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(Hypertension. 1999;33:640-646.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Heart Rate and Subsequent Blood Pressure in Young Adults

The CARDIA Study

Jang-Rak Kim; Catarina I. Kiefe; Kiang Liu; O. Dale Williams; David R. Jacobs, Jr; Albert Oberman

From the University of Alabama at Birmingham, Division of Preventive Medicine (J-R.K., C.I.K., O.D.W., A.O.), Birmingham, Ala; Northwestern University Medical School, Department of Community Health & Preventive Medicine (K.L.), Chicago, Ill; and University of Minnesota, School of Public Health, Division of Epidemiology (D.R.J.), Minneapolis, Minn.

Correspondence to Dr Catarina Kiefe, University of Alabama at Birmingham, 1717 Eleventh Avenue South, MT 700, Birmingham, AL 35205-4785. E-mail ckiefe{at}dopm.uab.edu

Abstract—The objective of the present study was to examine the hypothesis that baseline heart rate (HR) predicts subsequent blood pressure (BP) independently of baseline BP. In the multicenter longitudinal Coronary Artery Risk Development in Young Adults study of black and white men and women initially aged 18 to 30 years, we studied 4762 participants who were not current users of antihypertensive drugs and had no history of heart problems at the baseline examination (1985–1986). In each race-sex subgroup, we estimated the effect of baseline HR on BP 2, 5, 7, and 10 years later by use of repeated measures regression analysis, adjusting for baseline BP, age, education, body fatness, physical fitness, fasting insulin, parental hypertension, cigarette smoking, alcohol consumption, oral contraceptive use, and change of body mass index from baseline. The association between baseline HR and subsequent systolic BP (SBP) was explained by multivariable adjustment. However, HR was an independent predictor of subsequent diastolic BP (DBP) regardless of initial BP and other confounders in white men, white women, and black men (0.7 mm Hg increase per 10 bpm). We incorporated the part of the association that was already present at baseline by not adjusting for baseline DBP: the mean increase in subsequent DBP was 1.3 mm Hg per 10 bpm in white men, white women, and black men. A high HR may be considered a risk factor for subsequent high DBP in young persons.

Key Words: heart rate • blood pressure • hypertension • regression analysis • race

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