To understand the characteristics of heart rate(HR) in hypertensive patients with renal damage; To analyze the relationship between HR and blood pressure(BP); To explore the factors affecting HR.Design and Method:
We enrolled 150 hypertensive patients with chronic kidney disease(CKD) from July 2012 to September 2013 in Third Xiangya Hospital of Central South University, Chenzhou first people's Hospital and Beijing Anzhen Hospital. In the same period, we selected 43 hypertensive patients with normal renal function as the control. The general demographic, laboratory examination, resting HR, clinical BP, ambulatory HR and ambulatory BP data of the patients were collected. Then the data was used to analyze the characteristics of HR, to illustrate the relationship between HR and BP and to explore the factors affecting the HR.Results:
1. With the deterioration of renal function, HR increased, at the same time, the rate of dipping HR patterns deceased, and the dynamic HR, especially nighttime HR, increased significantly. Compared with patients with normal renal function, the difference in nighttime HR of CKD stage 5 patients was statistically significant (P = 0.032, P < 0.001).2. The nighttime HR was positively correlated with the night SBP as well as night DBP. After adjusting the age, gender, BMI, GFR, high-density lipoprotein, low-density lipoprotein and blood glucose, nighttime HR was significantly correlated with nighttime DBP (r = 0.310, P = 0.001) and nocturnal SBP (r = 0.304, P = 0.001). 3. The factors that effecting nighttime HR of hypertensive patients with CKD are mean nocturnal DBP (β = 0.221, P < 0.001), creatinine (β = 0.01, P < 0.001), High-density lipoprotein (β = -3.504, P = 0.047) and gender (β = 3.999, P = 0.006).Conclusions:
1. HR increased rapidly in hypertensive patients with CKD, especially nighttime HR. 2. HR of hypertensive patients with renal damage was positively related with BP. Particularly, the nighttime HR was significantly correlated with nighttime BP. 3. The factors that affect the nighttime HR increase were the average DBP, creatinine, high-density lipoprotein and gender.