Hypertension:十秒心率变异性及其变化与高血压的关系

2022-04-20 MedSci原创 MedSci原创

10秒心电图上较高的HRV和随时间增加的HRV与较低的高血压风险相关。该研究的结果表明,使用10秒标准心电图估计的自主功能在预测高血压方面发挥着重要作用,在年轻人中效果更好。

高血压是中风的主要危险因素,冠心病、心力衰竭、肾病和过早死亡。虽然高血压在老年人中更常见,但据报道,它在小于40岁的年轻人群中患病率高达18%,预计还会随着肥胖率的增长而增长。此外,高血压发病年龄越小,患心血管疾病(CVD)和死亡的风险就越高。因此,实施预防高血压的策略和确定其危险因素很重要,即使是在并发症较少的年轻人群中。

心率变异性(HRV)试验是一种无创、可行、临床应用最广泛的自主神经系统活动评估方法。虽然短期HRV必须测量至少5分钟,但最近使用10秒12导联心电图记录的研究表明,超短期HRV与心脏和非心脏事件有关。超短期心率变异性(HRV)及其时间变化在高血压发病中的作用尚未明确。近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员的目的是探究年龄40岁以下及以上成人10秒HRV及其变化与高血压发病的关系。

该研究对象为232587名没有高血压的韩国人(平均年龄为37.6岁)。高血压的定义依据2017年美国心脏病学会和美国心脏协会高血压指南。HRV采用标准12导联10秒心电图估计的连续RR间期差的均方根和正常至正常RR间期的标准差。

在3.8年的中位随访中,研究人员发现了40268例高血压病例(发病率:青年和老年参与者分别为36.1人和67.9人/1000人次每年)。HRV与高血压风险呈剂量依赖性负相关。高血压的多变量校正风险比(95%CI)分别为1.58(1.52~1.63)和1.35(1.30~1.39)。这些关联在年轻人中比在老年人中更强。在150301名参与者的亚样本中,与稳定的HRV相比,HRV随时间的增加也与高血压发生率呈负相关。

由此可见,10秒心电图上较高的HRV和随时间增加的HRV与较低的高血压风险相关。该研究的结果表明,使用10秒标准心电图估计的自主功能在预测高血压方面发挥着重要作用,在年轻人中效果更好。

 

原始出处:

Jeonggyu Kang.et al.Ten-Second Heart Rate Variability, Its Changes Over Time, and the Development of Hypertension.Hypertension.2022.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.18589.

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    2022-05-30 feather89
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