Elevated resting heart rate predisposes metabolic syndrome in women rather than in men: a 15-year prospective study

BMC Cardiovascular Disorders

Xiaoping Chen¹  Shixi Wan¹  Yong Wang¹  Qingtao Meng¹  Xin Zhang¹  Kai Liu¹  Si Wang¹ 

[1] Department of Cardiovascular Medicine, West China Hospital, Sichuan University, Chengdu 610041, China

关键词: Gender differences;    Sympathetic activity;    Metabolic syndrome;    Resting heart rate;   

Others  :  1228288
DOI  :  10.1186/s12872-015-0104-3

 received in 2015-06-08, accepted in 2015-09-21,  发布年份 2015

【 摘 要 】

Background

Increasing evidences have indicated that there are gender differences in the prevalence of metabolic syndrome(MS), but the mechanism is uncertain.

Methods

A total of 711 subjects aged 35–65 years accepted health examinations both in 1992 and 2007. Since 114 subjects had MS and 7 had heart disease at baseline, they were excluded from the analysis. Therefore, 590 subjects with complete data (male: 61.5 %) were available and analysed. After the relationship between gender and incident MS at follow-up was tested, these subjects were categorized into four groups according to the baseline resting heart rate(RHR) classified by genders. Trend tests of MS incidences across the four groups of resting heart rate were conducted by Cochran-Armitage tend tests in both men and women. Additionally, three logistic regression models were used to estimate the effects of RHR on the new onset of MS by taking RHR as a continuous variable(per 4 beats/min elevation).

Results

Gender(women) itself was an independent risk factor for incident MS at follow-up(OR = 2.64, 1.33–5.23, P = 0.005). The incidences of MS according to the RHR categories showed a statistical linear trend in women(P for trend = 0.018) rather than in men(P for trend = 0.194). The ORs[95 % confidence intervals(CIs)] of MS for each 4 bpm elevation in RHR was 1.18(1.03–1.36)(P = 0.020) in a univariate model, 1.20 (1.04–1.38) (P = 0.011) adjusted for age and health related behaviors only and 1.23(1.06–1.43)(P = 0.007) adjusted for age, health related behaviors and pre-existing components of MS in the baseline in women. Otherwise, RHR did not have any significant associations with incident MS in men neither in a univariate model nor in multivariate models.

Conclusions

In this study, elevated RHR is correlated with the development of MS in women rather than in men.

【 授权许可】

   
2015 Wang et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al.: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009, 120:1640-5.
• [2]Zhang L, Guo Z, Wu M, Hu X, Xu Y, Zhou Z: Interaction of smoking and metabolic syndrome on cardiovascular risk in a Chinese cohort. Int J Cardiol 2013, 167:250-3.
• [3]Vishram JK, Borglykke A, Andreasen AH, Jeppesen J, Ibsen H, Jørgensen T, et al. Impact of age and gender on the prevalence and prognostic importance of the metabolic syndrome and its components in Europeans. The MORGAM Prospective Cohort Project. PLoS One. 2014. doi:10.1371/journal.pone.0107294.
• [4]Song QB, Zhao Y, Liu YQ, Zhang J, Xin SJ, Dong GH: Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: the CHPSNE study. Diab Vasc Dis Res 2015, 12:189-98.
• [5]Morales DD, Punzalan FE, Paz-Pacheco E, Sy RG, Duante CA: Metabolic syndrome in the Philippine general population: prevalence and risk for atherosclerotic cardiovascular disease and diabetes mellitus. Diab Vasc Dis Res 2008, 5:36-43.
• [6]Ford ES, Giles WH, Mokdad AH: Increasing prevalence of the metabolic syndrome among U.S. Adults. Diabetes Care 2004, 27:2444-2449.
• [7]Inoue T, Iseki K, Iseki C, Ohya Y, Kinjo K, Takishita S: Effect of heart rate on the risk of developing metabolic syndrome. Hypertens Res 2009, 32:801-6.
• [8]Oda E, Aizawa Y: Resting heart rate predicts metabolic syndrome in apparently healthy non-obese Japanese men. Acta Diabetol 2014, 51:85-90.
• [9]Vongpatanasin W: Autonomic regulation of blood pressure in menopause. Semin Reprod Med 2009, 27:338-45.
• [10]Lee JO, Kang SG, Kim SH, Park SJ, Song SW: The relationship between menopausal symptoms and heart rate variability in middle aged women. Korean J Fam Med 2011, 32:299-305.
• [11]Sherwood A, Park SB, Hughes JW, Blumenthal JA, Hinderliter A, Trivedi R, et al.: Cardiovascular hemodynamics during stress in premenopausal versus postmenopausal women. Menopause 2010, 17:403-9.
• [12]Keil U, Kuulasmaa K: WHO MONICA project: risk factors. Int J Epidemiol 1989, 18(Suppl 1):S46-55.
• [13]Friedewald W, Levy R, Fredrickson D: Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972, 18:499-502.
• [14]Oda E, Kawai R: Significance of heart rate in the prevalence of metabolic syndrome and its related risk factors in Japanese. Circ J 2009, 73:1431-6.
• [15]Licht CM, Vreeburg SA, van Reedt Dortland AK, Giltay EJ, Hoogendijk WJ, DeRijk RH, et al.: Increased sympathetic and decreased parasympathetic activity rather than changes in hypothalamic-pituitary-adrenal axis activity is associated with metabolic abnormalities. J Clin Endocrinol Metab 2010, 95:2458-66.
• [16]Rogowski O, Steinvil A, Berliner S, Cohen M, Saar N, Ben-Bassat OK, et al.: Elevated resting heart rate is associated with the metabolic syndrome. Cardiovasc Diabetol 2009, 8:55. BioMed Central Full Text
• [17]Perlini S, Naditch-Brule L, Farsang C, Zidek W, Kjeldsen SE: Pulse pressure and heart rate in patients with metabolic syndrome across Europe: insights from the GOOD survey. J Hum Hypertens 2013, 27:412-6.
• [18]Rana JS, Hardison RM, Pop-Busui R, Brooks MM, Jones TL, Nesto RW, et al.: Resting heart rate and metabolic syndrome in patients with diabetes and coronary artery disease in bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial. Prev Cardiol 2010, 13:112-6.
• [19]Zhang X, Shu XO, Xiang YB, Yang G, Li H, Cai H, et al.: Resting heart rate and risk of type 2 diabetes in women. Int J Epidemiol 2010, 39:900-6.
• [20]Laakso M, Edelman SV, Brechtel G, Baron AD: Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. A novel mechanism for insulin resistance. J Clin Invest 1990, 85:1844-52.
• [21]Jamerson KA, Julius S, Gudbrandsson T, Andersson O, Brant DO: Reflex sympathetic activation induces acute insulin resistance in the human forearm. Hypertension 1993, 21:618-23.
• [22]Kneale BJ, Chowienczyk PJ, Brett SE, Coltart DJ, Ritter JM: Gender differences in sensitivity to adrenergic agonists of forearm resistance vasculature. J Am Coll Cardiol 2000, 36:1233-8.
• [23]Ferrer M, Meyer M, Osol G: Estrogen replacement increases beta-adrenoceptor- mediated relaxation of rat mesenteric arteries. J Vasc Res 1996, 33:124-31.
• [24]Gilligan DM, Badar DM, Panza JA, Quyyumi AA, Cannon RO III: Acute vascular effects of estrogen in postmenopausal women. Circulation 1994, 90:786-91.
• [25]Moreau KL, Donato AJ, Tanaka H, Jones PP, Gates PE, Seals DR: Basal leg blood flow in healthy women is related to age and hormone replacement therapy status. J Physiol 2003, 547:309-16.
• [26]Scott PA, Tremblay A, Brochu M, St-Louis J: Vasorelaxant action of 17-estradiol in rat uterine arteries: role of nitric oxide synthases and estrogen receptors. Am J Physiol Heart Circ Physiol 2007, 293:H3713-9.
• [27]Volterrani M, Rosano G, Coats A, Beale C, Collins P: Estrogen acutely increases peripheral blood flow in postmenopausal women. Am J Med 1995, 99:119-22.
• [28]Sudhir K, Elser MD, Jennings GL, Komesaroff PA: Estrogen supplementation decreases norepinephrine-induced vasoconstriction and total body norepinephrine spillover in perimenopausal women. Hypertension 1997, 30:1538-43.