畲族人群静息心率与动脉硬化的关系研究

目的探讨中国福建畲族人静息心率与动脉硬化的关系及其影响因素。 方法于2009年采用整体抽样法抽取中国福建省福安市畲族聚集地6个自然村511人为调查对象，最终样本量325例，进行颈-股动脉脉搏波传导速度（CF-PWV）、颈-桡动脉脉搏波传导速度（CR-PWV）、心踝血管指数（CAVI）、踝臂指数（ABI）检查，超声检测颈动脉内-中膜厚度（CIMT），静息心率（RHR）为动脉硬化设备VS-1000和超声设备三次测量的平均值，并检测血液血脂、血糖、尿酸、超敏C反应蛋白，调查人群一般资料（如年龄、性别、家族史和既往史等）。 结果不同四分位数RHR水平，RHR₁≤61次/分，RHR₂为62~69次/分，RHR₃为70~77次/分，RHR₄≥78次/分，其收缩压（SBP）、舒张压（DBP）、总胆固醇/高密度脂蛋白胆固醇（TC/HDL-C）、HDL-C、CF-PWV、CR-PWV显著不同（P＜0.05），RHR₄组甘油三酯（TG）、TC/HDL-C、DBP、CF-PWV、CR-PWV显著高于RHR₁组，而HDL-C显著低于RHR₁组（P＜0.05）；而CAVI、ABI、CIMT水平差异无统计学意义（P＞0.05）。非条件Logistic回归分析提示在未调整其他危险因素的模型中，与RHR₁组相比，RHR₄组的动脉硬化OR值为3.074（95%置信区间为1.555~6.075，P=0.001）；而进一步调整了年龄和性别之后，RHR₄组的OR值增加为4.542（95%置信区间为2.078~9.928，P＜0.001）；再一次调整了年龄、性别、血压、血脂、血糖及超敏C反应蛋白等传统危险因素之后，RHR₄组的OR值更进一步增加为5.336（95%置信区间为1.512~18.831，P=0.009）。 结论在中国福建畲族自然人群中，较高的静息心率水平伴随有较高的血压、血脂和动脉硬化水平。此外，较高的静息心率与动脉硬化密切相关，且独立于传统的血管疾病危险因素。

Relationship between resting heart rate and arterial stiffness in apparently normal She minority people in Fujian Province

ObjectiveTo evaluate the relationship between resting heart rate (RHR) and arterial stiffness in apparently normal She minority people from Fujian Province, China. MethodsA total of 511 She minority participants from six natural villages were enrolled into this study using cluster sampling method in 2009. Eventually, 325 subjects with full data were analyzed. All subjects were detected for carotid femoral pulse wave velocity (CF-PWV), carotid radial pulse wave velocity (CR-PWV), cardio ankle vascular index (CAVI), ankle brachial index (ABI), and carotid intima media thickness (CIMT) by Doppler ultrasound, and blood tests were performed for measuring fasting plasma glucose (FPG), blood lipids, blood uric acid (UA), and high sensitive C reactive protein (hs-CRP). RHR was the mean of three values measured using VS-1000 vascular detection equipment and ultrasound equipment. ResultsSystolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol/high density lipoprotein cholesterol ratio (TC/HDL-C), HDL-C, CF-PWV, and CR-PWV were significantly different among participants classified into different quartiles of RHR (RHR₁: ≤61 beats/min; RHR₂: 62~69 beats/min; RHR₃: 70~77 beats/min; RHR₄: ≥78 beats/min) (P＜0.05); SBP, DBP, TC/HDL-C, CF-PWV, and CR-PWV in the RHR₄ group were significantly higher than those in the RHR₁ group (P＜0.05), but HDL-C in the RHR₄ group was significantly lower than that of the RHR₁ group (P＜0.05). However, there were no statistical difference in CAVI, ABI, or CIMT among different RHR groups (P＞0.05). Logistic regression analysis indicated in the model without adjustment, RHR₄ was associated with higher CF-PWV (CF-PWV＞9 m/s; odds ratio OR]=3.074, 95% confidence interval CI]: 1.555~6.075, P＜0.05) compared with RHR1. After adjustment for age and gender, the OR of RHR₄ was 4.542 (95%CI: 2.078~9.928, P＜0.05). And after further adjustment for SBP, DBP, plasma lipids, FPG, and hs-CRP, the OR of RHR₄ was 5.336 (95%CI: 1.512~18.831, P＜0.05). ConclusionIn apparently normal She minority people in Fujian Province, China, high RHR is followed by high levels of blood pressure, plasma lipids, and arterial stiffness. Furthermore, higher rest heart rate is independently associated with arterial stiffness.