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Shalnova SA, Kutsenko VA, Kapustina AV, Yarovaya EB, Balanova YA, Evstifeeva SE, Imaeva AE, Maksimov SA, Muromtseva GA, Kulakova NV, Kalachikova ON, Chernykh TM, Belova OA, Artamonova GV, Indukaeva EV, Grinshtein YI, Libis RA, Duplyakov DV, Rotar OP, Trubacheva IA, Serebryakova VN, Efanov AY, Konradi AO, Boytsov SA, Drapkina OM. Associations of Blood Pressure and Heart Rate and Their Contribution to the Development of Cardiovascular Complications and All-Cause Mortality in the Russian Population of 25-64 Years. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-10-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the relationship of blood pressure (BP) and heart rate (HR) in a sample of men and women 25-64 years old and their predictive value for the development of fatal and non-fatal cardiovascular diseases (CVD) and mortality from all causes.Material and methods. Prospective observation was for cohorts of the population aged 25-64 years from 11 regions of the Russian Federation. 18,251 people were included in the analysis. Each participant gave written informed consent. All surveyed persons were interviewed with a standard questionnaire. BP was measured on the right hand with an automatic tonometer. BP and HR were measured twice with an interval of 2-3 min with the calculation of the average value. The patients were divided into 4 groups: the first group with BP<140/90 ><140/90 mm Hg and HR≤80 beats/min; the second group – BP<140/><140/90 mm Hg and HR>80; the third group – BP≥140/90 mm Hg and HR≤80; the fourth group – BP≥140/90 mm Hg and HR>80 beats/min. Risk factors and cardiovascular history were analyzed as well. Deaths over 6 years of follow-up occurred in 393 people (141 – from CVD). Statistical analysis was performed using the open source R3.6.1 system.Results. A HR>80 beats/min was found in 26.3% of people with BP≥140/90 mm Hg, regardless of medication. Analysis of the associations between HR and BP showed that for every increase in HR by 10 beats/min, systolic BP increases by 3 mm Hg. (p<0.0001). The group with HR>80 beats/min and BP≥140/90 mm Hg had the shortest life expectancy (p<0.001). Adding an increased HR to BP≥140/90 mm Hg significantly><0.001). Adding an increased HR to BP≥140/90 mm Hg significantly worsened the prognosis of patients. Similar results were obtained in the analysis of cardiovascular survival. Elevated BP and elevated HR had the same effect on outcomes, except for the combined endpoint, where the contribution of elevated BP was predominant. However, their combined effect was the largest and highly significant for the development of the studied outcomes, even after adjusting for other predictors. With an increase in HR by every 10 beats/min, the risk of mortality increased statistically significantly by 22%.Conclusion. The prevalence of HR>80 beats/min in people with BP≥140 mm Hg amounted to 26.34%. Every 10 beats/min significantly increases the risk of mortality by 22%. Increased HR with elevated BP leads to increased adverse outcomes.
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Affiliation(s)
- S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine;
Lomonosov Moscow State University
| | - A. V. Kapustina
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. B. Yarovaya
- National Medical Research Center for Therapy and Preventive Medicine;
Lomonosov Moscow State University
| | - Yu. A. Balanova
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. E. Evstifeeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. E. Imaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Maksimov
- National Medical Research Center for Therapy and Preventive Medicine
| | - G. A. Muromtseva
- National Medical Research Center for Therapy and Preventive Medicine
| | | | | | - T. M. Chernykh
- Voronezh State Medical University named after N. N. Burdenko
| | | | - G. V. Artamonova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - E. V. Indukaeva
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - Yu. I. Grinshtein
- Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
| | | | - D. V. Duplyakov
- Samara State Medical University, Research Institute of Cardiology
| | | | - I. A. Trubacheva
- Cardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - V. N. Serebryakova
- Cardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | | | | | | | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Smirnova MD, Barinova IV, Fofanova TV, Blankova ZN, Svirida ON, Ageev FT, Boytsov SA. What “new” factors should be considered when assessing cardiovascular risk? КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-6-77-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
One of the causes of high mortality from cardiovascular diseases is the lack of effective measures for the primary and secondary prevention of cardiovascular complications (CCO), due to the difficulty of timely identification risk factors (RF) and individuals with a high individual risk of CCO. This is especially true for patients from low/mean risk. This group is heterogeneous. Often, clinical manifestations of atherosclerosis occur for the first time without “classical” RF. Possible factors that increase the risk of developing cardiovascular diseases and CCO, are: heart rate, increased formation of advanced glycation endproducts, disorders of bone mineral metabolism, thyroid function, low adherence to therapy, psychosocial factors and climatic features. This review is devoted to the analysis of the evidence base of the influence of these “new” CCO RF and the individual patient prognosis.
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Affiliation(s)
- M. D. Smirnova
- Scientific Medical Research Center of Cardiology of the Ministry of Health
| | - I. V. Barinova
- Scientific Medical Research Center of Cardiology of the Ministry of Health
| | - T. V. Fofanova
- Scientific Medical Research Center of Cardiology of the Ministry of Health
| | - Z. N. Blankova
- Scientific Medical Research Center of Cardiology of the Ministry of Health
| | - O. N. Svirida
- Scientific Medical Research Center of Cardiology of the Ministry of Health
| | - F. T. Ageev
- Scientific Medical Research Center of Cardiology of the Ministry of Health
| | - S. A. Boytsov
- Scientific Medical Research Center of Cardiology of the Ministry of Health
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