Association of resting heart rate trajectories with incident chronic kidney disease in patients with hypertension.

Abstract

Background: An elevated resting heart rate (RHR) increases the risk of chronic kidney disease (CKD), but the relationship between longitudinal patterns of RHR and the risk of CKD in hypertensive patients is unclear. We aimed to explore the association between RHR trajectories and incident CKD in hypertensive patients.

Methods: A total of 21,509 hypertensive participants from the Kailuan cohort who were free of CKD and cardiovascular disease before 2010 were included. The RHR trajectories were developed using latent mixture modeling based on examination data in 2006, 2008, and 2010. Cox proportional hazards regression models were established to evaluate the association between RHR trajectories and risk of incident CKD.

Results: We identified 4 RHR trajectories in participants with hypertension between 2006 and 2010: low-stable group (n = 2,465 [11.46%], mean RHR range, 63.33-65.06 beats/min); moderate low-stable group (n = 15,610 [72.57%], mean RHR range, 73.09-74.32 beats/min); moderate high-stable group (n = 3,158 [14.68%], mean RHR range, 84.32-85.43 beats/min,) and elevated-stable group (n = 276 [1.28%], mean RHR range, 99.63-100.74 beats/min). During an average follow-up of 7.93 years, 2,769 cases of CKD were identified. Compared with the moderate low-stable group, adjusted hazard ratios for CKD were 1.15 (95% confidence interval [CI], 1.03-1.29) for the low-stable group, 1.22 (95% CI, 1.10-1.37) for the moderate high-stable group, and 1.54 (95% CI, 1.13-2.09) for the elevated-stable group.

Conclusions: RHR trajectories were associated with the risks of CKD in patients with hypertension.