Abstract
BackgroundHigh resting heart rate (HR) is associated with increased cardiovascular risk in general populations, possibly due to elevated blood pressure (BP) or sympathetic over-activity. We studied the association of resting HR with cardiovascular function, and examined whether the hemodynamics remained similar during passive head-up tilt.MethodsHemodynamics were recorded using whole-body impedance cardiography and continuous radial pulse wave analysis in 522 subjects (age 20–72 years, 261 males) without medication influencing HR or BP, or diagnosed diabetes, coronary artery, renal, peripheral arterial, or cerebrovascular disease. Correlations were calculated, and results analysed according to resting HR tertiles.ResultsHigher resting HR was associated with elevated systolic and diastolic BP, lower stroke volume but higher cardiac output and work, and lower systemic vascular resistance, both supine and upright (p < 0.05 for all). Subjects with higher HR also showed lower supine and upright aortic pulse pressure and augmentation index, and increased resting pulse wave velocity (p < 0.001). Upright stroke volume decreased less in subjects with highest resting HR (p < 0.05), and cardiac output decreased less in subjects with lowest resting HR (p < 0.009), but clear hemodynamic differences between the tertiles persisted both supine and upright.ConclusionsSupine and upright hemodynamic profile associated with higher resting HR is characterized by higher cardiac output and lower systemic vascular resistance. Higher resting HR was associated with reduced central wave reflection, in spite of elevated BP and arterial stiffness. The increased cardiac workload, higher BP and arterial stiffness, may explain why higher HR is associated with less favourable prognosis in populations.Trial registrationClinicalTrials.gov, NCT01742702
Highlights
High resting heart rate (HR) is associated with increased cardiovascular risk in general populations, possibly due to elevated blood pressure (BP) or sympathetic over-activity
Use of alcohol, amount of smoking, hematocrit, and plasma concentrations of sodium, potassium, High-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and glucose did not differ between the HR tertiles (p > 0.05 for all)
The present results suggest that the relationship between HR and Augmentation index (AIx) could arise from the inverse association of HR with systemic vascular resistance: the reflection point of the forward arterial pressure wave is shifted more peripherally during lower systemic vascular resistance index, and this prolongs the time to wave reflection shifting it towards diastole [24]
Summary
High resting heart rate (HR) is associated with increased cardiovascular risk in general populations, possibly due to elevated blood pressure (BP) or sympathetic over-activity. Increased resting HR is associated with higher cardiovascular mortality and morbidity in general populations [1,2,3,4,5], even when other cardiac risk factors are taken into consideration [2,4,5]. Higher HR is a risk factor for elevated. Higher resting HR has been associated with increased pulse wave velocity (PWV), i.e. increased arterial stiffness [19,20,21,22]. High PWV is a marker of cardiovascular aging and an acknowledged independent risk factor for cardiovascular morbidity [23]
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