Heart Rate as a Predictor of Mortality: The MATISS Project

Seccareccia, Fulvia; Pannozzo, Fabio; Dima, Francesco; Minoprio, Anna; Menditto, Antonio; Noce, Cinzia Lo; Giampaoli, Simona

doi:10.2105/ajph.91.8.1258

Cited by 168 publications

(110 citation statements)

References 38 publications

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“…Increased resting heart rate has also been identified as an independent risk factor for cardiovascular and all-cause mortality in prospective population studies (47)(48)(49)(50). The mechanism by which this operates is not known, but it may reflect physical fitness.…”

Section: Discussionmentioning

confidence: 99%

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Doornum¹,

McColl²,

Jenkins³

et al. 2003

Arthritis & Rheumatism

126

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Objective. Inflammation appears to play a central role in atherosclerosis, and endothelial damage mediated by systemic inflammation may contribute to the increased cardiovascular mortality in rheumatoid arthritis (RA). Brachial artery flow-mediated dilatation (FMD) and pulse wave analysis (PWA) are measures of vascular function. The aim of this study was to determine if FMD and PWA are abnormal in patients with RA.Methods. Twenty-five RA patients and 25 matched healthy controls were studied. All were free of traditional cardiovascular risk factors. FMD was measured in all subjects. PWA was performed in 18 RA patients and 18 controls, with results expressed as large and small artery compliance (C1 and C2). Modified Sharp scores were calculated in 13 RA patients.Results. Results (mean ؎ SD) in RA patients and controls, respectively, were as follows: FMD 107.6 ؎ 4.6% versus 108.5 ؎ 4.1% (P ‫؍‬ 0.49), C1 14.8 ؎ 2.8 ml/mm Hg ؋ 10 versus 17.9 ؎ 3.1 ml/mm Hg ؋ 10 (P ‫؍‬ 0.0033), C2 4.5 ؎ 2.3 ml/mm Hg ؋ 100 versus 7.7 ؎ 3.7 ml/mm Hg ؋ 100 (P ‫؍‬ 0.0039). There was an inverse correlation between C2 and modified Sharp scores in the RA patients (Spearman's rho -0.69, P ‫؍‬ 0.0085).Conclusion. FMD was normal in these RA patients, whereas arterial compliance was markedly reduced. PWA appears to be a more sensitive measure of vascular dysfunction than FMD in RA and may be the preferred surrogate marker of vascular dysfunction in longitudinal studies of RA patients. The inverse correlation between C2 and the modified Sharp score, a measure that reflects disease activity over time, supports the notion that chronic inflammation plays a role in RA-associated atherosclerosis.

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Section: Discussionmentioning

confidence: 99%

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Doornum¹,

McColl²,

Jenkins³

et al. 2003

Arthritis & Rheumatism

126

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“…Both increased resting heart rate and decreased heart rate variability are predictors of mortality, independent of the ejection fraction. 28 In a study of obese patients without clinical heart disease, the prevalence of late potentials (high-frequency, low-amplitude signals at the terminal part of the QRS complex demonstrated using high-resolution signal averaged recording) are seen to be increased proportionately with BMI. The presence of late potentials has been documented to be associated with increased risk of ventricular arrhythmias in several cardiac conditions and is present in less than 3% of normal controls.…”

Section: Arrhythmiasmentioning

confidence: 99%

Obesity: Effects on Cardiovascular Disease and its Diagnosis

Mathew¹,

Francis²,

Kayalar³

et al. 2008

The Journal of the American Board of Family Medicine

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The higher prevalence of cardiovascular disease in obese individuals is indirectly mediated, to a large extent, by the increased frequency of various well known risk factors like hypertension, diabetes, and dyslipidemia, either individually or as part of the metabolic syndrome. However, there are several ways in which obesity directly affects the cardiovascular system; these will be discussed in detail. We also focus on various challenges posed by obesity in the performance and interpretation of cardiac investigations and how they can be addressed. (J Am Board Fam Med 2008;21:562-8.)

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“…Unlike other dihydropyridine CCBs, however, azelnidipine has been shown to inhibit sympathetic activity. 37 On the contrary, natriuresis and the decrease of body fluid volume caused by diuretics are considered likely to increase sympathetic activity and the heart rate. In this study, the heart rate was lower during azelnidipine therapy than with thiazide therapy.…”

Section: Combined Antihypertensive Therapy With Olmesartan T Ishimitsmentioning

confidence: 99%

Angiotensin-II receptor antagonist combined with calcium channel blocker or diuretic for essential hypertension

et al. 2009

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To achieve the target blood pressure recommended by the latest guidelines, multiple antihypertensive drugs are needed in most patients. In this study, the efficacy of treatment using an angiotensin II receptor antagonist (ARB) combined with a calcium channel blocker (CCB) or a diuretic was compared from multiple perspectives in patients with hypertension. Twenty-nine patients with essential hypertension, who had failed to achieve their target blood pressure (o130/85 mm Hg for patients o65 years old and o140/90 mm Hg for those X65 years) when treated with the ARB olmesartan at 20 mg day À1 , were additionally given 8-16 mg day À1 of the CCB azelnidipine or 1-2 mg day À1 of trichlormethiazide (a thiazide diuretic) in a randomized crossover manner for 4 months each. At the end of each combination therapy period, blood and urine samples were collected and arterial stiffness was evaluated by measuring the cardio-ankle pulse wave velocity. Compared with monotherapy, the blood pressure was reduced similarly by adding azelnidipine (À12/À10 mm Hg) or trichlormethiazide (À14/À9 mm Hg). The heart rate was decreased with the CCB by 4 b.p.m. (Po0.05), whereas it was unchanged with the thiazide. Serum K, lipids and blood glucose were not significantly changed with either combination, whereas serum uric acid was increased with the thiazide (Po0.01) but was unchanged with azelnidipine. Plasma levels of renin, angiotensin II and aldosterone were also increased with the thiazide period, whereas high-sensitivity C-reactive protein and oxidized low-density lipoprotein were decreased with azelnidipine. In addition, the cardio-ankle vascular index, a parameter of arterial stiffness, was decreased with the azelnidipine period but was unchanged with the thiazide period (Po0.01). It is suggested that the combination of olmesartan and azelnidipine has advantages over the combination of olmesartan and a thiazide with respect to avoiding hyperuricemia, sympathetic activation, renin-angiotensin-aldosterone system stimulation, inflammation, oxidative stress, and increased arterial stiffness in patients with moderate hypertension. These properties may provide cardiovascular protection in addition to the hypotensive effect.

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Heart Rate as a Predictor of Mortality: The MATISS Project

Abstract: Heart rate is an independent predictor of cardiovascular, noncardiovascular, and total mortality in this Italian middle-aged male population.

Cited by 168 publications

References 38 publications

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Obesity: Effects on Cardiovascular Disease and its Diagnosis

Angiotensin-II receptor antagonist combined with calcium channel blocker or diuretic for essential hypertension

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