摘要
目的:探索中国≥60岁老年人群心率与心血管死亡、非心血管死亡及全因死亡风险的相关性。方法:本研究基于前瞻性城乡流行病学研究中国队列(PURE-China)的随访调查。针对60岁以上老年人群,在基线调查时通过数字血压计测量心率,在随访时通过标准化的病例报告表收集心血管死亡、非心血管死亡和全因死亡事件。所有入选者按照不同性别将心率作为分类变量,分为<60次/min组、60~69次/min组、70~79次/min组、80~89次/min组和≥90次/min组共5组,以60~69次/min组作为参照组。最终8 487例纳入分析。采用Cox共享脆弱模型探索心率与死亡风险的相关性。结果:8 487例年龄≥60岁的老年人中,男性3 925例,占总人群的46.25%,平均心率为(73.2±11.6)次/min;女性4 562例,占总人群的53.75%,平均心率为(75.8±10.9)次/min。经过63 688人年(中位随访时间8.55年)的随访,共发生262例心血管死亡事件、399例非心血管死亡事件和682例全因死亡事件。心率增快与≥60岁老年人群死亡风险增加有关。以心率60~69次/min组为参照组,在≥60岁老年男性人群中,当心率>80次/min以上时,三个终点事件死亡风险均显著增加(P均<0.05),而在≥60岁老年女性人群中只有当心率≥90次/min时,心血管死亡(HR=2.04,95%CI:1.07~3.87)和全因死亡(HR=1.78,95%CI:1.18~2.71)风险才显著增加。结论:心率增快与我国≥60岁老年人群的死亡风险增加有关,该关联在男性和女性人群中存在一定的差异。
Objectives:To assess the associations between heart rate(HR)with all-cause,cardiovascular and non-cardiovascular mortality in elderly Chinese aged≥60 years old.Methods:Data from present study were derived from the prospective urban and rural epidemiology study in China(PURE-China).HR was measured at the baseline by trained health workers using digital sphygmomanometers.Cardiovascular mortality,non-cardiovascular mortality,and all-cause mortality events were collected through standardized case reports at follow-ups.Cox frailty model was used to explore the correlation between heart rate and risk of death.Results:A total of 8 487 subjects aged≥60 years old were included in this study(3 925 males,46.25%,heart rate:[73.2±11.6]beats/min[bpm];4 562 women,53.75%,heart rate:[75.8±10.9]bpm).During a total observational time of 63 688 person-years,a total of 262 cardiovascular death events,399 non-cardiovascular death events,and 682 all-cause death events were documented.Increased heart rate is associated with higher risk of death in aged population.In adjusted analyses,males with heart rate>80.0 bpm faced higher risk of death compared with those with the heart rate between 60-69 bpm(all P<0.001).Significant associations of all-cause mortality(HR=1.78,95%CI:1.18-2.71)and cardiovascular mortality(HR=2.04,95%CI:1.07-3.87)were shown for females with heart rates≥90 bpm.Conclusions:Elevated HR is associated with increased risk of cardiovascular mortality,non-cardiovascular mortality and total mortality for elderly Chinese aged≥60 years old.
作者
王月波
尹潞
成小如
胡泊
游凯
李卫
刘远立
WANG Yuebo;YIN Lu;CHENG Xiaoru;HU Bo;YOU Kai;LI Wei;LIU Yuanli(Medical Research&Biometrics Center,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)
出处
《中国循环杂志》
CSCD
北大核心
2019年第9期877-881,共5页
Chinese Circulation Journal
基金
中国医学科学院医学与健康科技创新工程(2016-I2M-2-004)
关键词
心率
死亡风险
老年人群
相关性
heart rate
mortality
older adults
correlation
