夷陵地区中老年人群静息心率升高与脂代谢异常的相关性研究

目的:研究夷陵地区中老年人群静息心率升高与脂代谢异常的相关性。方法 :选取湖北省宜昌市夷陵地区9 994名40岁以上常住居民进行问卷调查、体格检查(包括血压、静息心率等)、生化检测(包括血糖、血脂等)。脂代谢异常诊断采用中国成人血脂异常防治指南(2016年修订版)诊断标准。按静息心率水平将人群分为4组,分别为70、70～79、80～89及≥90次/min。采用Logistic回归分析静息心率升高与脂代谢异常的相关性。结果:随着静息心率增高,男性高三酰甘油(triglyceride,TG)血症、高胆固醇血症、高低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)血症及低高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol,HDL-C)血症的患病率显著升高(趋势P0.05),而女性中,仅高TG血症患病率呈现增加趋势(趋势P0.05)。多元Logistic回归分析显示,校正传统危险因素后,心率≥90次/min的男性其高TG血症、高胆固醇血症、高LDL-C血症及低HDL-C血症的患病风险明显高于心率70次/min的男性[优势比(odds ratio, OR)、95%可信区间(confidence interval, CI)分别为1.85(1.26～2.71)、1.43(1.03～1.98)、1.60(1.04～2.47)、2.17(1.08～4.36)]。心率≥90次/min的女性高TG血症的患病风险高于心率70次/min的女性[OR(95%CI):1.71(1.25～2.34)]。结论:夷陵地区中老年人群静息心率升高与脂代谢异常的患病风险呈正相关。     

中老年人静息心率升高与动脉硬化的相关性研究

目的:研究中老年人静息心率升高与动脉硬化的相关性。方法:在上海市嘉定区选取2 519名年龄40岁以上的居民进行问卷调查、体格检查、生化检测以及肱-踝动脉脉搏波传导速度(ba-PWV)的测量。以ba-PWV上四分位定义为动脉硬化。以ba-PWV作为应变量,采用多重线性回归模型,分析心率及其他传统危险因素与ba-PWV的相关性。同时,将人群按心率四分位值分成4组,以心率上四分位组作为对照,采用多重Logistic回归模型分析其余3组人群动脉硬化的患病风险。结果:按心率四分位分组为≤73次/min组、74~81次/min组、82~90次/min组、≥91次/min组;ba-PWV与心率呈显著正相关(r=0.23,P0.000 1),在多重线性回归中,心率对ba-PWV仍然有很好的相关性(标准β=0.17,P0.000 1)。在心率四分位组间,随着心率水平的增高,动脉硬化的患病率也随之增高,从上四分位组到下四分位组,动脉硬化的患病率依次为15.5%、20.9%、24.5%和39.9%。多重Logistic回归分析显示,在校正了其他传统危险因素后,心率≥91次/min组人群的动脉硬化患病风险是心率≤73次/min组人群的4.36倍[比值比(OR)=4.36,95%可信区间(CI):2.98~6.38]。结论:中老年人静息心率升高与动脉硬化独立相关。     

静息心率与踝臂血压指数的关系

目的探讨静息心率与踝臂血压指数(ABI)的关系。方法采用横断面研究方法,从参加了2006-2007年唐山开滦集团健康体检的职工101 510人中以随机分层抽样方法抽取5852人,根据纳入排除标准,最终纳入统计的为4778人,进行统一问卷调查和血液生化检查,采用多因素Logistic回归分析静息心率对ABI的影响。结果静息心率四分位组(≤63,63~≤70,70~≤76,76次/min)平均ABI分别为1.11±0.10,1.09±0.09,1.08±0.10,1.06±0.10(P0.05)。多元线性回归分析结果显示,在校正了性别、年龄、空腹血糖、体质量指数(BMI)、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、高敏C反应蛋白(hsCRP)、吸烟、经常锻炼和饮酒后,静息心率与ABI呈负相关。多因素Logistic回归结果显示,在校正了性别、年龄、空腹血糖、BMI、总胆固醇、三酰甘油、HDL-C、hsCRP、吸烟、经常锻炼和饮酒之后,与静息心率≤63次/min组相比,静息心率70~≤76和76次/min组发生ABI≤0.9的风险增加[OR值分别为1.99(95%CI 1.23~3.24)和2.86(1.82~4.50)]。结论静息心率升高是ABI≤0.9的独立危险因素。     

收缩压和静息心率与新发糖尿病的关系

目的观察收缩压和静息心率对新发糖尿病的联合影响。方法选择参加2006-2007年度开滦集团公司职工健康体检且无糖尿病病史的研究对象作为观察队列。于2008-2009、2010-2011、2012-2013年度分别对观察队列进行第2、3、4次健康体检。将研究对象按基线静息心率(≤60、61~70、71~80、80次/min)和收缩压水平(≤120、121~140、141~160、160mm Hg)进行分组,比较各组糖尿病发生率的差异,并采用多因素Cox回归分析各组糖尿病发病风险。结果共入选离退休职工69 048人进行最后分析。随访6年,新发糖尿病5931例,发生率为8.6%。随静息心率和收缩压水平升高,糖尿病发生率呈递增趋势,其中静息心率80次/min且收缩压160mm Hg组糖尿病发生率最高,为18.0%,而静息心率≤60次/min且收缩压≤120mm Hg组糖尿病发生率最低,为4.6%。多因素Cox回归分析显示,在校正基线年龄、性别、体质量指数等混杂因素后,静息心率80次/min且收缩压160mm Hg组发生糖尿病的风险最高,为静息心率≤60次/min且收缩压≤120 mm Hg组的2.88(95%CI2.26~3.66)倍。结论收缩压升高和静息心率加快者的糖尿病发病风险增加。     

老年人静息心率过快发病相关临床指标研究

从连续两年的健康体检资料中抽取静息心率正常的老年人群作为研究对象,记录其基本情况,及各项可能影响静息心率过快发病的临床指标,跟踪调查一年后,检测他们的静息心率,应用SPSS19.0软件进行单因素及多因素logistic回归分析它们的作用。结果:单因素分析中,高血压,糖尿病,高甘油三酯血症有统计学意义:高血压,糖尿病,高甘油三酯组老年人高于相应的老年人组;多因素logistic回归中,高血压,糖尿病,肥胖,年龄有统计学意义,高血压,糖尿病,肥胖的RR值分别为1.303,1.738,0.530,基线年龄每减少一岁,静息心率过快患病风险降低为原来的0.972倍。结论:老年人静息心率过快发病的影响因素有高血压,糖尿病,肥胖,年龄,其中高血压,糖尿病为危险因素,肥胖为保护因素,随着基线年龄的增加,静息心率过快发病风险也增大。     

静息心率与高血压发病风险的关系及性别、年龄对其的修饰效应

目的探讨我国农村地区成年人群静息心率与高血压发病风险的关系及性别、年龄对其的修饰效应。方法该研究为队列研究。于2007年7月至2008年8月在河南省新安县选取2个镇为研究现场,以自然村为单位采用整群随机抽样的方法抽取调查村庄,进行基线调查。根据标准入选常住居民20194人。于2013年7月至2014年10月对入选者进行随访,最终完成随访者17265人。排除基线高血压患者、基线静息心率资料缺失者、随访期间死亡者、随访时高血压诊断资料缺失者以及诊断为妊娠高血压者,最终共10212人纳入该研究。基线和随访调查均包含问卷调查(人口统计学资料、行为危险因素、疾病史及用药史等)、人体测量(身高、体重、静息心率及血压测量)、空腹血糖以及脂质谱检测。按照静息心率的四分位数值将研究对象分为4组,即Q1组、Q2组、Q3组和Q4组。既往无高血压病史,随访期间收缩压≥140 mmHg(1 mmHg=0.133 kPa)和/或舒张压≥90 mmHg,或正在服用降压药物定义为新发高血压。以基线静息心率为自变量,以随访与基线的血压差值为因变量,采用多重线性回归分析静息心率与血压差值的关系。采用多因素logistic回归模型分析静息心率与高血压发病风险的关联强度[即比值比(OR)及其95%可信区间(CI)]。然后采用公式计算高血压发病风险,即计算其相对危险度(RR)。该研究还针对性别(男性和女性)和年龄(<60岁和≥60岁)进行了亚组分析。结果研究平均随访6.0年,新发高血压病例累计2059例,其中男性839例。多因素logistic回归分析结果显示,在总人群中校正了潜在混杂因素后,静息心率每增加5次/min,高血压发病风险的RR值为1.04(95%CI 1.01~1.08,P<0.05)。校正潜在混杂因素后,在女性人群中静息心率每增加5次/min,收缩压差值增加0.18 mmHg(95%CI 0.01~0.36 mmHg,P=0.046),同时高血压发病风险增加(RR=1.07,95%CI 1.03~1.11,P<0.05)。在女性人群中,Q3组(静息心率76~82次/min)和Q4组(静息心率>82次/min)高血压发病风险均高于Q1组(静息心率<70次/min),RR值分别为1.39(95%CI 1.18~1.63,P<0.05)和1.22(95%CI 1.02~1.45,P<0.05)。在男性人群中,无论<60岁组还是≥60岁组,静息心率加快均不增加高血压发病风险(P均>0.05)。而<60岁组的女性静息心率加快则高血压发病风险增加(RR=1.05,95%CI 1.01~1.10,P<0.05),≥60岁组的女性静息心率加快高血压的发病风险则更高(RR=1.14,95%CI 1.04~1.25,P<0.05)。结论对于我国农村地区成年人群而言,静息心率与高血压发病风险具有一定的关联,且具有性别差异。静息心率较快的女性人群高血压发病风险更高,且以老年女性为甚。     

老年人高血压患病率与血脂和血糖及心率的相关性研究

目的调查内蒙古地区老年人群高血压的患病情况与血脂、空腹血糖和静息心率的关系,为健康管理提供理论依据。方法选择2012年1¹2月在内蒙古自治区人民医院干部保健所进行健康体检的491例年龄≥60岁的老年人,检测血压、血脂全项、空腹血糖,并行12导联心电图检查,分析血脂、空腹血糖和静息心率与高血压患病率之间的关系。结果该地区老年人群高血压患病率为47.0%。高血压患病率随TG、TC、LDL-C、空腹血糖的升高以及静息心率增快而升高,随HDL-C水平降低而升高,差异均有统计学意义(P<0.05)。结论内蒙古地区老年人群高血压患病率较高,高血压患病率与TC、TG、空腹血糖升高以及静息心率增快密切相关。应加强老年人群的血糖、血脂、静息心率的系统化健康管理,以控制高血压的发生率。     

1566例住院2型糖尿病患者心率现状调查

目的:分析2型糖尿病患者的静息心率和与年龄、糖尿病病程、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPG)、体质指数(BMI)的相关性,及伴高血压、冠心病患者的心率现状和危险因素,为降低心性猝死发病率提供理论依据。方法:采用横断面调查方法对2014-04-2016-03我院住院的2型糖尿病患者按顺序入组,进行病案检索,记录一般情况和心率、糖尿病病程、HbA1c、FPG、2hPG、BMI、合并症及用药情况。共调查2 012例患者,进入分析的2型糖尿病患者1 566例。其中单纯2型糖尿病患者830例,2型糖尿病合并高血压患者588例,2型糖尿病合并冠心病患者46例,2型糖尿病合并高血压和冠心病患者102例,有影响心率因素(起搏器植入、发热、甲亢、应用β受体阻滞剂和非二氢吡啶类钙拮抗剂)、影响血红蛋白因素(贫血、脾亢)、严重肝肾损害疾病患者341例和溯源问题105例均未纳入分析。心率的测量用12导联心电图机以卧位静息为准;HbA1c、FPG、2hPG以空腹静脉血为准,采用葡萄糖氧化酶法,进行生化仪检测;BMI的采集用体重身高测量仪测量身高、体重,用BMI=体重(kg)/身高(cm)~2公式求得。结果:2型糖尿病住院患者的静息平均心率为76.24次/min,主要分布区间在70~79次/min,在单纯2型糖尿病患者中心率≥80次/min者占37.47%,≥90次/min者占14.82%。双变量相关分析显示年龄与心率呈负相关(r=-0.098,P=0.005),HbA1c、FPG和2hPG分别与心率呈正相关(分别为r=0.170,P=0.000;r=0.148,P=0.000;r=0.199,P=0.000),而与糖尿病病程和BMI不相关。HbA1c、FPG、2hPG控制欠佳者心率显著增快。2型糖尿病患者、2型糖尿病伴高血压患者、伴冠心病患者、伴高血压和冠心病患者的静息平均心率分别为(76.42±11.86)、(76.58±11.42)、(77.37±11.08)及(72.28±11.50)次/min。糖尿病合并高血压风险增加与年龄、BMI有关,合并冠心病风险增加与糖尿病病程有关。结论:2型糖尿病患者心率偏快,与长期血糖控制不理想致糖尿病心肌损害有关。因此,HbA1c达标对防治糖尿病心肌损害具有重要意义。     

中老年女性静息心率与糖脂代谢的相关性研究

目的研究静息心率(RHR)与中老年女性糖脂代谢的相关性。方法以2010年1月至2014年6月在珠海市人民医院体检科参与体检并符合纳入标准的862例中老年女性为研究对象,根据不同的RHR分为4组:70次/min组(对照组)、70~79次/min组、80~89次/min组、≥90次/min组;比较不同RHR组女性糖尿病和高血压患病率,空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平差异;并采用多因素非条件Logistic回归模型分析RHR对血脂代谢的影响强度。结果高血压患病率随着RHR的加快呈上升趋势(χ2trend=23.52,Ptrend0.001),RHR≥90次/min组高血压患病率约为63.2%,显著高于70次/min组(33.2%)、70~79次/min组(46.7%)、80~89次/min组(53.6%);糖脂代谢指标分析结果显示,外周血TG水平随着RHR加快逐渐增多(Ftrend=4.03,Ptrend=0.045),且≥90次/min组的TG水平较70次/min组女性升高了19.4%(2.22±1.84比1.86±1.06)。多因素Logistic回归分析显示,在校正了其他传统危险因素后,心率≥90次/min组中老年女性患高血压和高TG血症的风险分别是RHR70次/min组人群的3.11倍(95%CI:1.64~5.88)和2.60倍(95%CI:1.38~4.90)。结论中老年女性RHR越快,高血压和高TG血症的发生危险性越高,因此本文将为临床上心血管疾病及其中间表型的评估与预测提供新的靶向研究方向。     

合并快静息心率的高血压患者的临床特征分析

目的:探究合并快静息心率的高血压患者的临床特征及其常见临床合并症情况。方法:本研究回顾性分析了2000年山东青岛港研究和2005年河南信阳研究纳入的静息心电图资料完整的18岁以上社区人群,包括高血压与非高血压患者。收集患者的临床合并症(包括糖尿病、冠心病、高脂血症、脑卒中等)、实验室检查结果、心电图静息心率(RHR)、体重指数(BMI)、腰臀比以及诊室血压。结果:纳入受试者18 183例,61.6%为男性,平均年龄(45.2±12.7)岁,高血压患者6 763例。高血压患者的静息心率明显高于正常血压人群[(73.5±11.6)次/min vs(70.6±9.6)次/min,P0.001],合并快静息心率的患者比例显著高于非高血压者(14.5%vs 6.4%,P0.001)。在高血压患者中,与正常静息心率的患者相比,合并快静息心率的患者年龄更大[(51.8±11.2)岁vs(53.9±12.2)岁,P0.001),体重指数更低([26.4±3.4)kg/m~2 vs(25.8±3.6)kg/m~2,P0.001],3级高血压患者比例更高(59.0%vs 68.2%,P0.001),空腹血糖[(5.6±1.5)mmol/L vs(6.0±2.4)mmol/L,P0.001]、甘油三酯([1.7±1.3)mmol/L vs(2.0±1.8)mmol/L,P0.001]及低密度脂蛋白胆固醇水平更高([3.1±0.8)mmol/L vs(3.2±0.9)mmol/L,P=0.001)],合并糖尿病(3.9%vs 6.6%,P=0.007)和脑卒中(8.3%vs 11.1%,P=0.005)的比例高。多因素回归分析校正传统危险因素后发现,快静息心率与高血压患者的脑卒中风险呈正相关(OR=1.306,95%CI:1.021~1.671)。结论:高血压人群中快静息心率比例显著高于正常血压人群。合并快静息心率的高血压患者年龄更大,体重指数更低,多为3级高血压患者,且多合并糖尿病、脑卒中。快静息心率增加高血压患者的脑卒中风险。     

The association of resting heart rate with cardiovascular, cancer and all-cause mortality. Eight year follow-up of 3527 male Israeli employees (the CORDIS Study)

BACKGROUND: Resting heart rate has frequently been shown to be a predictor of coronary heart disease mortality. Elevated heart rate could also be a marker for the presence of other risk factors, which have not been taken into consideration in previous studies. OBJECTIVE: To evaluate the effect of resting heart rate on the risk of all-cause cardiovascular and cancer mortality, taking into consideration haematological variables. METHOD: The association between resting heart rate and mortality was assessed applying Cox's proportional hazard models to data obtained in an 8 year follow-up of 3527 Israeli male industrial employees. During this period 135 deaths were recorded, 57 from cardiovascular disease and 45 from cancer. Resting heart rate was assessed at entry; potential confounding demographic, anthropometric and socioeconomic variables, haematological data, serum lipid levels and health-related habits were accounted for. RESULTS: We found that the relative risk of all-cause mortality increased with increasing resting heart rate, workers with resting heart rate >90 beats. min(-1)had an adjusted relative risk of 2.23 (95% CI 1.4-3.6) compared with those with a heart rate <70 beats. min(-1). A similar result was achieved for cardiovascular disease mortality (adjusted relative risk 2.02, 95% CI 1.1-4.0). Cancer mortality was not associated with resting heart rate. CONCLUSION: This study found that resting heart rate is associated with all-cause and cardiovascular disease mortality after controlling (in various statistical models) for platelet counts, haemoglobin concentration, white blood cell counts, total protein, and other recognized risk factors.     

Association of heart rate and diabetes among 0.5 million adults in the China Kadoorie biobank: Results from observational and Mendelian randomization analyses

Background and aimsObservational studies have associated resting heart rate with incident diabetes. Whether the associations are causal remains unclear. We aimed to examine the shape and strength of the associations and assessed the causal relevance of such associations in Chinese adults.Methods and resultsThe China Kadoorie Biobank enrolled 512,891 adults in China. Cox proportional hazard regression models was conducted to estimate hazard ratios (HRs) for the associations of resting heart rate with type 2 diabetes and total diabetes. Among 92,724 participants, 36 single-nucleotide polymorphisms (SNPs) related to resting heart rate were used to construct genetic risk score. We used Mendelian randomization analyses to make the causal inferences. During a median follow-up of 9 years, 7872 incident type 2 diabetes and 13,349 incident total diabetes were documented. After regression dilution bias adjustment, each 10 bpm higher heart rate was associated with about a 26% higher risk of type 2 diabetes (HR, 1.26 [95% CI, 1.23, 1.29]) and 23% higher risk of total diabetes (HR, 1.23 [95% CI, 1.20, 1.26]). Instrumental variable analyses showed participants at top quintile compared with those at bottom quintile had 30% higher risk for type 2 diabetes (HR, 1.30 [95% CI, 1.17, 1.43]), and 10% higher risk for total diabetes (HR, 1.10 [95% CI, 1.02, 1.20]).ConclusionsThis study provides evidence that resting heart rate is an important risk factor for diabetes risk. The results suggest that novel treatment approaches targeting reduction of high heart rate for incidence of diabetes may be worth further investigation.     

老老年高血压患者静息心率与动态血压水平相关性研究

目的 研究老老年高血压患者静息心率与动态血压参数之间的相关性.方法 选取2013年2月至2014年2月中国中医科学院广安门医院心内科老老年高血压住院患者147例,均行动态血压监测及心电图检查.根据静息心率的数值将患者分成4组：RHR≥80次/min为1组,70次/min≤RHR≤79次/min为2组,60次/min≤RHR≤69次/min为3组,50次/min≤RHR≤59次/min为4组.比较四组之间的一般临床资料、常规生化指标和动态血压参数.结果 各组比较：总胆固醇3组＞1组,P＜0.05;低密度脂蛋白1组＞其余三组;24h平均DBP 1组（67.11±8.55）mm Hg＞3组（61.47±8.34）mm Hg,1组＞4组（61.79±7.77）mm Hg;白天平均DBP 1组（67.29±8.95）mm Hg＞3组（62.22±8.48）mm Hg,1组＞4组（61.53±8.44）mm Hg;白天SBP负荷1组（40.61±32.57）mm Hg＞2组（33.16±33.36）mm Hg＞3组（23.00±26.26）mm Hg＞4组（20.87±27.22）mm Hg,差异均有统计学意义（P＜0.05）.经多元线性逐步回归分析显示,24h平均DBP、LDL-C为静息心率的影响因素.结论 老老年高血压患者的静息心率与全天平均DBP、LDL-C有着密切的联系,故在诊疗中应予以重视,以期进一步改善生活质量及心脑血管病预后.     

Influence of heart rate at rest for predicting the metabolic syndrome in older Chinese adults

The aim of this study was to examine the relationship between seated resting heart rate and the metabolic syndrome (MetS) among older residents of Guangzhou, South China. A total of 30,519 older participants (≥50 years) from the Guangzhou Biobank Cohort Study were stratified into quartiles based on seated resting heart rate. The associations between each quartile and the MetS were assessed using multivariable logistic regression. A total of 6,907 (22.8 %) individuals were diagnosed as having the MetS, which was significantly associated with increasing heart rate quartiles (P < 0.001). Participants in the uppermost quartile (mean resting heart rate 91 ± 8 beats/min) of this cardiovascular proxy had an almost twofold increased adjusted risk (odds ratio (95 % CI) = 1.94 (1.79, 2.11), P < 0.001) for the MetS, as compared to those in the lowest quartile (mean resting heart rate, 63 ± 4 beats/min). Heart rate, which is an inexpensive and simple clinical measure, was independently associated with the MetS in older Chinese adults. We hope these observations will spur further studies to examine the usefulness of resting heart rate as a means of risk stratification in such populations, for which targeted interventions should be implemented.     

北京中老年自然人群颈-股动脉脉搏波速度的分布及相关因素

目的 了解我国中老年自然人群颈-股动脉脉搏波速度(CFPWV)的分布及相关因素.方法 对北京市石景山区1519名44～79岁居民进行心血管病危险因素调查及CFPWV测量.采用单因素方差分析、Pearson相关和偏相关、多元逐步回归分析CFPWV的相关因素.结果 (1)调整年龄后,男女CFPWV均值分别为11.4 m/s和11.1 m/s,男性显著高于女性(P<0.01).无论男女,随着年龄增长,CFPWV增加,趋势榆验有显著性(P<0.01).(2)调整年龄、件别后,高血压、糖尿病和心率较高组(≥70次/min)CFPWV显著高于非高血压、非糖尿病和心率较低组(<70次/min)(P均<0.01).(3)简单相关显示:不论男女,年龄、收缩压、舒张压、空腹血糖、心率均与CFPWV显著相关,相关系数为0.12～0.46(P均<0.01);女性CFPWV还与总胆固醇、甘油三酯显著相关,相关系数为0.11和0.13(P均<0.01);多元逐步同门显示年龄、性别、收缩压、舒张压、空腹血糖、心率是CFPWV的独市相关因素,年龄是CFPWV最大的相关因素.结论 我国中老年自然人群中,年龄、性别、收缩压、舒张压、空腹血糖、心率与CFPWV显著相关,高密度脂蛋白胆固醇、体质指数与CFPWV不相关.     

Prevalence and determinants of restless leg syndrome in type 2 diabetes mellitus (T2DM) in Pakistan

Background and aimsRestless legs syndromes (RLS) are intrinsic sleeping disorder and its prevalence rate is 10–15% in general population but it is observed that prevalence rate is different in diabetes patients. Current study aims to find prevalence and determinants of RLS in people living with type 2 diabetes mellitus in Pakistan.MethodA multicenter cross-sectional observational study was conducted in 388 diabetes patients attending daily diabetes clinics and teaching hospitals in Pakistan’s twin city between August 2019 and February 2020. The chi-square test and linear regression were used to detect RLS-related factors in type 2 diabetes mellitus.ResultsThe prevalence of RLS found was; 3.1% patients with diabetes were suffering from very severe RLS, 23.5% from severe RLS, 34% from moderate RLS, 21.1% from mild RLS and 18.3% from non-RLS. Gender, age, education, blood glucose fasting (BSF), blood glucose random (BSR) and HBA1c were found to be significant predictors of RLS in patients with diabetes.ConclusionPolicy makers can develop local interventions to curb the growing RLS prevalence by keeping in control the risk factors of RLS in people living with type 2 diabetes.     

Heart rate predicts mortality in patients with heart failure and preserved systolic function

BackgroundElevated resting heart rates have been associated with increased mortality and morbidity in patients with heart failure and decreased left ventricular ejection fraction (EF). It is unclear, though, if this association applies to those with heart failure and preserved EF.Methods and ResultsWe determined outcome for 685 consecutive patients with a prior diagnosis of heart failure and a preserved EF (>50%) documented on echocardiography at 1 of 3 laboratories. Patients with non-sinus rhythm were excluded from the analysis. We determined adjusted mortality rates at 1 year after the echocardiogram. The mean age of the cohort was 70 ± 11 years. Of the 685 included patients, 87% had a history of hypertension, 50% had diabetes, and the mean EF was 60% ± 6%. All-cause mortality at 1 year was significantly lower in the group with heart rate below 60 beats/min (10%) when compared with the group with heart rates between 60 and 70 beats/min (18%), 71–90 beats/min (20%), and >90 beats/min (35%) (P < .0001). After adjustment for patient history, demographics, laboratory values, and echocardiographic findings, the hazard ratios for total mortality (relative to a heart rate of <60) were 1.26 (95% CI, 0.88–1.80) for HR 60–69, 1.47 (95% CI, 1.02–2.07) for HR 70–90, and 2.00 (95% CI, 1.31–3.04) for HR>90 (P = .01 across all groups).ConclusionsThese data suggest that an elevated resting heart rate is a marker for increased mortality in patients with heart failure and preserved systolic function. Heart rate may be useful in these patients for improved cardiovascular risk assessment.     

Factors affecting heart rate as measured at home among treated hypertensive patients: the Japan home versus office blood pressure measurement evaluation (J-HOME) study.

We previously reported that a resting heart rate measured at home (home HR) of >or=70 beats per minute was a powerful predictor of the risk of cardiovascular disease mortality, and identified factors affecting home HR in the general Japanese population. The present study examines factors affecting home HR in hypertensive patients treated with antihypertensive medications. Home HR was measured using a home blood pressure (BP) device. Information about the characteristics of the patients was collected using questionnaires administered by a physician. Among 3,400 patients, 3,086 measured home HR both in the morning and evening. The mean values of home HR in the morning and evening were 67.2+/-9.1 and 69.6+/-9.2 beats per minute, respectively. Multivariate linear regression analysis showed that lower age, diabetes mellitus, habitual smoking, higher diastolic BP, and the lack of beta-blocker or angiotensin-converting enzyme inhibitor use were determinants of elevated morning or evening home HR. These results suggest that adequate control of risk factors for cardiovascular disease such as smoking and diabetes mellitus or use of heart rate-lowering agents might help to decrease home HR in treated hypertensive patients.