联最强;心肌梗塞风险显示出线性关系.
结论:
- 在DM患者中,RHR值约为每分钟77次,可能比每分钟80次更适合确定心血管风险增加.
- 这些发现可以为糖尿病患者的RHR降低干预指导临床决策.
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