EHJ：静息心率升高是心血管疾病的危险标志

流行病学研究显示静息状态心率是全因死亡和心血管死亡率的预测因子。心率升高与预后不良有关。近期哥本哈根大学的一项研究以尚未出现明显心脏病症状的人群为研究对象，结果显示心率升高与死亡率增加、心血管疾病密切相关，其中夜间心率最为重要。该研究发表在《欧洲心脏杂志》上。

研究者由此得出结论，在尚未出现明显心脏病症状的中年人当中，心率升高与死亡率增加和心血管疾病危险因素有关。其中，夜间心率最为重要，是多变量调整后与病人预后相关的唯一参数。

Resting, night-time, and 24 h heart rate as markers of cardiovascular risk in middle-aged and elderly men and women with no apparent heart disease
Aims
Increased heart rate (HR) is a predictor of all-cause and cardiovascular (CV) mortality. We tested which measure of HR had the strongest prognostic value in a population with no apparent heart disease.
Methods and results
Six hundred and fifty-three men and women between the age of 55 and 75 years were included in the Copenhagen Holter Study and underwent 48 h ambulatory electrocardiographic (ECG) monitoring. Resting HR was measured after at least 10 min of rest. Twenty-four-hour HR was derived from the mean time between normal-to-normal RR intervals (MEANNN). Night-time HR was derived from a 15 min sequence between 2:00 and 2:15 a.m. The median follow-up time was 76 months, and an adverse outcome was defined as all-cause mortality and the combined endpoint of CV death, acute myocardial infarction (AMI), and revascularization. All three measures of HR were significantly associated with all-cause mortality, also after adjustment for conventional risk factors. We found an association between all three measures of HR and CV events in analyses adjusted for sex and age. However, when adjusting for CV risk factors, the association with resting HR and 24 h HR disappeared. In a fully adjusted model, only night-time HR remained in the model, hazard ratio = 1.17 (1.05–1.30), P = 0.005.
Conclusion
In middle-aged subjects with no apparent heart disease, all measures of increased HR were associated with increased mortality and CV risk. However, night-time HR was the only parameter with prognostic importance after multivariable adjustment.