The influence of elevated heart rate assessed by automated office blood pressure measurement on the risk of cardiovascular events.

Pubmed ID: 36602062

Journal: Polish archives of internal medicine

Publication Date: March 29, 2023

MeSH Terms: Humans, Male, Risk Factors, Hypertension, Blood Pressure, Myocardial Infarction, Heart Rate

Authors: Sobieraj P, Lewandowski J, Siński MP

Cite As: Sobieraj P, Siński MP, Lewandowski J. The influence of elevated heart rate assessed by automated office blood pressure measurement on the risk of cardiovascular events. Pol Arch Intern Med 2023 Mar 29;133. (3). Epub 2023 Jan 5.

Studies:

Abstract

INTRODUCTION: The predictive value of heart rate (HR) assessed using an automated office blood pressure measurement (AOBPM) remains unknown. OBJECTIVES: This study aimed to determine the impact of AOBPM HR on the risk of cardiovascular events in hypertensive patients with and without prior cardiovascular disease (CVD). PATIENTS AND METHODS: Data of 9361 participants of the Systolic Blood Pressure Intervention Trial (median follow‑up, 3.26 years) were used to perform a post hoc analysis based on baseline AOBPM HR levels (<50, 50-60, 60-70, 70-80, and >80 bpm). Clinical composite end point (CE) was defined as myocardial infarction (MI), acute coronary syndrome other than MI, heart failure exacerbation, stroke, or cardiovascular death. Cardiovascular‑related and all‑cause mortalities were also evaluated. RESULTS: A total of 1877 participants with and 7484 individuals without CVD were included. Those with higher baseline HR were less frequently men and more often smokers, had higher body mass index and estimated glomerular filtration rate, lower baseline systolic blood pressure, and higher diastolic blood pressure. No differences were observed in the CE frequency, its components, and all‑cause death between the baseline HR groups. Elevated HR (>70 bpm) was associated with a higher risk of CE, MI, and cardiovascular death in a multivariable Cox model. Moreover, the model determining the MI risk showed a J‑shaped relationship with HR and a significant interaction term (P = 0.049) between HR and CVD history. CONCLUSIONS: High AOBPM HR is associated with a higher risk of cardiovascular events and mortality, whereas low HR may result in higher MI risk in patients with previous CVD.