Gender and the relationship between resting heart rate and left ventricular geometry

Objectives Heightened mortality is common to both an elevated resting heart rate and left ventricular hypertrophy (LVH). We examined the relationship between resting heart rate and left ventricular geometry. Methods We analysed resting heart rate and echocardiographic data on 1685 i ndividuals aged 25-93 years, 756 males and 929 females, without heart failu re. The study population, 719 normotensives and 966 untreated hypertensives , was derived from the Egyptian National Hypertension Project (1991-94); a cross-sectional study of the prevalence of hypertension and cardiovascular risk factors in Egyptians. The mean of the last two of three heart rate rea dings was used to represent the resting heart rate. Results Left ventricular mass index (LVMI) was weakly inversely related to heart rate in total males (r= -0.14, P< 0.0005) and total females (r= -0.1, P= 0.007) after controlling for age and blood pressure. The relative wall thickness (RWT) of the left ventricle was positively associated with heart rate in females. Resting heart rate increased linearly from 83.8 to 89 b.p. m. (P= 0.03) from the lowest (<less than or equal to> 0.33) to highest (gre ater than or equal to 0.47) RWT quintiles in hypertensive females after adj usting for age and blood pressure. In both those with and without LVH (defi ned as LVMI > 125 g/m(2)), hypertensive females with RWT > 0.45 compared to those with RWT less than or equal to 0.45 had consistently higher resting heart rate (93.8 b.p.m. versus 84.2 b.p.m., P = 0.047 and 88.9 b.p.m, versu s 85 b.p.m., P = 0.005, respectively) after adjusting for age and blood pre ssure. No such relationship was found in males. Conclusions Among hypertensive females, an elevated resting heart rate is a ssociated with abnormal left ventricular geometry, namely, concentric left ventricular remodelling and hypertrophy. J Hypertens 19:367-373 (C) 2001 Li ppincott Williams & Wilkins.