Abstract
The joint effect of blood pressure (BP) and heart rate (HR) on cardiovascular disease is unclear. Rate pressure product (RPP), the product of systolic BP and HR, is assessed in this study. This study aimed to determine the longitudinal patterns of RPP from childhood to adulthood and to explore the relationship between RPP trajectories in early life and left ventricular hypertrophy (LVH) in midlife. We included individuals with 3 or more RPP values from 7 visits over a 30-year follow-up period in the Hanzhong Adolescent Hypertension Study cohort to fit trajectory groups and performed logistic regression to evaluate the relative risk of developing LVH. Three discrete trajectories in RPP were identified among 2412 participants assessed from childhood to middle-aged adulthood, which were tagged as “low stable,” “moderate stable,” and “moderate increasing”. A higher waist-to-hip ratio, smoking, alcohol consumption, hypertension, diabetes, and hyperlipidemia were associated with increased RPP trajectories. The Cornell voltage product was positively correlated with RPP in 2017 and was higher in the moderate-stable and moderate-increasing groups than in the low-stable group in RPP trajectories. Compared with the low-stable group, the ORs of LVH were 1.65 (1.13, 2.92) for the moderate-stable and 3.56 (2.26, 5.44) for the moderate-increasing group. Subjects with moderate-stable and moderate-increasing trajectories showed higher probabilities of LVH at an elderly age than those in the low stable trajectory group even after adjusting for multiple cardiovascular risk factors. RPP trajectories are identifiable from childhood and are associated with LVH in midlife. Monitoring RPP trajectories from early life may be an effective approach to predict cardiovascular health status later in life.
Highlights
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Clinical relevance—RPP trajectories are identifiable from childhood and are associated with LVH in midlife. Monitoring RPP trajectories from early life may be an effective approach to predict cardiovascular health status later in life.
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Future direction—Multicenter, multihereditary or various environmental background studies are warranted to verify the association of RPP with LVH.
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Consideration for the Asian population—While RPP reflected myocardial oxygen consumption and was related to LVH, some differences in RPP have been reported between Asian and European populations [1].
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References
Chaturvedi N, Bathula R, Shore AC, Panerai R, Potter J, Kooner J, et al. South Asians have elevated postexercise blood pressure and myocardial oxygen consumption compared to Europeans despite equivalent resting pressure. J Am Heart Assoc. 2012;1:e000281.
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–10.
Tian Y, Liu H, Si Y, Cao Y, Song J, Li M, et al. Association between temperature variability and daily hospital admissions for cause-specific cardiovascular disease in urban China: a national time-series study. PLoS Med. 2019;16:e1002738.
Zhao D, Liu J, Wang M, Zhang X, Zhou M. Epidemiology of cardiovascular disease in China: current features and implications. Nat Rev Cardiol. 2019;16:203–12.
Antikainen RL, Peters R, Beckett NS, Fagard RH, Wang JG, Rajkumar C, et al. Left ventricular hypertrophy is a predictor of cardiovascular events in elderly hypertensive patients: hypertension in the very elderly trial. J Hypertens. 2016;34:2280–6.
Shenasa M, Shenasa H. Hypertension, left ventricular hypertrophy, and sudden cardiac death. Int J Cardiol. 2017;237:60–3.
Soliman EZ, Ambrosius WT, Cushman WC, Zhang ZM, Bates JT, Neyra JA, et al. Effect of intensive blood pressure lowering on left ventricular hypertrophy in patients with hypertension: SPRINT (Systolic Blood Pressure Intervention Trial). Circulation. 2017;136:440–50.
Mbaye A, Dodo B, Ngaïde AA, Sy NF, Babaka K, Mingou JS, et al. Left ventricular hypertrophy in black African subjects with artery hypertension: results of a cross-sectional survey conducted in semi-rural area in Senegal. Ann Cardiol Angeiol. 2017;66:210–6.
Kavey RE. Left ventricular hypertrophy in hypertensive children and adolescents: predictors and prevalence. Curr Hypertens Rep. 2013;15:453–7.
Klein FJ, Bell S, Runte KE, Lobel R, Ashikaga T, Lerman LO, et al. Heart rate-induced modifications of concentric left ventricular hypertrophy: exploration of a novel therapeutic concept. Am J Physiol Heart Circ Physiol. 2016;311:H1031–9.
Saba MM, Ibrahim MM, Rizk HH. Gender and the relationship between resting heart rate and left ventricular geometry. J Hypertens. 2001;19:367–73.
Verma AK, Sun JL, Hernandez A, Teerlink JR, Schulte PJ, Ezekowitz J, et al. Rate pressure product and the components of heart rate and systolic blood pressure in hospitalized heart failure patients with preserved ejection fraction: Insights from ASCEND-HF. Clin Cardiol. 2018;41:945–52.
Atkinson G, Leary AC, George KP, Murphy MB, Jones H. 24-hour variation in the reactivity of rate-pressure-product to everyday physical activity in patients attending a hypertension clinic. Chronobiol Int. 2009;26:958–73.
Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, et al. Association of blood pressure trajectories in early life with subclinical renal damage in middle age. J Am Soc Nephrol. 2018;29:2835–46.
Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R, Becerro-de-Bengoa-Losa KR. Reliability and concurrent validity of a peripheral pulse oximeter and health-app system for the quantification of heart rate in healthy adults. Health Inform J. 2016;22:151–9.
Okin PM, Devereux RB, Jern S, Kjeldsen SE, Julius S, Nieminen MS, et al. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive treatment and the prediction of major cardiovascular events. JAMA. 2004;292:2343–9.
Li XX, Zhao Y, Huang LX, Xu HX, Liu XY, Yang JJ, et al. Effects of smoking and alcohol consumption on lipid profile in male adults in northwest rural China. Public Health. 2018;157:7–13.
Prantl L, Gründl M. Males prefer a larger bust size in women than females themselves: an experimental study on female bodily attractiveness with varying weight, bust size, waist width, hip width, and leg length independently. Aesthetic Plast Surg. 2011;35:693–702.
Selvin E, Parrinello CM, Sacks DB, Coresh J. Trends in prevalence and control of diabetes in the United States, 1988–1994 and 1999–2010. Ann Intern Med. 2014;160:517–25.
Pan J, Ren Z, Li W, Wei Z, Rao H, Ren H, et al. Prevalence of hyperlipidemia in Shanxi Province, China and application of Bayesian networks to analyse its related factors. Sci Rep. 2018;8:3750.
Andruff H, Carraro N, Thompson A, Gaudreau P, Louvet B. Latent class growth modelling: a tutorial. Tutor Quant Methods Psychol. 2009;5:11–24.
Allen NB, Siddique J, Wilkins JT, Shay C, Lewis CE, Goff DC, et al. Blood pressure trajectories in early adulthood and subclinical atherosclerosis in middle age. JAMA. 2014;311:490–7.
Lim YH, Kim YM, Shin J, Lee CH, Kim JH, Kim MK, et al. Association of heart rate and left ventricular structure in a rural population in Korea. Clin Exp Hypertens. 2014;36:165–72.
Ozturk C, Aparci M, Karaduman M, Balta S, Çelik T, İyisoy A. Relationship of systolic blood pressure and body mass index with left ventricular mass and mass index in adolescents. Angiology. 2016;67:58–65.
Ansari M, Javadi H, Pourbehi M, Mogharrabi M, Rayzan M, Semnani S, et al. The association of rate pressure product (RPP) and myocardial perfusion imaging (MPI) findings: a preliminary study. Perfusion. 2012;27:207–13.
Robinson BF. Relation of heart rate and systolic blood pressure to the onset of pain in angina pectoris. Circulation. 1967;35:1073–83.
Kiviniemi AM, Kenttä TV, Lepojärvi S, Perkiömäki JS, Piira OP, Ukkola O, et al. Recovery of rate-pressure product and cardiac mortality in coronary artery disease patients with type 2 diabetes. Diabetes Res Clin Pract. 2019;150:150–7.
White WB. Heart rate and the rate-pressure product as determinants of cardiovascular risk in patients with hypertension. Am J Hypertens. 1999;12:50S–5S. 2 Pt 2.
Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010;6:109–38.
Zhang T, Li S, Bazzano L, He J, Whelton P, Chen W. Trajectories of childhood blood pressure and adult left ventricular hypertrophy: the Bogalusa heart study. Hypertension. 2018;72:93–101.
Singh K. Effect of smoking on QT interval, QT dispersion and rate pressure product. Indian Heart J. 2004;56:140–2.
Unverdorben M, van der Bijl A, Potgieter L, Venter C, Munjal S, Liang Q, et al. Effects of different levels of cigarette smoke exposure on prognostic heart rate and rate–pressure-product parameters. J Cardiovasc Pharm Ther. 2008;13:175–82.
Grace F, Sculthorpe N, Baker J, Davies B. Blood pressure and rate pressure product response in males using high-dose anabolic androgenic steroids (AAS). J Sci Med Sport. 2003;6:307–12.
Nagpal S, Walia L, Lata H, Sood N, Ahuja GK. Effect of exercise on rate pressure product in premenopausal and postmenopausal women with coronary artery disease. Indian J Physiol Pharm. 2007;51:279–83. PMID: 18341225
Mota J, Soares-Miranda L, Silva JM, Dos Santos SS, Vale S. Influence of body fat and level of physical activity on rate-pressure product at rest in preschool children. Am J Hum Biol. 2012;24:661–5.
Schwerdtfeger A, Schmukle SC, Egloff B. Interactive effects of avoidant coping and parental hypertension on rate pressure product reactivity in women. Ann Behav Med. 2005;29:106–15.
Greenwood JP, Scott EM, Stoker JB, Mary DA. Hypertensive left ventricular hypertrophy: relation to peripheral sympathetic drive. J Am Coll Cardiol. 2001;38:1711–7.
Figueroa MA, Demeersman RE, Manning J. The autonomic and rate pressure product responses of tai chi practitioners. N Am J Med Sci. 2012;4:270–5.
White WB, Krishnan S, Giacco S, Mallareddy M. Effects of metoprolol succinate extended release vs. amlodipine besylate on the blood pressure, heart rate, and the rate-pressure product in patients with hypertension. J Am Soc Hypertens. 2008;2:378–84.
Krakoff LR, Dziedzic S, Mann SJ, Felton K, Yeager K. Plasma epinephrine concentration in healthy men: correlation with systolic pressure and rate-pressure product. J Am Coll Cardiol. 1985;5:352–6. 2 Pt 1
Funding
The study was supported by the National Natural Science Foundation of China (Grant nos.: 81870319 (JJM), 81570381 (JJM), 82200472(WLZ) and 81700368 (CC)); the Major Chronic Non-communicable Disease Prevention and Control Research Key Project of the Ministry of Science and Technology of the People’s Republic of China (Grant no.: 2017YFC1307604 (JJM)); the Key Research Project of Shaanxi Province (Grant no.: 2017ZDXM-SF-107 (JJM)); and the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University (Grant no.: XJTU1AF-CRF-2019-004 (JJM)).
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Zheng, W., Mu, J., Yan, Y. et al. Association of rate pressure product trajectories at an early age with left ventricular hypertrophy in midlife: a prospective cohort study. Hypertens Res 46, 321–329 (2023). https://doi.org/10.1038/s41440-022-01076-y
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DOI: https://doi.org/10.1038/s41440-022-01076-y
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