328 PERSISTENTLY ELEVATED HEART RATE AS A CARDIOVASCULAR RISK IN ESSENTIAL HYPERTENSION

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Objectives: Persistently elevated heart rate (HR) has been highlighted as a risk of cardiovascular disease. In this study, the association of 24-hour HR with cardiovascular structures was analyzed according to 24-hour blood pressure (BP) status in essential hypertensives (EHT). Design and Methods: In 252 untreated EHT, 24-hour systolic BP (SBP) and HR, glucose and lipid metabolism and neurohumoral factors were measured. Stiffness index “β” of common carotid artery, a marker of large arterial stiffness was also evaluated by ultrasonic phase-locked echo-tracking system. According to SBP, EHT were divided into three groups: 81 EHT with SBP <130 mmHg (N group), 114 with 130-150 mmHg (M group) and 57 with ≥150 mmHg (S group). Results: In S group, HR positively correlated with cardiovascular risk factors including triglyceride, fasting glucose, homeostasis model assessment ratio, plasma renin activity and plasma norepinephrine (PNE) (r = 0.23, 0.26, 0.23, 0.33, 0.28). Additionally, there was a positive correlation between HR and stiffness index “β” (r = 0.23). In S group, multiple regression analysis revealed that HR was an independent determinant for stiffness index “β” in addition to PNE (r2 = 0.08, P <0.05). In contrast, HR did not associate with the cardiovascular risk factors and stiffness index “β” in either N or M group. Thus, HR could contribute to increase in large arterial stiffness together with elevated sympathetic activity only in EHT with SBP ≥150 mmHg. Conclusions: These data indicate that the cardiovascular effects of persistently elevated HR were different according to BP status in EHT.

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