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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Association of rate pressure product trajectories at an early age with left ventricular hypertrophy in midlife: a prospective cohort study

Hypertension Research volume 46, pages 321–329 (2023)Cite this article

Abstract

The joint effect of blood pressure (BP) and heart rate (HR) on cardiovascular disease is unclear. Rate pressure product (RPP), the product of systolic BP and HR, is assessed in this study. This study aimed to determine the longitudinal patterns of RPP from childhood to adulthood and to explore the relationship between RPP trajectories in early life and left ventricular hypertrophy (LVH) in midlife. We included individuals with 3 or more RPP values from 7 visits over a 30-year follow-up period in the Hanzhong Adolescent Hypertension Study cohort to fit trajectory groups and performed logistic regression to evaluate the relative risk of developing LVH. Three discrete trajectories in RPP were identified among 2412 participants assessed from childhood to middle-aged adulthood, which were tagged as “low stable,” “moderate stable,” and “moderate increasing”. A higher waist-to-hip ratio, smoking, alcohol consumption, hypertension, diabetes, and hyperlipidemia were associated with increased RPP trajectories. The Cornell voltage product was positively correlated with RPP in 2017 and was higher in the moderate-stable and moderate-increasing groups than in the low-stable group in RPP trajectories. Compared with the low-stable group, the ORs of LVH were 1.65 (1.13, 2.92) for the moderate-stable and 3.56 (2.26, 5.44) for the moderate-increasing group. Subjects with moderate-stable and moderate-increasing trajectories showed higher probabilities of LVH at an elderly age than those in the low stable trajectory group even after adjusting for multiple cardiovascular risk factors. RPP trajectories are identifiable from childhood and are associated with LVH in midlife. Monitoring RPP trajectories from early life may be an effective approach to predict cardiovascular health status later in life.

Highlights

  • Clinical relevance—RPP trajectories are identifiable from childhood and are associated with LVH in midlife. Monitoring RPP trajectories from early life may be an effective approach to predict cardiovascular health status later in life.

  • Future direction—Multicenter, multihereditary or various environmental background studies are warranted to verify the association of RPP with LVH.

  • Consideration for the Asian population—While RPP reflected myocardial oxygen consumption and was related to LVH, some differences in RPP have been reported between Asian and European populations [1].

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Funding

The study was supported by the National Natural Science Foundation of China (Grant nos.: 81870319 (JJM), 81570381 (JJM), 82200472(WLZ) and 81700368 (CC)); the Major Chronic Non-communicable Disease Prevention and Control Research Key Project of the Ministry of Science and Technology of the People’s Republic of China (Grant no.: 2017YFC1307604 (JJM)); the Key Research Project of Shaanxi Province (Grant no.: 2017ZDXM-SF-107 (JJM)); and the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University (Grant no.: XJTU1AF-CRF-2019-004 (JJM)).

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, China

    Wenling Zheng, Jianjun Mu, Yu Yan & Chao Chu

  2. Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Wenling Zheng, Xianming Su, Yanping Ren & Dan Luo

  3. Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China

    Fangyao Chen

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  1. Wenling Zheng
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Correspondence to Jianjun Mu.

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Zheng, W., Mu, J., Yan, Y. et al. Association of rate pressure product trajectories at an early age with left ventricular hypertrophy in midlife: a prospective cohort study. Hypertens Res 46, 321–329 (2023). https://doi.org/10.1038/s41440-022-01076-y

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