Office and 24-hour heart rate and target organ damage in hypertensive patients

Angel García-García, Manuel A Gómez-Marcos, José I Recio-Rodríguez, Maria C Patino-Alonso, Emiliano Rodríguez-Sánchez, Cristina Agudo-Conde, Luis García-Ortiz, Vaso-risk group, Luis García-Ortiz, Manuel A Gómez-Marcos, José I Recio-Rodríguez, Cristina Agudo-Conde, Maria C Patino-Alonso, Emiliano Rodriguez-Sanchez, Emilio Ramos-Delgado, Luis J González-Elena, Ángel García-García, Javier Parra-Sánchez, Carmela Rodríguez-Martín, Carmen Castaño-Sánchez, Ángela de Cabo-Laso, Benigna Sánchez-Salgado, Carlos Martínez-Salgado, Ana M Blázquez-Medela, Angel García-García, Manuel A Gómez-Marcos, José I Recio-Rodríguez, Maria C Patino-Alonso, Emiliano Rodríguez-Sánchez, Cristina Agudo-Conde, Luis García-Ortiz, Vaso-risk group, Luis García-Ortiz, Manuel A Gómez-Marcos, José I Recio-Rodríguez, Cristina Agudo-Conde, Maria C Patino-Alonso, Emiliano Rodriguez-Sanchez, Emilio Ramos-Delgado, Luis J González-Elena, Ángel García-García, Javier Parra-Sánchez, Carmela Rodríguez-Martín, Carmen Castaño-Sánchez, Ángela de Cabo-Laso, Benigna Sánchez-Salgado, Carlos Martínez-Salgado, Ana M Blázquez-Medela

Abstract

Background: We investigated the association between heart rate and its variability with the parameters that assess vascular, renal and cardiac target organ damage.

Methods: A cross-sectional study was performed including a consecutive sample of 360 hypertensive patients without heart rate lowering drugs (aged 56 ± 11 years, 64.2% male). Heart rate (HR) and its standard deviation (HRV) in clinical and 24-hour ambulatory monitoring were evaluated. Renal damage was assessed by glomerular filtration rate and albumin/creatinine ratio; vascular damage by carotid intima-media thickness and ankle/brachial index; and cardiac damage by the Cornell voltage-duration product and left ventricular mass index.

Results: There was a positive correlation between ambulatory, but not clinical, heart rate and its standard deviation with glomerular filtration rate, and a negative correlation with carotid intima-media thickness, and night/day ratio of systolic and diastolic blood pressure. There was no correlation with albumin/creatinine ratio, ankle/brachial index, Cornell voltage-duration product or left ventricular mass index. In the multiple linear regression analysis, after adjusting for age, the association of glomerular filtration rate and intima-media thickness with ambulatory heart rate and its standard deviation was lost. According to the logistic regression analysis, the predictors of any target organ damage were age (OR = 1.034 and 1.033) and night/day systolic blood pressure ratio (OR = 1.425 and 1.512). Neither 24 HR nor 24 HRV reached statistical significance.

Conclusions: High ambulatory heart rate and its variability, but not clinical HR, are associated with decreased carotid intima-media thickness and a higher glomerular filtration rate, although this is lost after adjusting for age.

Trial registration: ClinicalTrials.gov: NCT01325064.

Figures

Figure 1
Figure 1
Simple linear regression of IMT and eGFR with 24-hour HR and 24-hour HRV. eGFR: estimate glomerular filtration rate; IMT: Intima-media thickness; HR: Heart rate; HRV: Heart rate variability; bpm: beat per minute.

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