Research Article
Association between resting heart rate and hypertension in Chinese with different waist-to-height ratio: a population-based cross-sectional study

https://doi.org/10.1016/j.jash.2018.08.005Get rights and content

Highlights

  • Elevated resting heart rate (RHR) was associated with the risk of hypertension.

  • High waist-to-height ratio increased the association of RHR with hypertension, particularly for male.

  • The population with high RHR and high waist-to-height ratio should be highlighted in preventing hypertension.

Abstract

Elevated resting heart rate (RHR) and obesity are important risk factors for hypertension. However, studies are rare on the combined impact of RHR and obesity on prehypertension and hypertension. This study aimed to investigate the association between RHR and hypertension with different waist-to-height ratio (WHtR) in Chinese. The population-based cross-sectional study was conducted during 2013-2015 in Henan province, China, and 15,536 participants aged ≥15 years were included. RHR was classified according to sex-specific quartiles. The cutoff value of WHtR was 0.5 in both sexes. Multilinear and multilogistic regression models were used to evaluate the association of RHR and WHtR with prehypertension and hypertension. In both sexes, higher RHR was associated with higher blood pressure and lower pulse pressure. Compared with the lowest RHR quartile, participants in the highest RHR quartile had an increased risk of prehypertension (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.18–1.65; OR: 1.27, 95% CI: 1.09–1.48) and hypertension (OR: 1.75, 95% CI: 1.43–2.15; OR: 1.36, 95% CI: 1.13–1.63) for male and female, respectively, after fully adjusting the data. In addition, adjusted ORs for prehypertension and hypertension of participants with high WHtR and high RHR were 2.91 (95% CI: 2.38–3.55) and 6.28 (4.96–7.97) for male and 2.45 (2.05–2.93) and 4.63 (3.66–5.85) for female, respectively, compared with the normal WHtR and normal RHR. In conclusion, elevated RHR was significantly associated with the risk of prehypertension and hypertension in Chinese and WHtR as a measure of abdominal obesity further increased this association.

Introduction

Hypertension is an important global health challenge because of its high prevalence.1 Prehypertension could increase the risk of hypertension and cardiovascular diseases.2, 3 In 2000, 26.4% of the world's adult population had hypertension, and the proportion would increase to 29.2% by 2025.4 Similarly, 25%–50% of adults were affected by prehypertension.5 This phenomenon in China is more serious, a recent report has revealed that the prevalence of hypertension and prehypertension was 32.5% and 39.5% in Chinese population aged 35 to 74 years, respectively.6 Previous studies have identified risk factors for hypertension, including alcohol drinking, smoking, less physical activity, overweight and obesity, elevated resting heart rate (RHR), and other factors.7, 8, 9

RHR is an easily collected cardiovascular parameter. Several studies have reported the association between RHR and a range of cardiovascular incidents, metabolic syndrome, and all-cause mortality.10, 11 Similarly, the association of RHR with hypertension has also been explored.12 Although studies have demonstrated elevated RHR is an established risk factor for hypertension, RHR with other known predictors to predict the risk of prehypertension and hypertension is less known. Obesity is well recognized to be an important risk factor for hypertension and prehypertension.8 Several recent studies have indicated that waist-to-height ratio (WHtR), as a surrogate for abdominal obesity, was a better anthropometric index than body mass index (BMI) and waist circumference (WC) for the prediction of hypertension.13 However, few studies have been performed to investigate the difference of RHR level in risk of prehypertension and hypertension across different WHtR especially in Chinese population.

Therefore, the aim of this study was to evaluate the independent and combined association of RHR and WHtR with prehypertension and hypertension in Chinese by a population-based cross-sectional study. We hypothesized that high RHR and high WHtR would correlate to a higher risk of prehypertension and hypertension.

Section snippets

Methods

The methods and design of this study were ever introduced elsewhere.14 We made use of the data generated from a cross-sectional survey conducted between August of 2013 and August of 2015 in Henan province, China, which was part of a national survey on the prevalence of cardiovascular diseases in China that encompassed 31 provinces and 262 countries and was supported by the National Key R&D Program in the Twelfth Five-year Plan (No. 2011BAI11B01) from the Chinese Ministry of Science and

Results

The baseline characteristics of the participants according to RHR quartiles and sex are shown in Table 1 and Table 2. Among the participants, 24.7% of male and 23.4% of female had hypertension; 46.7% of male and 32.5% of female had prehypertension. Participants in the highest RHR quartile had significant higher prevalence of prehypertension and hypertension compared to those in the lowest RHR quartile. Participants with higher RHR were more likely to have a higher value of WC, WHtR, SBP, DBP,

Discussion

In this large population-based cross-sectional study, we investigated the association of RHR with prehypertension and hypertension stratified by WHtR in Chinese population. The results of linear regression were consistent with logistic regression. As can be expected, elevated RHR was significantly associated with the risk of prehypertension and hypertension in Chinese. In addition, elevated RHR in combination with high WHtR significantly enhanced the association of RHR with prehypertension and

Acknowledgments

This work was supported by grants from the National Key R&D Program in the Twelfth Five-year Plan (No. 2011BAI11B01) and Henan Health Science & Technology Leading Talents 2017. The authors thank all the officers at each sample site for calling and organizing the selected participants. The authors also appreciate all the team members who participated in the survey for their contribution in this epidemiology investigation and thank all the participants for their cooperation.

Authors'

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  • Each author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

    Conflict of interest: None.

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