title: Office and 24-hour heart rate and target organ damage in hypertensive patients.
abstract: BACKGROUND
  We investigated the association between heart rate and its variability with the parameters that assess vascular, renal and cardiac target organ damage.
  
  
  METHODS
  A cross-sectional study was performed including a consecutive sample of 360 hypertensive patients without heart rate lowering drugs (aged 56 ± 11 years, 64.2% male). Heart rate (HR) and its standard deviation (HRV) in clinical and 24-hour ambulatory monitoring were evaluated. Renal damage was assessed by glomerular filtration rate and albumin/creatinine ratio; vascular damage by carotid intima-media thickness and ankle/brachial index; and cardiac damage by the Cornell voltage-duration product and left ventricular mass index.
  
  
  RESULTS
  There was a positive correlation between ambulatory, but not clinical, heart rate and its standard deviation with glomerular filtration rate, and a negative correlation with carotid intima-media thickness, and night/day ratio of systolic and diastolic blood pressure. There was no correlation with albumin/creatinine ratio, ankle/brachial index, Cornell voltage-duration product or left ventricular mass index. In the multiple linear regression analysis, after adjusting for age, the association of glomerular filtration rate and intima-media thickness with ambulatory heart rate and its standard deviation was lost. According to the logistic regression analysis, the predictors of any target organ damage were age (OR = 1.034 and 1.033) and night/day systolic blood pressure ratio (OR = 1.425 and 1.512). Neither 24 HR nor 24 HRV reached statistical significance.
  
  
  CONCLUSIONS
  High ambulatory heart rate and its variability, but not clinical HR, are associated with decreased carotid intima-media thickness and a higher glomerular filtration rate, although this is lost after adjusting for age.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01325064.
authors.affiliation: Primary Care Research Unit, La Alamedilla Health Center, REDIAPP, IBSAL, SACyL, Salamanca, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: García-García
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gómez-Marcos
authors.forename: José I
authors.initials: JI
authors.lastname: Recio-Rodríguez
authors.forename: Maria C
authors.initials: MC
authors.lastname: Patino-Alonso
authors.forename: Emiliano
authors.initials: E
authors.lastname: Rodríguez-Sánchez
authors.forename: Cristina
authors.initials: C
authors.lastname: Agudo-Conde
authors.forename: Luis
authors.initials: L
authors.lastname: García-Ortiz
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged