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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

https://doi.org/10.20996/1819-6446-2020-10-02

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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.

About the Authors

S. A. Shalnova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Svetlana A. Shalnova – MD, PhD, Professor, Head of Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



V. A. Kutsenko
National Medical Research Center for Therapy and Preventive Medicine; Lomonosov Moscow State University
Russian Federation

Vladimir A. Kutsenko – Junior Researcher, Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases, National Medical Research Center for Therapy and Preventive Medicine; Post-Graduate Student, Chair of Probability Theory, Department of Mathematics, Faculty of Mechanics and Mathematics, Lomonosov Moscow State University

Petroverigsky per. 10, Moscow, 101990, 

Leninskiye Gory 1, Moscow, 119991



A. V. Kapustina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Anna V. Kapustina – Senior Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



E. B. Yarovaya
National Medical Research Center for Therapy and Preventive Medicine; Lomonosov Moscow State University
Russian Federation

Elena B. Yarovaya – PhD (Physics and Mathematics), Professor, Head of Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases, National Medical Research Center for Therapy and Preventive Medicine; Associate Professor, Chair of Probability Theory, Department of Mathematics, Faculty of Mechanics and Mathematics, Lomonosov Moscow State University

Petroverigsky per. 10, Moscow, 101990, 

Leninskiye Gory 1, Moscow, 119991



Yu. A. Balanova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Yulia A. Balanova – MD, PhD, Leading Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



S. E. Evstifeeva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Svetlana E. Evstifeeva – MD, PhD, Senior Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



A. E. Imaeva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Asiia E. Imaeva – MD, PhD, Senior Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



S. A. Maksimov
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Sergey A. Maksimov – MD, PhD, Leading Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



G. A. Muromtseva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Galina A. Muromtseva – PhD (Biology), Leading Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases

Petroverigsky per. 10, Moscow, 101990



N. V. Kulakova
Pacific State Medical University

Natalia V. Kulakova – MD, PhD, Associate Professor

Ostryakova prospect 2, Vladivostok, 690002



O. N. Kalachikova
Vologda Research Center of the Russian Academy of Sciences

Olga N. Kalachikova – PhD (Economics), Deputy Director for Research, Head of Department for Research on the Level and Lifestyle of the Population

Gorkogo ul. 56a, Vologda, 160014



T. M. Chernykh
Voronezh State Medical University named after N. N. Burdenko

Tatiana M. Chernykh – MD, PhD, Professor, Head of Chair of Hospital Therapy and Endocrinology

Studencheskaya ul. 10, Voronezh, 394005



O. A. Belova
Ivanovo Regional Cardiology Clinic

Olga A. Belova – MD, Deputy Chief Physician for Organizational and Methodological Work

Sheremetevsky prospect 22, Ivanovo, 153012



G. V. Artamonova
Research Institute for Complex Issues of Cardiovascular Diseases

Galina V. Artamonova – MD, PhD, Professor, Deputy Director for Research, Head of Department of Optimization of Medical Care for Cardiovascular Diseases

Sosnoviy bulvar 6, Kemerovo, 650002



E. V. Indukaeva
Research Institute for Complex Issues of Cardiovascular Diseases

Elena V. Indukaeva – MD, PhD, Senior Researcher, Laboratory of Epidemiology of Cardiovascular Diseases, Department of Optimization of Medical Care for Cardiovascular Diseases

Sosnoviy bulvar 6, Kemerovo, 650002



Yu. I. Grinshtein
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky

Yurii I. Grinshtein – MD, PhD, Professor, Head of Chair of Therapy, Institute of Postgraduate Education

Partizana Zheleznyaka ul. 1, Krasnoyarsk, 660022



R. A. Libis
Orenburg State Medical University

Roman A. Libis – MD, PhD, Professor, Head of Chair of Hospital Therapy

Sovetskaya ul. 6, Orenburg, 123457



D. V. Duplyakov
Samara State Medical University, Research Institute of Cardiology

Dmitry V. Duplyakov – MD, PhD, Professor, Director of Research Institute of Cardiology

Chapaevskaya ul. 89, Samara, 433099



O. P. Rotar
Almazov National Medical Research Centre

Oxana P. Rotar – MD, PhD, Chief Researcher, Research Laboratory of Epidemiology of Non-Communicable Diseases

Parkhomenko ul. 2, St. Petersburg, 194156



I. A. Trubacheva
Cardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

Irina A. Trubacheva – MD, PhD, Head of Department of Population Cardiology, Deputy Director for Scientific and Organizational Work

Kievskaya ul. 111a, Tomsk, 634012



V. N. Serebryakova
Cardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences

Victoria N. Serebryakova – MD, PhD, Head of Laboratory of Registers of Cardiovascular Diseases, High-Tech Interventions and Telemedicine

Kievskaya ul. 111a, Tomsk, 634012



A. Yu. Efanov
Tyumen State Medical University

Alexey Yu. Efanov – MD, PhD, Head of Center for International Education

Odesskaya ul. 54, Tyumen, 625023



A. O. Konradi
Almazov National Medical Research Centre

Alexandra O. Konradi – MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Deputy Director General for Research

Parkhomenko ul. 2, St. Petersburg, 194156



S. A. Boytsov
National Medical Research Center of Cardiology

Sergey A. Boytsov – MD, PhD, Professor, Academician of the Russian Academy of Sciences, Director

Tretya Cherepkovskaya ul. 15a, Moscow, 121552



O. M. Drapkina
National Medical Research Center for Therapy and Preventive Medicine

Oxana M. Drapkina – MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Director

Petroverigsky per. 10, Moscow, 101990



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For citation:


Shalnova S.A., Kutsenko V.A., Kapustina A.V., Yarovaya E.B., Balanova Yu.A., Evstifeeva S.E., Imaeva A.E., Maksimov S.A., Muromtseva G.A., Kulakova N.V., Kalachikova O.N., Chernykh T.M., Belova O.A., Artamonova G.V., Indukaeva E.V., Grinshtein Yu.I., Libis R.A., Duplyakov D.V., Rotar O.P., Trubacheva I.A., Serebryakova V.N., Efanov A.Yu., Konradi A.O., Boytsov S.A., Drapkina O.M. 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;16(5):759-769. (In Russ.) https://doi.org/10.20996/1819-6446-2020-10-02

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