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
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. ShalnovaRussian 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
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
Russian Federation
Anna V. Kapustina – Senior Researcher, Department of Epidemiology of Chronic Non-Communicable Diseases
Petroverigsky per. 10, Moscow, 101990
E. B. Yarovaya
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
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
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
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
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
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
Natalia V. Kulakova – MD, PhD, Associate Professor
Ostryakova prospect 2, Vladivostok, 690002
O. N. Kalachikova
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
Tatiana M. Chernykh – MD, PhD, Professor, Head of Chair of Hospital Therapy and Endocrinology
Studencheskaya ul. 10, Voronezh, 394005
O. A. Belova
Olga A. Belova – MD, Deputy Chief Physician for Organizational and Methodological Work
Sheremetevsky prospect 22, Ivanovo, 153012
G. V. Artamonova
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
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
Yurii I. Grinshtein – MD, PhD, Professor, Head of Chair of Therapy, Institute of Postgraduate Education
Partizana Zheleznyaka ul. 1, Krasnoyarsk, 660022
R. A. Libis
Roman A. Libis – MD, PhD, Professor, Head of Chair of Hospital Therapy
Sovetskaya ul. 6, Orenburg, 123457
D. V. Duplyakov
Dmitry V. Duplyakov – MD, PhD, Professor, Director of Research Institute of Cardiology
Chapaevskaya ul. 89, Samara, 433099
O. P. Rotar
Oxana P. Rotar – MD, PhD, Chief Researcher, Research Laboratory of Epidemiology of Non-Communicable Diseases
Parkhomenko ul. 2, St. Petersburg, 194156
I. A. Trubacheva
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
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
Alexey Yu. Efanov – MD, PhD, Head of Center for International Education
Odesskaya ul. 54, Tyumen, 625023
A. O. Konradi
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
Sergey A. Boytsov – MD, PhD, Professor, Academician of the Russian Academy of Sciences, Director
Tretya Cherepkovskaya ul. 15a, Moscow, 121552
O. M. Drapkina
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