著者

井上 卓 新里 譲 Inoue Taku Shinzato Yuzuru 琉球大学院医学研究科臨床薬理学分野 沖縄赤十字病院循環器科

出版者

琉球医学会

雑誌

琉球医学会誌 = Ryukyu Medical Journal (ISSN:1346888X)

巻号頁・発行日

vol.27, no.3, pp.123-129, 2008

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Background: Elevated heart rate is closely associated with cardiovascular morbidity, mortality and all-cause mortality. Elevated heart rate is also associated with cardiovascular risk factors. The aim of the present study was to evaluate whether elevated heart rate is associated with cardiovascular morbidity independent of cardiovascular risk factors. Methods & Results: We examined the association between heart rate and cardiovascular morbidity of ambulatory patients. Of 102 patients, 3 were excluded because of low ejection fraction. Among the remaining 99 subjects (54 men, 45 women, $66 pm 12$ years of age), 34 (20 men, 14 women, $ 71\pm 8$ years of age) had a history of cardiovascular disease. The subjects with cardiovascular disease were significantly older, and had lower systolic blood pressure and lower total cholesterol levels than those without cardiovascular disease. Multivanable logistic regression analysis adjusted for age, sex, and antihypertensive agents revealed that a 20 beats/min heart rate increase was associated with an approximately 4-fold increase in the risk for cardiovascular disease (OR 3.597, 95% CI 1.456 - 8.888, p=0.0055). Metabolic syndrome (OR 1.276, 95% CI 0.434 - 3.752, p=NS) and chronic kidney disease (OR 0.736, 95% CI 0.238 - 2.279, p=NS) were not associated with cardiovascular disease. After excluding the patients prescribed such heart rate-lowering drugs as $ \beta $ -antagonist or diltiazem, heart rate increase was still the only factor associated with the risk for cardiovascular disease ( OR3.692, 95% CI 1.123 - 12.137, p=0.0351). Conclusions: Elevated heart rate is closely associated with cardiovascular morbidity independent of other cardiovascular risk factors such as metabolic syndrome or chronic kidney disease.