Tachycardia is a strong predictor of cardiovascular events in the value trial

Details

Serval ID
serval:BIB_D5E4CFB8DDE7
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Tachycardia is a strong predictor of cardiovascular events in the value trial
Title of the conference
20th Annual Meeting of the European-Society-of-Hypertension
Author(s)
Julius S., Palatini P., Kjeldsen S. E., Zanchetti A., Weber M., McInnes G., Brunner H., Hua T., Holzhauer B., Zappe D.
Address
Oslo, Norway, June 18-21, 2010
ISBN
0263-6352
Publication state
Published
Issued date
2010
Volume
28
Series
Journal of Hypertension
Pages
E234
Language
english
Notes
Meeting Abstract
Abstract
Objective: Tachycardia is associated with hypertension and is a predictor of cardiovascular events. The predictive effect of tachycardia might reflect its connection with hypertension. In this analysis of 15,245 VALUE study patients we explore whether tachycardia predicts cardiovascular endpoints in high risk hypertension and whether the in-trial blood pressure lowering modified the tachycardia - related risk.
Methods: Heart rate from ECG readings at baseline and annually throughout the trial.
Results: In the Cox Regression analysis the primary endpoint hazard ratio for a 10 beats per minute increment of baseline heart rate was 1.16 (1.12-1.2) p < 0.0001, 1.17 (1.13-1.22) p < 0.0001 and 1.22 (1.18-1.27) p < 0.0001 unadjusted, adjusted for baseline blood pressure and for blood pressure plus risk factors, respectively.
Primary endpoints strikingly increased in the highest quintile of baseline heart rate (=/>79 beats). Primary endpoints in the highest heart rate quintile were 30 % higher in first, 55 % in second, 55 % in third, 52 % in fourth and 46 % in the fifth year of the study. The in-trial heart rate was also a potent predictor. The primary endpoint hazard ratios of highest heart rate quintile versus pooled lower 4 quintiles was (1.34-1.66) p < 0.0001 unadjusted, 1.52 (1.36-1.69) p <0.0001 adjusted for baseline blood pressure and risk factors and 1.52 (1.36-1.69) p < 0.0001 further adjusted for in trial pressure. The increase of primary events in the upper quintile of in-trial heart rate was 68% in the group with good and 63% in the group with inadequate blood pressure control (both p < 0.0001 by log rank test).
Conclusions: 1./ Tachycardia is a short term marker and a long term predictor of adverse event in high risk hypertension. 2./ Tachycardia contributes to the residual cardiovascular risk regardless of the degree of BP control. We hypothesize heart rate lowering with appropriate drugs may further decrease the cardiovascular risk in patients with high risk hypertension and tachycardia.
Keywords
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Web of science
Create date
20/01/2011 10:21
Last modification date
20/08/2019 15:55
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