Pulse Mass Index as first cardiovascular risk approach
Pulse Mass Index as first cardiovascular risk approach
In his review on evaluating cardiovascular risk assessment for
asymptomatic people (BMJ 5 Jan 2009), Ian Scott analyses the Framingham
Risk Score and the QRISK2.
Both the QRISK2, as the report from Aage Tverdal et. al. on heart
rate and mortality from cardiovascular causes (European Heart Journal,
November 2, 2008), are in agreement that a high HR (or other risk factors
that increase the RHR) is associated with an unfavourable pattern of risk
factors and may be a marker for sympathetic nervous system activity. All
the major CV risk factors – cholesterol, triglycerides, blood pressure,
body mass index, family history of CV disease, smoking, and sedentary
lifestyle – increased significantly across increasing quartiles of HR.
These findings are in fully agreement with our findings on the Pulse
Mass Index, published in The Lancet, March 13, 1999, which we recently
presented, actualized, in the World Congress of Internal Medicine, in
Buenos Aires, Argentina, September 19, 2008.
The Pulse Mass Index (Resting Heart Rate multiplied by the Body Mass
Index and divided by 1730), has a very high (95%) correlation with the
Framingham Risk Score.
A Pulse Mass Index over 1.3 indicates with a high probability a high
cardiovascular risk and the need of a more complete evaluation (eg.
exercise EKG or Coronary CT or calcium score) and management of the CV
risk factors in these patients.
Since our first report we explained that we correlated the Pulse with
the BMI, because the HR reflects the oxidative metabolic rate and activity
of the sympathetic nervous system, such as under stress, obesity or
hyperinsulinemia and that these findings probably indicate the relation
between hyperinsulinemia, stimulation of the sympathetic nervous system,
and oxidative metabolism that is seen in obese patients and which improves
when they exercise regularly or lose weight.
The Pulse Mass Index is also the most simple and economical first
clinical approach to the risk evaluation in a large population, and more
so in the developing countries, where around 80% of all cardiovascular
deaths occur.
Rapid Response:
Pulse Mass Index as first cardiovascular risk approach
Pulse Mass Index as first cardiovascular risk approach
In his review on evaluating cardiovascular risk assessment for
asymptomatic people (BMJ 5 Jan 2009), Ian Scott analyses the Framingham
Risk Score and the QRISK2.
Both the QRISK2, as the report from Aage Tverdal et. al. on heart
rate and mortality from cardiovascular causes (European Heart Journal,
November 2, 2008), are in agreement that a high HR (or other risk factors
that increase the RHR) is associated with an unfavourable pattern of risk
factors and may be a marker for sympathetic nervous system activity. All
the major CV risk factors – cholesterol, triglycerides, blood pressure,
body mass index, family history of CV disease, smoking, and sedentary
lifestyle – increased significantly across increasing quartiles of HR.
These findings are in fully agreement with our findings on the Pulse
Mass Index, published in The Lancet, March 13, 1999, which we recently
presented, actualized, in the World Congress of Internal Medicine, in
Buenos Aires, Argentina, September 19, 2008.
The Pulse Mass Index (Resting Heart Rate multiplied by the Body Mass
Index and divided by 1730), has a very high (95%) correlation with the
Framingham Risk Score.
A Pulse Mass Index over 1.3 indicates with a high probability a high
cardiovascular risk and the need of a more complete evaluation (eg.
exercise EKG or Coronary CT or calcium score) and management of the CV
risk factors in these patients.
Since our first report we explained that we correlated the Pulse with
the BMI, because the HR reflects the oxidative metabolic rate and activity
of the sympathetic nervous system, such as under stress, obesity or
hyperinsulinemia and that these findings probably indicate the relation
between hyperinsulinemia, stimulation of the sympathetic nervous system,
and oxidative metabolism that is seen in obese patients and which improves
when they exercise regularly or lose weight.
The Pulse Mass Index is also the most simple and economical first
clinical approach to the risk evaluation in a large population, and more
so in the developing countries, where around 80% of all cardiovascular
deaths occur.
Prof. Enrique Sánchez Delgado, MD
Internal Medicine-Clinical Pharmacology
Director of Medical Education
Hospital Metropolitano Vivan Pellas, Managua, Nicaragua
esanchez@metropolitano.com.ni
Competing interests:
None declared
Competing interests: No competing interests