江苏省35～75岁自报高血压患者静息心率与血压控制率的关系研究-现代医学

江苏省35～75岁自报高血压患者静息心率与血压控制率的关系研究

单位：1. 江苏省疾病预防控制中心杂志编辑部, 江苏南京 210009;
2. 江苏省疾病预防控制中心慢性非传染病防制所, 江苏南京 210009

分类号：R544.1

出版年·卷·期（页码）：2026·45·第四期（591-597）

摘要：

目的： 分析自报高血压患者的静息心率水平与血压控制率之间的关系，为制定针对性防控策略提供依据。方法： 基于2021—2024年江苏省心脑血管疾病综合防控项目，采用分层整群抽样方法在江苏省12个设区市的22个区县选取35～75岁常住居民进行问卷调查和体格检查，以自报已被诊断为高血压的居民为研究对象，分析静息心率水平和血压控制率，并采用多因素Logistic回归分析静息心率与血压控制的关联。结果： 共纳入48 479例自报高血压患者，其中＜60次·min^-1者2 890例(占5.96%)，60～79次·min^-1者30 399例(占62.71%)，80～84次·min^-1者6 329例(占13.06%)，≥85次·min^-1者8 861例(占18.28%)。静息心率≥80次·min^-1者15 190例，占31.33%。13 111例高血压患者血压得到控制，血压控制率为27.04%，年龄标化控制率为23.94%。多因素Logistic回归分析显示，与静息心率60～79次·min^-1者相比，静息心率80～84次·min^-1(OR=0.888，95%CI 0.834～0.944)和≥85次·min^-1(OR=0.670，95%CI 0.633～0.710)者的血压控制率均更低(均P＜0.001)，且静息心率每升高10次·min^-1，血压控制率下降12.5%(OR=0.875，95%CI 0.859～0.892)。剔除未服用降压药物的高血压患者进行敏感性分析，结果稳定。结论： 静息心率升高是血压控制的危险因素，高血压管理中应关注患者的静息心率，对静息心率偏快者采取综合干预措施。

Objective: To analyze the relationship between resting heart rate(RHR) and blood pressure(BP) control rate among self-reported hypertensive patients, so as to provide evidence for developing targeted hypertension prevention and control strategies. Methods: Based on data from the Comprehensive Cardiovascular and Cerebrovascular Disease Prevention and Control Project in Jiangsu Province(2021—2024), a stratified cluster sampling method was used to select permanent residents aged 35-75 years from 22 districts and counties across 12 prefecture-level cities in Jiangsu Province for questionnaires and physical examinations. Residents who self-reported a confirmed diagnosis of hypertension were enrolled as the study population. RHR levels and BP control rates were analyzed, and multivariate Logistic regression analysis was performed to examine the association between RHR and BP control. Results: A total of 48 479 patients with self-reported hypertension were enrolled. Among them, 2 890(5.96%) had a RHR<60 beats·min^-1, 30 399(62.71%) had a rate between 60 and 79 beats·min^-1, 6 329(13.06%) had a rate between 80 and 84 beats·min^-1, and 8 861(18.28%) had a rate ≥85 beats·min^-1. Overall, 15 190 individuals(31.33%) had an RHR ≥80 beats·min^-1. BP was controlled in 13 111 patients, yielding an overall control rate of 27.04% and an age-standardized control rate of 23.94%. Multivariate Logistic regression analysis showed that, compared with those having an RHR of 60-79 beats·min^-1, participants with an RHR of 80-84 beats·min^-1(OR=0.888, 95%CI 0.834-0.944) or ≥85 beats·min^-1(OR=0.670, 95%CI 0.633-0.710) had significantly lower BP control rates(both P<0.001). For every 10 beats·min^-1 increase in RHR, the BP control rate decreased by 12.5%(OR=0.875, 95%CI 0.859-0.892). Sensitivity analyses excluding participants not taking anti-hypertensive medications showed consistent findings. Conclusion: Elevated RHR is a risk factor for poor BP control. RHR should be monitored in hypertension management, and comprehensive interventions should be implement for patients with a high RHR.

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