Open Heart:中国慢性病前瞻性研究显示心率快,易发生肺心病!

2022-06-13 中国循环杂志 中国循环杂志

该研究结果提示,静息心率与右心衰的关系可能比与左心衰的关系更强。

一项基于中国慢性病前瞻性研究项目的新分析提示,静息心率越快,肺心病发生风险越高,当静息心率>75次/分时,心衰风险也显著增加。该研究于2004~2008年从中国10个地理位置不同的地区纳入近50万名成年人,其平均年龄为51.7岁,60%为女士。

这些人基线均无心脏病病史,也没有服用β受体阻滞剂;基线平均静息心率为79次/分,其中男士和女士分别为78次/分、80次/分,随着年龄增长心率下降,大约每10年下降1次/分。

中位随访11年期间,6082人出现心衰,5572人出现肺心病。仅4.7%的肺心病是在诊断心衰后发生的;心衰患者中,也仅有5.2%先诊断肺心病。

分析显示,平素静息心率与心衰之间呈J型曲线关系,与肺心病之间呈对数线性关系。平素静息心率每增加10次/分,肺心病发生风险增加74%。但只有当静息心率>75次/分时,每增加10次/分,心衰风险增加25%。进一步校正糖尿病和高血压后,静息心率>75次/分时,每增加10次/分,心衰风险大约减半。

这一研究结果与既往发表的弗明汉心脏研究相似。后者显示,静息心率>80次/分时,每增加10次/分,心衰风险增加14%。

作者指出,该研究结果提示,静息心率与右心衰的关系可能比与左心衰的关系更强。

对于慢阻肺患者,很多临床医生不愿意用β受体阻滞剂,该研究表明,从人群层面来看,降低静息心率可能会显著降低心衰和肺心病的发病和死亡风险,但需要进一步验证。该研究结果支持进一步开展研究来评估β受体阻滞剂对肺心病的疗效,以及探索慢阻肺患者心脏并发症的预防策略。

来源:Resting heart rate and risk of left and right heart failure in 0.5 million Chinese adults. Open Heart, 2022, 9(1): e001963.

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    2022-07-29 feather89
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    2022-06-20 ms3000000884115523

    学习

    0

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    2022-06-10 qjddjq
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