1
|
He K, Chen X, Shi Z, Shi S, Tian Q, Hu X, Song R, Bai K, Shi W, Wang J, Li H, Ding J, Geng S, Sheng X. Relationship of resting heart rate and blood pressure with all-cause and cardiovascular disease mortality. Public Health 2022; 208:80-88. [PMID: 35728416 DOI: 10.1016/j.puhe.2022.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/21/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study aimed to investigate associations of resting heart rate (RHR) and blood pressure (BP) with all-cause and cardiovascular disease (CVD) mortality. STUDY DESIGN A retrospective cohort study. METHODS A total of 67,028 Chinese participants aged ≥60 years were included in the analysis. RHR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were evaluated according to quartiles ([41-69, 70-74, 75-79, 80-127 beats/min], [80-119, 120-129, 130-139, 140-238 mm Hg], and [40-70, 71-79, 80-84, 85-133 mm Hg]). Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause and CVD mortality with RHR, SBP, and DBP. Restricted cubic splines were used to evaluate the dose-response association. RESULTS During the 361,975 person-year follow-up, 9326 deaths were recorded, of which 5039 deaths were due to CVD. The risk of all-cause mortality was increased by 25% with the quartiles four vs quartile one of RHR (HR [95% CI]:1.25 [1.17-1.33]), and CVD mortality was increased by 32% (HR [95% CI]: 1.32 [1.22-1.44]). Similar results were observed when comparing the quartiles four vs quartile one of SBP with the risk of all-cause and CVD mortality (HRs [95% CIs]: 1.14 [1.07, 1.22] and 1.23 [1.12. 1.34]) and DBP with the risk of all-cause and CVD mortality (HRs [95% CIs]: 1.17 [1.11. 1.24] and 1.36 [1.26. 1.47]). We found linear associations of RHR, SBP, and DBP with all-cause and CVD mortality (Pnon-linearity >0.05), except for the approximately J-shaped association between DBP and all-cause mortality (Pnon-linearity = 0.008). There was a significant interaction of RHR and SBP with all-cause and CVD mortality (Pinteraction <0.05). CONCLUSIONS RHR and BP increased the risk of all-cause and CVD mortality, especially fast RHR combined with high SBP.
Collapse
Affiliation(s)
- K He
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Chen
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Z Shi
- Department of Pharmacy, Zhengzhou People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - S Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Q Tian
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - R Song
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - K Bai
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - W Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - J Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - H Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - J Ding
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - S Geng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Sheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| |
Collapse
|
2
|
Wang Z, Chen X, Wu Y, Jiang W, Yang L, Wang H, Liu S, Liu Y. Admission Resting Heart Rate as an Independent Predictor of All-Cause Mortality in Elderly Patients with Hip Fracture. Int J Gen Med 2021; 14:7699-7706. [PMID: 34764683 PMCID: PMC8575447 DOI: 10.2147/ijgm.s333971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To investigate the relationship between admission resting heart rate (RHR) and all-cause mortality in elderly patients with hip fracture. Methods A retrospective cohort study with 837 patients based on the established hip fracture database was conducted. Admission RHR was measured via electrocardiogram, and patients were grouped by the median RHR value (beats per minute, bpm). The main outcomes were 1-year and total all-cause mortality. Cox proportional hazard models and restricted cubic spline were used to assess the relationship between RHR and mortality. Sensitivity analyses were further performed to determine whether the results were stable. Results The mean and median RHR were 82.3 and 80.0 bpm, respectively. After a median follow-up of 31.8 months, the 1-year and total all-cause mortality were 17.6% and 31.2%. Multivariable Cox analyses showed that high RHR was an independent risk factor for 1-year mortality (HR = 1.51; 95% CI: 1.08–2.13; p = 0.016), and total mortality (HR = 1.44; 95% CI: 1.12–1.85; p = 0.005). For each 10 bpm increase in RHR, the risk of 1-year death increased by 23.0% (HR = 1.23; 95% CI: 1.09–1.39; p = 0.001), and total death increased by 21.0% (HR = 1.21; 95% CI: 1.09–1.34; p < 0.001). A typical J-shaped curve was observed in the restricted cubic spline for the association between RHR and 1-year mortality, with the lowest mortality risk at 70 bpm. Sensitivity analyses yielded similar findings. Conclusion An increase in RHR was independently associated with all-cause mortality, and may be a useful prognostic predictor for elderly patients with hip fracture.
Collapse
Affiliation(s)
- Zhicong Wang
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Xi Chen
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Yuxuan Wu
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Wei Jiang
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Ling Yang
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Hong Wang
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Shuping Liu
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| | - Yuehong Liu
- Orthopaedic Center of Deyang City, Department of Orthopedics, Deyang People's Hospital, Deyang, Sichuan, People's Republic of China
| |
Collapse
|
3
|
Lee JD, Kuo YW, Lee CP, Huang YC, Lee M, Lee TH. Initial in-hospital heart rate is associated with long-term survival in patients with acute ischemic stroke. Clin Res Cardiol 2021; 111:651-662. [PMID: 34687320 PMCID: PMC9151537 DOI: 10.1007/s00392-021-01953-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/13/2021] [Indexed: 11/24/2022]
Abstract
Aims Increased heart rate has been associated with stroke risk and outcomes. The purpose of this study was to explore the long-term prognostic value of initial in-hospital heart rate in patients with acute ischemic stroke (AIS). Methods We analyzed data from 21,655 patients with AIS enrolled (January 2010–September 2018) in the Chang Gung Research Database. Mean initial in-hospital heart rates were averaged and categorized into 10-beat-per-minute (bpm) increments. The primary and secondary outcomes were all-cause mortality and cardiovascular death. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable adjusted Cox proportional hazard models, using the heart rate < 60 bpm subgroup as the reference. Results The adjusted HRs for all-cause mortality were 1.23 (95% CI 1.08–1.41) for heart rate 60–69 bpm, 1.74 (95% CI 1.53–1.97) for heart rate 70–79 bpm, 2.16 (95% CI 1.89–2.46) for heart rate 80–89 bpm, and 2.83 (95% CI 2.46–3.25) for heart rate ≥ 90 bpm compared with the reference group. Likewise, heart rate ≥ 60 bpm was also associated with an increased risk of cardiovascular death (adjusted HR 1.18 [95% CI 0.95–1.46] for heart rate 60–69 bpm, 1.57 [95% CI 1.28–1.93] for heart rate 70–79 bpm, 1.98 [95% CI 1.60–2.45] for heart rate 80–89 bpm, and 2.36 [95% CI 1.89–2.95] for heart rate ≥ 90 bpm). Conclusions High initial in-hospital heart rate is an independent predictor of all-cause mortality and cardiovascular death in patients with AIS. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00392-021-01953-5.
Collapse
Affiliation(s)
- Jiann-Der Lee
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Wen Kuo
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yen-Chu Huang
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Meng Lee
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsong-Hai Lee
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
4
|
Zhou D, Li Z, Shi G, Zhou J. Effect of heart rate on hospital mortality in critically ill patients may be modified by age: a retrospective observational study from large database. Aging Clin Exp Res 2021; 33:1325-1335. [PMID: 32638341 DOI: 10.1007/s40520-020-01644-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Heart rate has been found associated with mortality in critically ill patients. However, whether the association differs between the elderly and non-elderly patients was unknown. METHODS We conducted a retrospective observational study of adult patients admitted to the intensive care unit (ICU) in the United States. Demographic, vital signs, laboratory tests, and interventions were extracted and compared between the elderly and non-elderly patients. The main exposure was heart rate, the proportion of time spent in heart rate (PTS-HR) was calculated. The primary outcome was hospital mortality. The multivariable logistic regression model was performed to assess the relationship between PTS-HR and hospital mortality, and interaction between PTS-HR and age categories was explored. RESULTS 104,276 patients were included, of which 52,378 (50.2%) were elderly patients and 51,898 (49.8%) were non-elderly patients. The median age was 66 (IQR 54-76) years. After adjusting for confounders, PTS-HR < 60 beats per minute (bpm) (OR 0.972, 95% CI [0.945, 0.998], p = 0.031, Pinteraction = 0.001) and 60-80 bpm (OR 0.925, 95% CI [0.912, 0.938], p < 0.001, Pinteraction = 0.553) were associated with decreased risk of mortality; PTS-HR 80-100 bpm was associated with decreased mortality in the non-elderly patients (OR 0.955, 95% CI [0.941,0.975], p < 0.001) but was associated with increased mortality in the very elderly patients (OR 1.018, 95% CI [1.003,1.029], p = 0.017, Pinteraction < 0.001). PTS-HR > 100 bpm (OR 1.093, 95% CI [1.081,1.105], p < 0.001, Pinteraction = 0.004) was associated with increased mortality. CONCLUSIONS The effect of heart rate on hospital mortality differs between the elderly and non-elderly critically ill patients.
Collapse
|
5
|
Torres-Acosta N, O'Keefe JH, O'Keefe CL, Lavie CJ. Cardiovascular Effects of ADHD Therapies: JACC Review Topic of the Week. J Am Coll Cardiol 2021; 76:858-866. [PMID: 32792083 DOI: 10.1016/j.jacc.2020.05.081] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 12/16/2022]
Abstract
Although the prevalence of attention-deficit/hyperactivity disorder (ADHD) has been stable over the past 3 decades, prescriptions of sympathomimetic stimulants have steadily increased in the United States. This study consisted of a systematic review of PubMed articles screened for ADHD medications and potential cardiovascular toxicity as well as nondrug strategies for managing ADHD. The cumulative body of data showed that ADHD medications cause modest elevations in resting heart rate and blood pressure. Other adverse effects reported with ADHD stimulants included arrhythmia, nonischemic cardiomyopathy, Takotsubo cardiomyopathy, and sudden death. However, such reports did not imply causation, and there was a paucity of randomized trial evidence addressing long-term safety of ADHD medications, particularly among adults. Further studies are essential to clarify the risks and benefits of ADHD stimulant medications and to explore nonpharmacological options, including regular exercise and omega-3 fatty acids, which could be helpful for improving ADHD symptoms.
Collapse
Affiliation(s)
| | - James H O'Keefe
- University of Missouri-Kansas City, Kansas City, Missouri; Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
| | | | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, Louisiana
| |
Collapse
|
6
|
Raisi-Estabragh Z, Cooper J, Judge R, Khanji MY, Munroe PB, Cooper C, Harvey NC, Petersen SE. Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK. PLoS One 2020; 15:e0233898. [PMID: 32470091 PMCID: PMC7259773 DOI: 10.1371/journal.pone.0233898] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To define the sex, age, and disease-specific associations of resting heart rate (RHR) with cardiovascular and mortality outcomes in 502,534 individuals from the UK Biobank over 7-12 years of prospective follow-up. METHODS The main outcomes were all-cause, cardiovascular, and ischaemic heart disease mortality. Additional outcomes included incident acute myocardial infarction (AMI), fatal AMI, and cancer mortality. We considered a wide range of confounders and the effects of competing hazards. Results are reported as hazard ratios (HR) for all-cause mortality and sub-distribution hazard ratios (SHR) for other outcomes with corresponding 95% confidence intervals (CI) per 10bpm increment of RHR. RESULTS In men, for every 10bpm increase of RHR there was 22% (HR 1.22, CI 1.20 to 1.24, p = 3×10-123) greater hazard of all-cause and 17% (SHR 1.17, CI 1.13 to 1.21, p = 5.6×10-18) greater hazard of cardiovascular mortality; for women, corresponding figures were 19% (HR 1.19, CI 1.16 to 1.22, p = 8.9×10-45) and 14% (SHR 1.14, CI 1.07 to 1.22, p = 0.00008). Associations between RHR and ischaemic outcomes were of greater magnitude amongst men than women, but with similar magnitude of association for non-cardiovascular cancer mortality [men (SHR 1.18, CI 1.15-1.21, p = 5.2×10-46); women 15% (SHR 1.15, CI 1.11-1.18, p = 3.1×10-18)]. Associations with all-cause, incident AMI, and cancer mortality were of greater magnitude at younger than older ages. CONCLUSIONS RHR is an independent predictor of mortality, with variation by sex, age, and disease. Ischaemic disease appeared a more important driver of this relationship in men, and associations were more pronounced at younger ages.
Collapse
Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Jackie Cooper
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Rebekah Judge
- Imperial College Healthcare Trust, St Mary’s Hospital, London, United Kingdom
| | - Mohammed Y. Khanji
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Patricia B. Munroe
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit (MRCLEU), Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Unit (MRCLEU), Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Steffen E. Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| |
Collapse
|
7
|
Resting heart rate and the risk of hypertension and heart failure: a dose-response meta-analysis of prospective studies. J Hypertens 2019; 36:995-1004. [PMID: 29176508 DOI: 10.1097/hjh.0000000000001627] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Studies on the relationship of resting heart rate to the risks of hypertension and heart failure have been inconsistent, and the question as to whether there is a linear association between them is unanswered. OBJECTIVE To evaluate this possible relationship, we carried out a dose-response meta-analysis of studies that looked at risks associated with resting heart rate and hypertension or heart failure. METHODS We searched PubMed, Embase, CNKI and WanFang databases for articles published before 15 June 2017. A random-effect model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the resting heart rate-hypertension and heart failure risk association. RESULTS We identified 13 and 17 cohort studies for hypertension and heart failure, respectively. The risk for each disease, respectively, increased by 11% relative risk: 1.11 (95% confidence interval: 1.07-1.15) and 19% relative risk: 1.19 (95% confidence interval: 1.13-1.25) for each 10 beats-per-minute increment in resting heart rate. The relationship between resting heart rate and hypertension or heart failure was consistent in most subgroup analyses except for gender subgroups, with no significant association observed in the women subgroup. The results provide no evidence of a nonlinear association of elevated resting heart rate with hypertension and heart failure risk. CONCLUSION Resting heart rate shows a linear positive association with the incidence of hypertension and heart failure.
Collapse
|
8
|
Chen XJ, Barywani SB, Hansson PO, Östgärd Thunström E, Rosengren A, Ergatoudes C, Mandalenakis Z, Caidahl K, Fu ML. Impact of changes in heart rate with age on all-cause death and cardiovascular events in 50-year-old men from the general population. Open Heart 2019; 6:e000856. [PMID: 31168369 PMCID: PMC6519434 DOI: 10.1136/openhrt-2018-000856] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 12/02/2018] [Accepted: 01/20/2019] [Indexed: 02/05/2023] Open
Abstract
Background Resting heart rate (RHR), a known cardiovascular risk factor, changes with age. However, little is known about the association between changes in RHR and the risk of cardiovascular events. The purpose of this study was therefore to assess the impact of RHR at baseline, and the change in RHR over time, on the risk of all-cause death and cardiovascular events. Design A random population sample of men born in 1943 who were living in Gothenburg, Sweden was prospectively followed for a 21-year period. Methods Participants were examined three times: first in 1993 and then re-examined in 2003 and 2014. At each visit, a clinical examination, an ECG and laboratory analyses were performed. Change in RHR between 1993 and 2003 was defined as a decrease if RHR decreased by 5 beats per minute (bpm), an increase if RHR increased by 5 bpm or stable if the RHR change was <4bpm). Results Participants with a baseline RHR of >75 bpm in 1993 had about a twofold higher risk of all-cause death (HR 2.3, CI 1.2 to 4.7, p=0.018), cardiovascular disease (CVD) (HR 1.8, CI 1.1 to 3.0, p=0.014) and coronary heart disease (CHD) (HR 2.2, CI 1.1 to 4.5, p=0.025) compared with those with <55 bpm in 1993. Participants with a stable RHR between 1993 and 2003 had a 44% decreased risk of CVD (HR 0.56, CI 0.35 to 0.87, p=0.011) compared with participants with an increasing RHR. Furthermore, every beat increase in heart rate from 1993 was associated with a 3% higher risk for all-cause death, 1% higher risk for CVD and 2% higher risk for CHD. Conclusion High RHR was associated with an increased risk of death and cardiovascular events in men from the general population. Moreover, individuals with an increase in RHR between 50 and 60 years of age had worse outcome.
Collapse
Affiliation(s)
- Xiao-Jing Chen
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Cardiology, Sichuan University West China Hospital, Chengdu, China
| | - Salim Bary Barywani
- Department of Cardiology, Sahlgrenska Academy. University of Gothenburg, Gothenburg, Sweden
| | - Per-Olof Hansson
- Department of Molecular and Clinical Medicine/ Emergency and Cardiovascular Medicine Cardiology, Sahlgrenska Academy, Gothenburg, Sweden
| | - Erik Östgärd Thunström
- Department of Cardiology, Sahlgrenska Academy. University of Gothenburg, Gothenburg, Sweden
| | | | | | - Zacharias Mandalenakis
- Molecular and Clinical Medicine, Goteborgs universitet Sahlgrenska Akademin, Goteborg, Sweden
| | - Kenneth Caidahl
- Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Michael Lx Fu
- Department of Cardiology, Sahlgrenska Academy. University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
9
|
Abstract
The autonomic nervous system exerts broad control over the involuntary functions of the human body through complex equilibrium between sympathetic and parasympathetic tone. Imbalance in this equilibrium is associated with a multitude of cardiovascular outcomes, including mortality. The cardiovascular static state of this equilibrium can be quantified using physiological parameters such as heart rate (HR), blood pressure, and by spectral analysis of HR variability. Here, we review the current state of knowledge of the genetic background of cardiovascular measurements of autonomic tone. For most parameters of autonomic tone, a large portion of variability is explained by genetic heritability. Many of the static parameters of autonomic tone have also been studied through candidate-gene approach, yielding some insight into how genotypes of adrenergic receptors affect variables such as HR. Genome-wide approaches in large cohorts similarly exist for static variables such as HR and blood pressure but less is known about the genetic background of the dynamic and more specific measurements, such as HR variability. Furthermore, because most autonomic measures are likely polygenic, pathway analyses and modeling of polygenic effects are critical. Future work will hopefully explain the control of autonomic tone and guide individualized therapeutic interventions.
Collapse
|
10
|
Li K, Yao C, Yang X, Dong L. Reply to Comment on Effect of Resting Heart Rate on All-Cause Mortality and Cardiovascular Events According to Age. J Am Geriatr Soc 2017; 65:1628-1629. [PMID: 28295140 DOI: 10.1111/jgs.14866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kuibao Li
- Heart Center of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
| | - Chonghua Yao
- Beijing Centers for Disease Control and Prevention, Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xinchun Yang
- Heart Center of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
| | - Lei Dong
- Beijing Centers for Disease Control and Prevention, Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
| |
Collapse
|
11
|
Pakzad R, Safiri S. Comment on Effect of Resting Heart Rate on All-Cause Mortality and Cardiovascular Events According to Age. J Am Geriatr Soc 2017; 65:1627-1628. [PMID: 28295132 DOI: 10.1111/jgs.14850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|