Abstract：【Objective 】 To explore the characteristics of heart rate and its influencing factors in patients with primary aldosteronism (PA) diagnosed for the first time.【Methods】A total of 196 patients with PA (observation group) admitted to the first people's Hospital of Changde from January 2015 to December 2019 were selected, and 196 patients with essential hypertension were included as the control group. The resting heart rate, 24 h average heart rate, day average heart rate, night average heart rate and blood potassium were compared between the two groups. The correlation between renin, aldosterone and aldosterone/renin activity ratio (ARR) and heart rate was studied by correlation analysis, and the effects of renin, aldosterone and ARR on heart rate were analyzed by multiple linear regression.【Results】The renin, blood potassium (K) and renin in the observation group were lower than those in the control group, and the fasting blood glucose (FPG), triglyceride (TG), blood sodium (Na), aldosterone and ARR in the observation group were higher than those in the control group (P<0.05). The resting heart rate, 24 h average heart rate, day average heart rate and night average heart rate of the patients in the observation group were lower than those in the control group, while the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher than those in the control group (P<0.05). According to the results of adrenal CT examination, PA patients were divided into hyperplasia group (n=81) and adenoma group (n=115). The resting heart rate, 24 h average heart rate, daytime average heart rate and nighttime average heart rate of hyperplasia group were higher than those of adenoma group, but the difference was not statistically significant (P>0.05). Spearman correlation analysis showed that renin was positively correlated with resting heart rate, 24 h average heart rate, daytime average heart rate and nighttime average heart rate (P<0.05); Aldosterone was negatively correlated with resting heart rate, 24 h mean heart rate and daytime mean heart rate (P<0.05); ARR was negatively correlated with resting heart rate, 24 h mean heart rate, daytime mean heart rate and nighttime mean heart rate (P<0.05). Multiple linear regression analysis showed that lnARR was an independent correlation factor of resting heart rate, 24 h average heart rate, daytime average heart rate and nighttime average heart rate (all P<0.05), and DBP was also a correlation factor of nighttime average heart rate (P<0.05). 【Conclusion】The resting heart rate, 24 hour average heart rate, day average heart rate and night average heart rate of PA patients are slower than those of essential hypertension patients. Renin is positively correlated with heart rate, while aldosterone and ARR are negatively correlated with heart rate.
罗家雯, 葛良清, 黄素兰. 初次确诊的原发性醛固酮增多症患者心率特点及其影响因素研究[J]. 医学临床研究, 2022, 39(8): 1149-1152.
LUO Jia-wen, GE Liang-qing, HUANG Su-lan. Study on the Characteristics of Heart Rate and its Influencing Factors in Patients with Primary Aldosteronism Diagnosed for the First Time. JOURNAL OF CLINICAL RESEARCH, 2022, 39(8): 1149-1152.
[1] 黄素兰,郭宁,梁莉,等.原发性醛固酮增多症患者糖代谢特点及其相关影响因素研究[J].医学临床研究,2021,38(10):1500-1503. [2] BÖHM M,TSIOUFIS K,KANDZARI D,et al.Effect of heart rate on the outcome of renal denervation in patients with uncontrolled hypertension[J].Am Coll Cardiol,2021,78(10):1028-1038. [3] MANCIA G,GRASSI G.The autonomic nervous system and hypertension[J].Ciru Res,2014,114(11):1804-1814. [4] LIN Y H,WU V C,LO M T,et al.Reversible heart rhythm complexity impairment in patients with primary aldosteronism[J].Sci Rep,2015,5:11249. [5] 中国高血压防治指南修订委员会.中国高血压防治指南(2018修订版)[J].中国心血管杂志,2019,24(1):1-46. [6] DIEGO G D,JULIANO C,LUIZ C,et al.Relationship between resting heart rate,blood pressure and pulse pressure in adolescents[J].Arq Bras Cardiol,2017,108(5):405-410. [7] 高血压心率管理多学科共识组.中国高血压患者心率管理多学科专家共识(2021年版)[J].中国医学前沿杂志(电子版),2021,13(4):38-48. [8] LUUK T R,JOEP H M,VAN E,et al. Hypertension:renin-angiotensin-aldosterone system alterations[J].Circ Res,2015,116(6):960-975. [9] KONTAK AC,WANG Z,ARBIQUE D,et al.Reversible sympathetic overactivity in hypertensive patients with primary aldosteronism[J].J Clin Endocrinol Metab,2010,95(10):4756-4761. [10] FRANCIS J,BELTZ T,JOHNSON A K,et al.Mineralocorticoids act centrally to regulate blood-borne tumor necrosis factor-αin normal rats[J].Am J Physiol Regul Integr Comp Physiol,2003,285(6):R1402-R1409. [11] MATSUKAWA T,MIYAMOTO T. Does infusion of ANG II increase muscle sympathetic nerve activity in patients with primary aldosteronism?[J].Am J Physiol Regul Integr Comp Physiol,2008,294(6):R1873-R1879. [12] LIN Y H,WU V C,LO M T,et al.Reversible heart rhythm complexity impairment in patients with primary aldosteronism[J].Sci Rep,2015,18(5):11249.
2022, Vol. 39 
