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Cardiorespiratory Interaction and Autonomic Sleep Quality Improve during Sleep in Beds Made from Pinus cembra (Stone Pine) Solid Wood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189749. [PMID: 34574675 PMCID: PMC8472742 DOI: 10.3390/ijerph18189749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 12/27/2022]
Abstract
Cardiorespiratory interactions (CRIs) reflect the mutual tuning of two important organismic oscillators—the heartbeat and respiration. These interactions can be used as a powerful tool to characterize the self-organizational and recreational quality of sleep. In this randomized, blinded and cross-over design study, we investigated CRIs in 15 subjects over a total of 253 nights who slept in beds made from different materials. One type of bed, used as control, was made of melamine faced chipboard with a wood-like appearance, while the other type was made of solid wood from stone pine (Pinus cembra). We observed a significant increase of vagal activity (measured by respiratory sinus arrhythmia), a decrease in the heart rate (as an indicator of energy consumption during sleep) and an improvement in CRIs, especially during the first hours of sleep in the stone pine beds as compared to the chipboard beds. Subjective assessments of study participants’ well-being in the morning and sub-scalar assessments of their intrapsychic stability were significantly better after they slept in the stone pine bed than after they slept in the chipboard bed. Our observations suggest that CRIs are sensitive to detectable differences in indoor settings that are relevant to human health. Our results are in agreement with those of other studies that have reported that exposure to volatile phytochemical ingredients of stone pine (α-pinene, limonene, bornyl acetate) lead to an improvement in vagal activity and studies that show a reduction in stress parameters upon contact with solid wood surfaces.
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Wang Y, Chen L, Cheng M, Wang Y, An D, Cai E, Wang Y, Zhang J, Tang X, Li Y, Zhu D. Predictive value of attended automated office blood pressure and resting pulse rate for mortality in community-dwelling octogenarians: Minhang study. J Clin Hypertens (Greenwich) 2021; 23:1239-1245. [PMID: 33949090 PMCID: PMC8678789 DOI: 10.1111/jch.14251] [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: 11/16/2020] [Revised: 01/23/2021] [Accepted: 03/21/2021] [Indexed: 11/28/2022]
Abstract
Systolic blood pressure (SBP) and resting pulse rate (RPR) have been linked to mortality and cardiovascular events in younger population. Till now, no studies simultaneously investigate the non-linear association of SBP and RPR with all-cause and cardiovascular mortality among population aged 80 and older. Data of 2828 eligible participants were selected from electronic health records linked attended automated office blood pressure measurement system. The dose-response relationship between the SBP, RPR, and the risk of all-cause and cardiovascular mortality was analyzed by Cox model with restricted cubic splines. During the 3.6-year follow-up, 442 deaths occurred. Comparing with the optimal SBP (117-145 mmHg), the lower (HR: 1.39, 95% CI: 1.07-1.81) and higher SBP (HR: 1.34, 95% CI: 1.08-1.65) were significantly associated with an increasing risk of all-cause mortality. The higher SBP (>144 mmHg) was associated with cardiovascular mortality, with the HR (95% CI) as 1.51 (1.07-2.12). The faster RPR showed the higher risk of all-cause (HR: 1.36, 95% CI: 1.05-1.76) and cardiovascular (HR: 1.51, 95% CI: 1.07-2.13) mortality. We found both higher SBP and faster RPR were independently associated with all-cause and cardiovascular mortality, and lower SBP was only associated with the increased risk of all-cause mortality in oldest old community-dwelling Chinese population. Our results demonstrate the prognostic importance of both SBP and RPR in the elderly.
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Affiliation(s)
- Yan Wang
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ling Chen
- Xinzhuang Community Health Service Center, Shanghai, China
| | - Minna Cheng
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China
| | - Yajuan Wang
- Xinzhuang Community Health Service Center, Shanghai, China
| | - Dewei An
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Enheng Cai
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuheng Wang
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China
| | - Jin Zhang
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaofeng Tang
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dingliang Zhu
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Warbeck C, Dowd AJ, Kronlund L, Parmar C, Daun JT, Wytsma-Fisher K, Millet GY, Schick A, Reimer RA, Fung T, Culos-Reed SN. Feasibility and effects on the gut microbiota of a 12-week high-intensity interval training plus lifestyle education intervention on inactive adults with celiac disease. Appl Physiol Nutr Metab 2021; 46:325-336. [DOI: 10.1139/apnm-2020-0459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study assessed the feasibility and benefits of high-intensity interval training (HIIT) plus lifestyle education among inactive adults with celiac disease. Forty-one participants were randomized to receive the intervention (HIIT plus lifestyle education; HIIT+) for 12 weeks or waitlist control (WLC). Testing was completed at baseline, immediately post-intervention, and 3 months post-intervention. Generalized estimating equations were used to assess changes in the outcome variables over time between the groups. Mean percent of age-predicted maximum heart rate was 97.9% and average rating of perceived exertion was 6.33 (out of 10) during HIIT intervals. Following the intervention, the HIIT+ showed enrichment in relative abundance of Parabacteroides and Defluviitaleaceae_UCG_011 while WLC showed enrichment in relative abundance of Roseburia intestinalis, Klebsiella, and Adlercreutzia. A unique set of taxa were differentially abundant between the groups at 3 months post-intervention. HIIT+ participants experienced a reduction in resting heart rate (−6.6 bpm) immediately post-intervention compared with WLC. Further research is needed to establish an optimal HIIT protocol that may improve maximal oxygen uptake and metabolic syndrome biomarkers. Findings from this pilot study provide preliminary evidence that an HIIT intervention is feasible for inactive adults with celiac disease and leads to favourable changes in resting heart rate alongside potentially beneficial shifts in gut microbiota. Trial registration number: ClinicalTrials.gov number NCT03520244. Novelty: HIIT leads to potentially beneficial changes in the gut microbiota of adults with celiac disease. An HIIT exercise intervention is feasible and well tolerated for patients with celiac disease.
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Affiliation(s)
- Cassandra Warbeck
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - A. Justine Dowd
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Liam Kronlund
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Candice Parmar
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Julia T. Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | - Guillaume Y. Millet
- Univ Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, EA 7424, F-42023, Saint-Etienne, France
| | - Alana Schick
- International Microbiome Centre, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Raylene A. Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children’s Hospital Research Institute, Calgary, AB T3B 6A8, Canada
| | - Tak Fung
- Research Computing Services, Information Technologies, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Abstract
Heart rate is a parameter that is very easy to measure and is widely used both in clinic and during daily life activities. Its value gained more relevance with the evidence, in prospective studies and meta-analysis, of association between elevated heart rate values and diseases and outcomes.The increased knowledge of physiological mechanisms of heart rate control and the pathophysiological mechanisms responsible for its dysfunction allows to identify the cut-off value of normalcy providing info for non-pharmacological and pharmacological treatments to reduce the cardiovascular risk both in general population and in pathophysiological conditions. This paper overviews the knowledges of the role of resting heart rate as predictor of cardiovascular risk.
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Affiliation(s)
- Gino Seravalle
- Department of Cardiology, Italian Auxological Institute S. Luca Hospital, Milan, Italy -
| | | | - Guido Grassi
- Department of Health Science, Milano-Bicocca University, Milan, Italy
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Abstract
Heart rate is a parameter that is widely used by the general population as a marker of health. The availability of wearable electronic heart rate monitoring devices and use of specific apps are widely used both at rest and during daily life activities. Resting heart rate values gained more relevance with the evidence of association between elevated heart rate values at rest and diseases and adverse events. Also longitudinal studies demonstrated a clear association between increase in heart rate over time and cardiovascular and all-cause mortality. The increased knowledge of physiological mechanisms of heart rate control and the pathophysiological mechanisms responsible for its dysfunction allows identification of the cutoff value of normalcy. This information can be used to select non-pharmacological and pharmacological interventions to reduce the cardiovascular risk both in the general population and in patients with pathophysiological conditions. This review provides an overview of the current knowledge of resting heart rate as cardiovascular risk factor.
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Affiliation(s)
- Gino Seravalle
- Cardiology Department, S. Luca Hospital, Istituto Auxologico Italiano IRCCS , Milan, Italy
| | - Guido Grassi
- Clinica Medica, S. Gerardo Hospital, University Milano-Bicocca , Monza, Italy
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Liang YD, Zhang YN, Li YM, Chen YH, Xu JY, Liu M, Li J, Ma Z, Qiao LL, Wang Z, Yang JF, Wang H. Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China. Clin Interv Aging 2019; 14:2249-2259. [PMID: 31908435 PMCID: PMC6927496 DOI: 10.2147/cia.s225149] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/01/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To survey the difference of frailty prevalence in elderly inpatients amongdifferent wards; to compare the diagnostic performance of five frailty measurements (Clinical Frailty Scale [CFS], FRAIL, Fried, Edmonton, Frailty Index [FI]) in identifying frailty; and to explore the risk factors of frailty in elderly inpatients. PARTICIPANTS AND METHODS This was a cross-sectional study including 1000 inpatients (mean age 75.2±6.7 years, 51.5% male; 542, 229, and 229 patients from cardiology, non-surgical, and surgical wards, respectively) in a tertiary hospital from September 2018 to February 2019. We applied the combined index to integrate the five frailty measurements mentioned above as the gold standard of frailty diagnosis. Multivariate logistic regression models were used to determine the independent risk factors of frailty. RESULTS Frailty prevalence was 32.3% (Fried), 36.2% (CFS), 19.2% (FRAIL), 25.2% (Edmonton), 35.1% (FI) in all patients. The frailty was more common in non-surgical wards, regardless of the frailty assessment tools used (non-surgical wards: 27.5% to 51.5%; cardiology ward: 14.9% to 29.3%; surgical wards: 18.8% to 41.9%). CFS≥5 showed a sensitivity of 94.1% and a specificity of 85.2% for all patients. FI≥0.25 showed a sensitivity of 94.8% and a specificity of 87.0% for all patients. Age [odds ratio (OR) = 1.089, P<0.001], education level (OR = 0.782, P=0.001), heart rate (OR = 1.025, P<0.001), albumin (OR = 0.911, P=0.002), log D-dimer (OR = 2.940, P<0.001), ≥5 comorbidities (OR = 2.164, P=0.002), and ≥5 medications (OR = 2.819, P<0.001) were independently associated with frailty in all participants. CONCLUSION Frailty is common among elderly inpatients, especially in non-surgical wards. CFS is a preferred screening tool and FI may be an optimal assessment tool. Old age, low educational level, fast heart rate, low albumin, high D-dimer, ≥5 comorbidities, and polypharmacy are independent risk factors of frailty in elderly hospitalized patients.
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Affiliation(s)
- Yao-Dan Liang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
| | | | - Yan-Ming Li
- Department of Pulmonary and Critical Care Medicine
| | | | | | | | | | - Zhao Ma
- Department of Rehabilitation
| | | | - Zi Wang
- Department of Cardiac Surgery, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China
| | - Jie-Fu Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China
| | - Hua Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China
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Wod M, Jensen MT, Galatius S, Hjelmborg JB, Jensen GB, Christensen K. Resting heart rate and mortality in the very old. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:566-571. [DOI: 10.1080/00365513.2019.1672085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Mette Wod
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
- The Unit of Epidemiology, Biostatistics and Biodemography, the Danish Twin Registry, University of Southern Denmark, Odense, Denmark
| | | | - Søren Galatius
- Department of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Jacob B. Hjelmborg
- The Unit of Epidemiology, Biostatistics and Biodemography, the Danish Twin Registry, University of Southern Denmark, Odense, Denmark
| | - Gorm B. Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital Frederiksberg, Frederiksberg, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kaare Christensen
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
- The Unit of Epidemiology, Biostatistics and Biodemography, the Danish Twin Registry, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
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He J, Yang Y, Zhang G, Lu XH. Clinical risk factors for new-onset atrial fibrillation in acute myocardial infarction: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15960. [PMID: 31261502 PMCID: PMC6616519 DOI: 10.1097/md.0000000000015960] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
New-onset atrial fibrillation (NOAF) remains common arrhythmia in acute myocardial infarction (AMI), and is closely associated with increased subsequent cardiovascular mortality. Our meta-analysis aims to summarize more clinical risk factors for NOAF.Comprehensive systematic search of MEDLINE, EMBASE, and the Cochrane Library were carried out to find relevant studies inception to December 2017. Pooled mean difference (MD) and 95% confidence interval (CI) were calculated to evaluate the value of clinical risk factors in the prediction of NOAF after AMI.Eleven studies containing 9570 patients were included in the meta-analysis. Overall, older age and increased heart rate (HR) levels had a significant positive association with NOAF in patients with AMI. The MD in age between the patients with, and those without NOAF, was 8.22 units (95% confidence interval [CI]: 7.44-9.01), test for overall effect z score = 20.51 (P < .00001, I = 0%). Moreover, the MD in a subgroup analysis for HR levels between the patients with, and those without NOAF was 4.34 units (95% Cl: 2.56-6.11), test for overall effect z score = 4.78 (P < .00001, I = 31%).In patient with AMI, our meta-analysis demonstrated that older age and increased HR levels on admission are related to greater risk of NOAF.
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Affiliation(s)
- Jing He
- Guangdong Sanjiu Brain Hospital
| | - Yi Yang
- Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces, Guangzhou Medical University, Guangzhou, China
| | - Gui Zhang
- Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces, Guangzhou Medical University, Guangzhou, China
| | - Xiu-Hong Lu
- Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces, Guangzhou Medical University, Guangzhou, China
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Tamarappoo BK, Fong Ling L, Cerqueira M, Hachamovitch R. Independent prognostic value of left ventricular contractile reserve and chronotropic response in patients with reduced left ventricular ejection fraction undergoing vasodilator stress myocardial perfusion imaging with Rb-82 positron emission tomography. Eur Heart J Cardiovasc Imaging 2018; 19:442-449. [PMID: 28673042 DOI: 10.1093/ehjci/jex157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/14/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives We evaluated the prognostic value of heart rate reserve (ΔHR) and left ventricular ejection fraction reserve (ΔLVEF) among patients with systolic dysfunction. Background Inadequate ΔHR (maximal stress HR - resting HR) and ΔLVEF (LVEF at stress - LVEF at rest) in response to stress are associated with adverse cardiac events. However, the significance of an abnormal ΔHR and ΔLVEF in patients with systolic dysfunction has not been described. Methods and results We performed a retrospective analysis of patients with rest LVEF < 45% who underwent dipyridamole stress-rest gated Rb-82 PET myocardial perfusion imaging (PET-MPI) at the Cleveland Clinic between 2006 and 2009. Stress LVEF and volumes were calculated using commercially available software (4DM). A Cox proportional hazards model (CPH) was used to examine the association between ΔLVEF, ΔHR, and all-cause death (ACD). Among 461 patients (mean age 65.7 ± 11.3 years, 82% men) 167 experienced ACD (median follow-up 1045 days). Survival was reduced among patients with ΔHR < 0 (1090 vs. 1300 days, P = 0.04) and ΔLVEF < 0 (1002 vs. 1057 days, P = 0.03). In a CPH after adjusting for confounding variables, ΔHR ≤ 0 and ΔLVEF ≤ 0 were associated with reduced survival (hazard ratio 0.93, P < 0.01 and 0.84, P = 0.01, respectively) with an interaction between age and ΔHR (χ2 = 8.1, P < 0.01). Our model predicts that the magnitude of ΔHR is associated with improved survival among younger patients. For any given ΔLVEF the magnitude of ΔHR has a greater positive effect on survival among younger patients. Conclusion Both ΔHR and ΔLVEF during pharmacologic stress PET-MPI provide incremental value in predicting ACD among patients with systolic dysfunction.
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Affiliation(s)
- Balaji K Tamarappoo
- Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Lee Fong Ling
- Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Manuel Cerqueira
- Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Rory Hachamovitch
- Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Prasada S, Oswalt C, Yeboah P, Saylor G, Bowden D, Yeboah J. Heart rate is an independent predictor of all-cause mortality in individuals with type 2 diabetes: The diabetes heart study. World J Diabetes 2018; 9:33-39. [PMID: 29359027 PMCID: PMC5763038 DOI: 10.4239/wjd.v9.i1.33] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/25/2017] [Accepted: 11/27/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To assess the association of resting heart rate with all-cause and cardiovascular disease (CVD) mortality in the Diabetes Heart Study (DHS).
METHODS Out of a total of 1443 participants recruited into the DHS, 1315 participants with type 2 diabetes who were free of atrial fibrillation and supraventricular tachycardia during the baseline exam were included in this analysis. Heart rate was collected from baseline resting electrocardiogram and mortality (all-cause and CVD) was obtained from state and national death registry. Kaplan-Meier (K-M) and Cox proportional hazard analyses were used to assess the association.
RESULTS The mean age, body mass index (BMI) and systolic blood pressure (SBP) of the cohort were 61.4 ± 9.2 years, 32.0 ± 6.6 kg/m2, and 139.4 ± 19.4 mmHg respectively. Fifty-six percent were females, 85% were whites, 15% were blacks, 18% were smokers. The mean ± SD heart rate was 69.8 (11.9) beats per minute (bpm). After a median follow-up time of 8.5 years (maximum follow-up time is 14.0 years), 258 participants were deceased. In K-M analysis, participants with heart rate above the median had a significantly higher event rate compared with those below the median (log-rank P = 0.0223). A one standard deviation increase in heart rate was associated with all-cause mortality in unadjusted (hazard ratio 1.16, 95%CI: 1.03-1.31) and adjusted (hazard ratio 1.20, 95%CI: 1.05-1.37) models. Similar results were obtained with CVD mortality as the outcome of interest.
CONCLUSION Heart rate is an independent predictor of all-cause mortality in this population with type 2 diabetes. In this study, a 1-SD increase in heart rate was associated with a 20% increase in risk suggesting that additional prognostic information may be gleaned from this ubiquitously collected vital sign.
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Affiliation(s)
- Sameer Prasada
- Department of Medical School (Medical students), Wake Forest University, Winston Salem, NC 27157, United States
| | - Cameron Oswalt
- Department of Medical School (Medical students), Wake Forest University, Winston Salem, NC 27157, United States
| | - Phyllis Yeboah
- Department of Internal Medicine, Wake Forest Baptist Health, Winston Salem, NC 27157, United States
| | - Georgia Saylor
- Department of Heart and Vascular Center of Excellence, Wake Forest Baptist Health, Winston Salem, NC 27157, United States
| | - Donald Bowden
- Department of Biochemistry, Genomics and Personalized Medicine Research, Wake Forest University, Winston Salem, NC 27157, United States
| | - Joseph Yeboah
- Department of Heart and Vascular Center of Excellence, Wake Forest Baptist Health, Winston Salem, NC 27157, United States
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Associations of the serum long-chain n-3 PUFA and hair mercury with resting heart rate, peak heart rate during exercise and heart rate recovery after exercise in middle-aged men. Br J Nutr 2017; 119:66-73. [PMID: 29208059 DOI: 10.1017/s0007114517003191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Long-chain n-3 PUFA from fish have been associated with lower risk of CVD. Fish may also contain methylmercury, which may attenuate the inverse associations of the long-chain n-3 PUFA. However, the mechanisms underlying these associations are not fully known. We evaluated the associations of the serum long-chain n-3 PUFA (EPA, DPA and DHA) and hair Hg with resting heart rate (HR), peak HR during cycle ergometer exercise and HR recovery after exercise. A total of 1008 men from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study, aged 42-60 years and free of CVD, were studied. After multivariate-adjustments in ANCOVA, higher serum total long-chain n-3 PUFA concentration was associated with lower resting HR (extreme-quartile difference 2·2 beats/min; 95 % CI 0·2, 4·1, P trend across quartiles=0·02), but not with peak HR or HR recovery. Associations were generally similar when EPA, DPA and DHA were evaluated individually, except for DPA, which was also associated with better HR recovery after exercise (extreme-quartile difference 2·1 beats/min; 95 % CI 0·1, 4·2, P trend=0·06). Higher hair Hg content had a trend towards lower peak HR after adjusting for the long-chain n-3 PUFA (P trend=0·05), but it only slightly attenuated the associations of the serum long-chain n-3 PUFA with HR. These findings suggest that higher serum long-chain n-3 PUFA concentrations are associated with lower resting HR in middle-aged men from Eastern Finland, which may partially explain the potential cardioprotective effect of fish intake.
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Zhang Y, Wu NQ, Xu RX, Li S, Zhu CG, Guo YL, Gao Y, Qing P, Cui CJ, Sun J, Li JJ. Elevated resting heart rate is associated with the severity of coronary artery disease in non-treated patients who underwent coronary angiography: potential role of lipoprotein subfractions. Arch Physiol Biochem 2017; 123:356-363. [PMID: 28686483 DOI: 10.1080/13813455.2017.1347688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To assess the association between resting heart rate (RHR) and lipoprotein subfractions to provide potential evidence for the relationship between RHR and severity of CAD. METHODS A total of 1119 consecutive non-treated subjects scheduled for coronary angiography were enrolled. High-density lipoprotein (HDL) and low-density lipoprotein (LDL) separation were performed by Lipoprint System. The link of RHR with lipoprotein subfractions was assessed. RESULTS Increased RHR was significantly associated with higher triglyceride, total cholesterol, non-HDL-cholesterol, and apolipoprotein B (all p < .01). Furthermore, data indicated that higher RHR was related to more severe CAD (all p < .05). In the following linear regression models, we observed that higher RHR (HRh bpm) was significantly associated with lower large HDL (β = -0.073, p = .024) and higher small LDL subfraction (β = 0.103, p = .005) after adjusting for potential confounders. CONCLUSIONS Increased RHR was associated with more severe CAD, which may be partly due to the significant relation to atherogenic lipoprotein subfractions.
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Affiliation(s)
- Yan Zhang
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Na-Qiong Wu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Rui-Xia Xu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Sha Li
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Cheng-Gang Zhu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Yuan-Lin Guo
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Ying Gao
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Ping Qing
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Chuan-Jue Cui
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Jing Sun
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Jian-Jun Li
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
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13
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Jensen MT, Wod M, Galatius S, Hjelmborg JB, Jensen GB, Christensen K. Heritability of resting heart rate and association with mortality in middle-aged and elderly twins. Heart 2017. [PMID: 28637897 DOI: 10.1136/heartjnl-2016-310986] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Resting heart rate (RHR) possibly has a hereditary component and is associated with longevity. We used the classical biometric twin study design to investigate the heritability of RHR in a population of middle-aged and elderly twins and, furthermore, studied the association between RHR and mortality. METHODS In total, 4282 twins without cardiovascular disease were included from the Danish Twin Registry, hereof 1233 twin pairs and 1816 'single twins' (twins with a non-participating co-twin); mean age 61.7 (SD 11.1) years; 1334 (31.2%) twins died during median 16.3 (IQR 13.8-16.5) years of follow-up assessed through Danish national registers. RHR was assessed by palpating radial pulse. RESULTS Within pair correlations for RHR adjusted for sex and age were 0.23 (95% CI 0.14 to 0.32) and 0.10 (0.03 to 0.17) for RHR in monozygotic (MZ) and dizygotic (DZ) twin pairs, respectively. Overall, heritability estimates were 0.23 (95% CI 0.15 to 0.30); 0.27 (0.15 to 0.38) for males and 0.17 (0.06 to 0.28) for females. In multivariable models adjusting for age, gender, body mass index, diabetes, hypertension, pulmonary function, smoking, physical activity and zygosity, RHR was significantly associated with mortality (eg, RHR >90 vs 61-70 beats per min: all-cause HR 1.56 (95% CI 1.21 to 2.03); cardiovascular 2.19 (1.30 to 3.67). Intrapair twin comparison revealed that the twin with the higher RHR was significantly more likely to die first and the probability increased with increase in intrapair difference in RHR. CONCLUSIONS RHR is a trait with a genetic influence in middle-aged and elderly twins free of cardiovascular disease. RHR is independently associated with longevity even when familial factors are controlled for in a twin design.
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Affiliation(s)
- Magnus T Jensen
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Mette Wod
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense C, Denmark
| | - Søren Galatius
- Department of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Jacob B Hjelmborg
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Gorm B Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital Frederiksberg, Frederiksberg, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kaare Christensen
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense C, Denmark.,Department of Clinical Genetics, Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
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14
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Aune D, Sen A, ó'Hartaigh B, Janszky I, Romundstad PR, Tonstad S, Vatten LJ. Resting heart rate and the risk of cardiovascular disease, total cancer, and all-cause mortality - A systematic review and dose-response meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis 2017; 27:504-517. [PMID: 28552551 DOI: 10.1016/j.numecd.2017.04.004] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/06/2017] [Accepted: 04/13/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIM Epidemiological studies have reported increased risk of cardiovascular disease, cancer and all-cause mortality with greater resting heart rate, however, the evidence is not consistent. Differences by gender, adjustment for confounding factors, as well as the potential impact of subclinical disease are not clear. A previous meta-analysis missed a large number of studies, and data for atrial fibrillation have not been summarized before. We therefore aimed to clarify these associations in a systematic review and meta-analysis of prospective studies. METHODS AND RESULTS PubMed and Embase were searched up to 29 March 2017. Summary RRs and 95% confidence intervals (CIs) were calculated using random effects models. Eighty seven studies were included. The summary RR per 10 beats per minute increase in resting heart rate was 1.07 (95% CI: 1.05-1.10, I2 = 61.9%, n = 31) for coronary heart disease, 1.09 (95% CI: 1.00-1.18, I2 = 62.3%, n = 5) for sudden cardiac death, 1.18 (95% CI: 1.10-1.27, I2 = 74.5%, n = 8) for heart failure, 0.97 (95% CI: 0.92-1.02, I2 = 91.4%, n = 9) for atrial fibrillation, 1.06 (95% CI: 1.02-1.10, I2 = 59.5%, n = 16) for total stroke, 1.15 (95% CI: 1.11-1.18, I2 = 84.3%, n = 35) for cardiovascular disease, 1.14 (95% CI: 1.06-1.23, I2 = 90.2%, n = 12) for total cancer, and 1.17 (95% CI: 1.14-1.19, I2 = 94.0%, n = 48) for all-cause mortality. There was a positive dose-response relationship for all outcomes except for atrial fibrillation for which there was a J-shaped association. CONCLUSION This meta-analysis found an increased risk of coronary heart disease, sudden cardiac death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer and all-cause mortality with greater resting heart rate.
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Affiliation(s)
- D Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Epidemiology and Public Health, Imperial College, London, UK; Bjørknes University College, Oslo, Norway.
| | - A Sen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - B ó'Hartaigh
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, USA; Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, Adler Geriatric Center, New Haven, USA
| | - I Janszky
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - P R Romundstad
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - S Tonstad
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - L J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Chen S, Li W, Jin C, Vaidya A, Gao J, Yang H, Wu S, Gao X. Resting Heart Rate Trajectory Pattern Predicts Arterial Stiffness in a Community-Based Chinese Cohort. Arterioscler Thromb Vasc Biol 2016; 37:359-364. [PMID: 27908892 DOI: 10.1161/atvbaha.116.308674] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether the long-term resting heart rate (RHR) pattern can predict the risk of having arterial stiffness in a large ongoing cohort. APPROACH AND RESULTS This community-based cohort included 12 554 participants in the Kailun study, who were free of myocardial infarction, stroke, arrhythmia, and cancer. We used latent mixture modeling to identify RHR trajectories in 2006, 2008, and 2010. We used multivariate linear regression model to examine the association between RHR trajectory patterns and the risk of having arterial stiffness, which was assessed by brachial-ankle pulse wave velocity in 2010 to 2016. We adjusted for possible confounding factors, including socioeconomic status, lifestyle factors, use of medications, comorbidities, and serum concentrations of lipids, glucose, and high-sensitivity C-reactive proteins. We identified 5 distinct RHR trajectory patterns based on their 2006 status and on the pattern of change during 2006 to 2010 (low-stable, moderate-stable, moderate-increasing, elevated-decreasing, and elevated-stable). We found that individuals with elevated-stable RHR trajectory pattern had the highest brachial-ankle pulse wave velocity value and individuals with the low-stable RHR trajectory pattern had the lowest value (adjusted mean difference=157 cm/s; P<0.001). Adjusted odds ratio for risk of having arterial stiffness (brachial-ankle pulse wave velocity ≥1400 cm/s) was 4.14 (95% confidence interval, 2.61-6.57) relative to these 2 extreme categories. Consistently, a higher average RHR, a higher annual RHR increase rate, and a higher RHR variability were all associated with a higher risk of having arterial stiffness. CONCLUSIONS Long-term RHR pattern is a strong predictor of having arterial stiffness.
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Affiliation(s)
- Shuohua Chen
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Weijuan Li
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Cheng Jin
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Anand Vaidya
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Jingli Gao
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Hui Yang
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Shouling Wu
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Xiang Gao
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.).
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16
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Zhang D, Wang W, Li F. Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis. CMAJ 2016; 188:E384-E392. [PMID: 27551034 DOI: 10.1503/cmaj.160050] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. METHODS We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine study-specific relative risks (RRs). We used restricted cubic splines to assess the dose-response relation. RESULTS We included 45 nonrandomized prospective cohort studies in the meta-analysis. The multivariable adjusted RR with an increment of 10 beats/min in resting heart rate was 1.12 (95% confidence interval [CI] 1.09-1.14) for coronary artery disease, 1.05 (95% CI 1.01-1.08) for stroke, 1.12 (95% CI 1.02-1.24) for sudden death, 1.16 (95% CI 1.12-1.21) for noncardiovascular diseases, 1.09 (95% CI 1.06-1.12) for all types of cancer and 1.25 (95% CI 1.17-1.34) for noncardiovascular diseases excluding cancer. All of these relations were linear. In an analysis by category of resting heart rate (< 60 [reference], 60-70, 70-80 and > 80 beats/min), the RRs were 0.99 (95% CI 0.93-1.04), 1.08 (95% CI 1.01-1.16) and 1.30 (95% CI 1.19-1.43), respectively, for coronary artery disease; 1.08 (95% CI 0.98-1.19), 1.11 (95% CI 0.98-1.25) and 1.08 (95% CI 0.93-1.25), respectively, for stroke; and 1.17 (95% CI 0.94-1.46), 1.31 (95% CI 1.12-1.54) and 1.57 (95% CI 1.39-1.77), respectively, for noncardiovascular diseases. After excluding studies involving patients with hypertension or diabetes, we obtained similar results for coronary artery disease, stroke and noncardiovascular diseases, but found no association with sudden death. INTERPRETATION Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all of the studies combined. When the analysis included only studies concerning general populations, resting heart rate was not associated with sudden death.
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Affiliation(s)
- Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, China
| | - Fang Li
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, China
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17
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Sharashova E, Wilsgaard T, Mathiesen EB, Løchen ML, Njølstad I, Brenn T. Resting heart rate predicts incident myocardial infarction, atrial fibrillation, ischaemic stroke and death in the general population: the Tromsø Study. J Epidemiol Community Health 2016; 70:902-9. [PMID: 26951324 DOI: 10.1136/jech-2015-206663] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/21/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Elevated resting heart rate (RHR) increases risk of death overall, but a comprehensive picture of the associations between RHR, cardiovascular morbidity and mortality events has not yet been presented. We aimed to investigate the effect of RHR on the risk of 5 cardiovascular events: incident myocardial infarction (MI), incident atrial fibrillation (AF), incident ischaemic stroke, total death and cardiovascular death in a general population from Norway. METHODS We followed 24 489 men and women from the Tromsø Study 1994-1995, a population-based cohort study, for 18 years, and analysed the association between RHR and the investigated cardiovascular events. Sex-specific Cox regression with time-dependent covariates was applied with the best-fitting fractional polynomials of RHR. RESULTS Among men, an independent positive relationship was observed for MI and AF (adjusted HR for AF per 20 bpm increase=1.14; 95% CI 1.02 to 1.27). In women, the corresponding HR for MI was 1.23 (1.09 to 1.40). A J-shaped association was observed for ischaemic stroke in women when compared with a RHR of 70 bpm (HR for 50 bpm=1.31; 0.90 to 1.90; HR for 100 bpm=1.32; 1.04 to 1.69). Total and cardiovascular death showed a strong positive association with RHR in men. In women, the pattern for total death was similar. CONCLUSIONS RHR is an independent risk factor for several cardiovascular events. A novel finding is the positive association between RHR and AF in men and the sex difference in association with ischaemic stroke.
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Affiliation(s)
- Ekaterina Sharashova
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tormod Brenn
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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18
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van Ockenburg SL, Rosmalen JGM, Bakker SJL, de Jonge P, Gans ROB. Effects of urinary cortisol levels and resting heart rate on the risk for fatal and nonfatal cardiovascular events. Atherosclerosis 2016; 248:44-50. [PMID: 26987065 DOI: 10.1016/j.atherosclerosis.2016.02.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 02/10/2016] [Accepted: 02/25/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Higher cortisol levels are associated with cardiovascular mortality in the elderly. It is unclear whether this association also exists in a general population of younger adults and for non-fatal cardiovascular events. Likewise, resting heart rate is associated with cardiovascular mortality, but fewer studies have also considered non-fatal events. The goal of this study was to investigate whether twenty-four-hour urinary cortisol (24-h UFC) levels and resting heart rate (RHR) predict major adverse fatal and non-fatal cardiovascular events (MACE) in the general population. METHODS We used data from a subcohort of the PREVEND study, a prospective general population based cohort study with a follow-up of 6.4 years for 24-h UFC and 10.6 years for RHR. Participants were 3432 adults (mean age 49 years, range 28-75). 24-h UFC was collected and measured by liquid chromatography-tandem mass spectrometry. RHR was measured at baseline in a supine position for 10 min with the Dinamap XL Model 9300. Information about cardiovascular events and mortality was obtained from the Dutch national registry of hospital discharge diagnoses and the municipal register respectively. RESULTS 24-h UFC did not significantly increase the hazard of MACE (hazard ratio = 0.999, 95% confidence interval = 0.993-1.006, p = 0.814). RHR increased the risk for MACE with 17% per 10 extra heart beats per minute (hazard ratio = 1.016, 95% confidence interval = 1.001-1.031, p = 0.036) after adjustment for conventional risk factors. CONCLUSIONS In contrast to 24-h UFC, RHR is a risk marker for MACE in the general population.
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Affiliation(s)
- Sonja L van Ockenburg
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Judith G M Rosmalen
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Peter de Jonge
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Reinold O B Gans
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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19
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Zhang D, Shen X, Qi X. Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis. CMAJ 2015; 188:E53-E63. [PMID: 26598376 DOI: 10.1503/cmaj.150535] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Data on resting heart rate and risk of all-cause and cardiovascular mortality are inconsistent; the magnitude of associations between resting heart rate and risk of all-cause and cardiovascular mortality varies across studies. We performed a meta-analysis of prospective cohort studies to quantitatively evaluate the associations in the general population. METHODS We searched PubMed, Embase and MEDLINE from inception to Jan. 1, 2015. We used a random-effects model to combine study-specific relative risks and 95% confidence intervals (CIs). We used restricted cubic spline functions to assess the dose-response relation. RESULTS A total of 46 studies were included in the meta-analysis, involving 1 246 203 patients and 78 349 deaths for all-cause mortality, and 848 320 patients and 25 800 deaths for cardiovascular mortality. The relative risk with 10 beats/min increment of resting heart rate was 1.09 (95% CI 1.07-1.12) for all-cause mortality and 1.08 (95% CI 1.06-1.10) for cardiovascular mortality. Compared with the lowest category, patients with a resting heart rate of 60-80 beats/min had a relative risk of 1.12 (95% CI 1.07-1.17) for all-cause mortality and 1.08 (95% CI 0.99-1.17) for cardiovascular mortality, and those with a resting heart rate of greater than 80 beats/min had a relative risk of 1.45 (95% CI 1.34-1.57) for all-cause mortality and 1.33 (95% CI 1.19-1.47) for cardiovascular mortality. Overall, the results did not differ after adjustment for traditional risk factors for cardiovascular disease. Compared with 45 beats/min, the risk of all-cause mortality increased significantly with increasing resting heart rate in a linear relation, but a significantly increased risk of cardiovascular mortality was observed at 90 beats/min. Substantial heterogeneity and publication bias were detected. INTERPRETATION Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This indicates that resting heart rate is a predictor of all-cause and cardiovascular mortality in the general population.
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Affiliation(s)
- Dongfeng Zhang
- Departments of Epidemiology and Health Statistics (Zhang, Shen), and Clinical Medicine (Qi), Medical College of Qingdao University, Shandong, China
| | - Xiaoli Shen
- Departments of Epidemiology and Health Statistics (Zhang, Shen), and Clinical Medicine (Qi), Medical College of Qingdao University, Shandong, China
| | - Xin Qi
- Departments of Epidemiology and Health Statistics (Zhang, Shen), and Clinical Medicine (Qi), Medical College of Qingdao University, Shandong, China
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20
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Wang SL, Wang CL, Wang PL, Xu H, Du JP, Zhang DW, Gao ZY, Zhang L, Fu CG, Chen KJ, Shi DZ. Resting heart rate associates with one-year risk of major adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention. Exp Biol Med (Maywood) 2015; 241:478-84. [PMID: 26585407 DOI: 10.1177/1535370215617563] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/15/2015] [Indexed: 11/16/2022] Open
Abstract
The study was to access the association between resting heart rate (RHR) and one-year risk of major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Patients with ACS after PCI (n = 808) were prospectively followed-up for MACE. RHR was obtained from electrocardiogram. MACE was defined as a composite of cardiac death, nonfatal recurrent myocardial infarction, ischemic-driven revascularization, and ischemic stroke. The association between RHR and one-year risk of MACE was assessed using Cox proportional hazards regression model. Compared with patients with RHR >76 bpm, the adjusted hazard ratio (AHR) was 0.51 (95% confidence intervals [CI]: 0.23-1.14; P = 0.100) for patients with RHR < 61 bpm, and 0.44 (95%CI: 0.23-0.85; P = 0.014) for those with RHR 61-76 bpm. For patients with RHR ≥ 61 bpm, an increase of 10 bpm in RHR was associated with an increase by 38.0% in the risk of MACE (AHR: 1.38; 95% CI: 1.04-1.83; P = 0.026). ACS patients after PCI with RHR >76 bpm were at higher risk of MACE during one-year follow-up compared with patients with RHR 61-76 bpm. An elevated RHR ≥ 61 bpm was associated with increased risk of one-year MACE in ACS patients.
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Affiliation(s)
- Shao-Li Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Cheng-Long Wang
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Pei-Li Wang
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Hao Xu
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Jian-Peng Du
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Da-Wu Zhang
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Zhu-Ye Gao
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Lei Zhang
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Chang-Geng Fu
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Ke-Ji Chen
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Da-Zhuo Shi
- Institute of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
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Linneberg A, Jacobsen RK, Skaaby T, Taylor AE, Fluharty ME, Jeppesen JL, Bjorngaard JH, Åsvold BO, Gabrielsen ME, Campbell A, Marioni RE, Kumari M, Marques-Vidal P, Kaakinen M, Cavadino A, Postmus I, Ahluwalia TS, Wannamethee SG, Lahti J, Räikkönen K, Palotie A, Wong A, Dalgård C, Ford I, Ben-Shlomo Y, Christiansen L, Kyvik KO, Kuh D, Eriksson JG, Whincup PH, Mbarek H, de Geus EJC, Vink JM, Boomsma DI, Smith GD, Lawlor DA, Kisialiou A, McConnachie A, Padmanabhan S, Jukema JW, Power C, Hyppönen E, Preisig M, Waeber G, Vollenweider P, Korhonen T, Laatikainen T, Salomaa V, Kaprio J, Kivimaki M, Smith BH, Hayward C, Sørensen TIA, Thuesen BH, Sattar N, Morris RW, Romundstad PR, Munafò MR, Jarvelin MR, Husemoen LLN. Effect of Smoking on Blood Pressure and Resting Heart Rate: A Mendelian Randomization Meta-Analysis in the CARTA Consortium. ACTA ACUST UNITED AC 2015; 8:832-41. [PMID: 26538566 DOI: 10.1161/circgenetics.115.001225] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 10/21/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Smoking is an important cardiovascular disease risk factor, but the mechanisms linking smoking to blood pressure are poorly understood. METHODS AND RESULTS Data on 141 317 participants (62 666 never, 40 669 former, 37 982 current smokers) from 23 population-based studies were included in observational and Mendelian randomization meta-analyses of the associations of smoking status and smoking heaviness with systolic and diastolic blood pressure, hypertension, and resting heart rate. For the Mendelian randomization analyses, a genetic variant rs16969968/rs1051730 was used as a proxy for smoking heaviness in current smokers. In observational analyses, current as compared with never smoking was associated with lower systolic blood pressure and diastolic blood pressure and lower hypertension risk, but with higher resting heart rate. In observational analyses among current smokers, 1 cigarette/day higher level of smoking heaviness was associated with higher (0.21 bpm; 95% confidence interval 0.19; 0.24) resting heart rate and slightly higher diastolic blood pressure (0.05 mm Hg; 95% confidence interval 0.02; 0.08) and systolic blood pressure (0.08 mm Hg; 95% confidence interval 0.03; 0.13). However, in Mendelian randomization analyses among current smokers, although each smoking increasing allele of rs16969968/rs1051730 was associated with higher resting heart rate (0.36 bpm/allele; 95% confidence interval 0.18; 0.54), there was no strong association with diastolic blood pressure, systolic blood pressure, or hypertension. This would suggest a 7 bpm higher heart rate in those who smoke 20 cigarettes/day. CONCLUSIONS This Mendelian randomization meta-analysis supports a causal association of smoking heaviness with higher level of resting heart rate, but not with blood pressure. These findings suggest that part of the cardiovascular risk of smoking may operate through increasing resting heart rate.
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Ó Hartaigh B, Gill TM, Shah I, Hughes AD, Deanfield JE, Kuh D, Hardy R. Association between resting heart rate across the life course and all-cause mortality: longitudinal findings from the Medical Research Council (MRC) National Survey of Health and Development (NSHD). J Epidemiol Community Health 2014; 68:883-9. [PMID: 24850484 DOI: 10.1136/jech-2014-203940] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Resting heart rate (RHR) is an independent risk factor for mortality. Nevertheless, it is unclear whether elevations in childhood and mid-adulthood RHR, including changes over time, are associated with mortality later in life. We sought to evaluate the association between RHR across the life course, along with its changes and all-cause mortality. METHODS We studied 4638 men and women from the Medical Research Council (MRC) National Survey of Health and Development (NSHD) cohort born during 1 week in 1946. RHR was obtained during childhood at ages 6, 7 and 11, and in mid-adulthood at ages 36 and 43. Using multivariable Cox regression, we calculated the HR for incident mortality according to RHR measured at each time point, along with changes in mid-adulthood RHR. RESULTS At age 11, those in the top fifth of the RHR distribution (≥97 bpm) had an increased adjusted hazard of 1.42 (95% CI 1.04 to 1.93) for all-cause mortality. A higher adjusted risk (HR, 95% CI 2.17, 1.40 to 3.36) of death was also observed for those in the highest fifth (≥81 bpm) at age 43. For a >25 bpm increased change in the RHR over the course of 7 years (age 36-43), the adjusted hazard was elevated more than threefold (HR, 95% CI 3.26, 1.54 to 6.90). After adjustment, RHR at ages 6, 7 and 36 were not associated with all-cause mortality. CONCLUSIONS Elevated RHR during childhood and midlife, along with greater changes in mid-adulthood RHR, are associated with an increased risk of all-cause mortality.
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Affiliation(s)
- Bríain Ó Hartaigh
- Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, Adler Geriatric Centre, New Haven, USA Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, USA
| | - Thomas M Gill
- Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, Adler Geriatric Centre, New Haven, USA
| | - Imran Shah
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Alun D Hughes
- International Centre for Circulatory Health, National Heart and Lung Institute Division, Imperial College London, London, UK
| | - John E Deanfield
- National Institute for Cardiovascular Outcome Research, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, University College London, London, UK
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Fong EM, Chung WY. Mobile cloud-computing-based healthcare service by noncontact ECG monitoring. SENSORS 2013; 13:16451-73. [PMID: 24316562 PMCID: PMC3892841 DOI: 10.3390/s131216451] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 10/14/2013] [Accepted: 11/21/2013] [Indexed: 11/16/2022]
Abstract
Noncontact electrocardiogram (ECG) measurement technique has gained popularity these days owing to its noninvasive features and convenience in daily life use. This paper presents mobile cloud computing for a healthcare system where a noncontact ECG measurement method is employed to capture biomedical signals from users. Healthcare service is provided to continuously collect biomedical signals from multiple locations. To observe and analyze the ECG signals in real time, a mobile device is used as a mobile monitoring terminal. In addition, a personalized healthcare assistant is installed on the mobile device; several healthcare features such as health status summaries, medication QR code scanning, and reminders are integrated into the mobile application. Health data are being synchronized into the healthcare cloud computing service (Web server system and Web server dataset) to ensure a seamless healthcare monitoring system and anytime and anywhere coverage of network connection is available. Together with a Web page application, medical data are easily accessed by medical professionals or family members. Web page performance evaluation was conducted to ensure minimal Web server latency. The system demonstrates better availability of off-site and up-to-the-minute patient data, which can help detect health problems early and keep elderly patients out of the emergency room, thus providing a better and more comprehensive healthcare cloud computing service.
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Affiliation(s)
- Ee-May Fong
- Department of Electronic Engineering, Graduate School, Pukyong National University, Busan 608-737, Korea.
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Takagi D, Morikami A, Kamo T, Fujita D, Goto M, Kubo Y, Saito M, Suzuki R, Kageyama M, Matsuura K, Nishida Y. The Association of Calf Circumference with Resting Pulse Rate in Community-dwelling Healthy Elderly Women -Pilot Study-. J Phys Ther Sci 2013; 25:705-7. [PMID: 24259834 PMCID: PMC3804995 DOI: 10.1589/jpts.25.705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/31/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] High resting blood pressure and heart rate are associated with the risk of
cardiovascular events. In patients with decreasing amounts of slow twitch muscle fiber,
hypertension may develop and resting heart rate may increase. Measurement of the amount of
slow twitch muscle fiber and capillary density using muscle biopsy is inconvenient and
expensive. Therefore, a better screening test is required to determine these parameters
for prevention of cardiovascular events. In this study, relationships among calf
circumference, resting blood pressure, and pulse rate in the soleus muscle were
investigated. [Subjects] Healthy elderly women (n= 19, 61–84 years of age) living in the
community were the subjects of this study. [Methods] Blood pressure was measured using an
automatic hemodynamometer on the left arm. The calf circumference was measured, and pulse
rate was measured on the left radial artery for 1 min by palpation. [Results] No
correlations were observed between calf circumference, resting systolic or diastolic
pressure, pulse pressure, or mean blood pressure. However, an inverse correlation was
observed between calf circumference and resting pulse rate. [Conclusion] Calf
circumference measurement may be used as a screening test for resting pulse rate. This
test may be useful for the prevention of cardiovascular events.
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Affiliation(s)
- Daisuke Takagi
- Department of Physiological Sciences for Physical Therapy, Rehabilitation Sciences, Seirei Christopher University ; Department of Physical Therapy, Health Science University
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Bemelmans RH, van der Graaf Y, Nathoe HM, Wassink AM, Vernooij JW, Spiering W, Visseren FL. The risk of resting heart rate on vascular events and mortality in vascular patients. Int J Cardiol 2013; 168:1410-5. [DOI: 10.1016/j.ijcard.2012.12.043] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 12/10/2012] [Accepted: 12/12/2012] [Indexed: 11/17/2022]
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[Resting heart rate and cardiovascular disease]. Med Clin (Barc) 2013; 143:34-8. [PMID: 23937816 DOI: 10.1016/j.medcli.2013.05.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/28/2013] [Accepted: 05/30/2013] [Indexed: 01/29/2023]
Abstract
Heart rate reflects autonomic nervous system activity. Numerous studies have demonstrated that an increased heart rate at rest is associated with cardiovascular morbidity and mortality as an independent risk factor. It has been shown a link between cardiac autonomic balance and inflammation. Thus, an elevated heart rate produces a micro-inflammatory response and is involved in the pathogenesis of endothelial dysfunction. In turn, decrease in heart rate produces benefits in congestive heart failure, myocardial infarction, atrial fibrillation, obesity, hyperinsulinemia, insulin resistance, and atherosclerosis. Alteration of other heart rate-related parameters, such as their variability and recovery after exercise, is associated with risk of cardiovascular events. Drugs reducing the heart rate (beta-blockers, calcium antagonists and inhibitors of If channels) have the potential to reduce cardiovascular events. Although not recommended in healthy subjects, interventions for reducing heart rate constitute a reasonable therapeutic goal in certain pathologies.
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García-López M, Martínez-González MA, Basterra-Gortari FJ, Barrio-López MT, Gea A, Beunza JJ. Adherence to the Mediterranean dietary pattern and heart rate in the SUN project. Eur J Prev Cardiol 2012; 21:521-7. [PMID: 23144202 DOI: 10.1177/2047487312467871] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND A higher heart rate has been related to an increase of total and cardiovascular mortality. The aim of this study was to assess the relation between adherence to the Mediterranean diet and heart rate. DESIGN The SUN project is an ongoing multipurpose cohort study based on university graduates from Spain. METHODS This cross-sectional study included 15,863 participants of the SUN project. Adherence to the Mediterranean dietary pattern was assessed through a validated 136-item food frequency questionnaire and calculated according to the 9-point score proposed by Trichopoulou. Multiple linear regression models were fitted to assess the relationship between adherence to the Mediterranean dietary pattern and heart rate and 95% confidence intervals were calculated. RESULTS The multivariable-adjusted models revealed that participants with a high adherence (7--9 points) to the Mediterranean dietary pattern had a heart rate 2.2 bpm (95% CI 1.4-3.1) lower than participants with a low adherence (0--2 points). CONCLUSIONS Adherence to the Mediterranean dietary pattern seems to be related to a lower heart rate.
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Kunutsor S, Powles J. Cardiovascular risk in a rural adult West African population: is resting heart rate also relevant? Eur J Prev Cardiol 2012; 21:584-91. [PMID: 22990761 DOI: 10.1177/2047487312462149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Elevated resting heart rate (RHR) is a neglected marker in cardiovascular risk factor studies of sub-Saharan African populations. This study aimed to determine the prevalence of elevated RHR and other risk factors for cardiovascular disease (CVD) and to investigate any associations between RHR and these risk factors in a rural population in Ghana. DESIGN Cross-sectional analysis. METHODS A total of 574 adults aged between 18-65 years were randomly sampled from a population register. Data collected included those on sociodemographic variables and anthropometric, blood pressure (BP), and RHR measurements. Within-person variability in RHR was calculated using data from repeat measurements taken 2 weeks apart. RESULTS Of study participants, 36% were male. Prevalence of casual high BP was 19%. In the population, 10% were current cigarette smokers and habitual alcohol use was high at 56%. As measured by body mass index, 2% were obese and 14% had abdominal obesity. RHR was elevated (>90 bpm) in 19%. Overall, 79% of study participants were found to have at least one CVD risk factor. RHR was significantly associated with age, waist circumference, and BP. Individuals with an elevated RHR had a higher risk (OR 1.94, 95% CI 1.15-3.26%, p = 0.013) of casual high BP compared with participants with normal RHR independently of several established CVD risk factors. The regression dilution ratio of RHR was 0.75 (95% CI 0.62-0.89). CONCLUSIONS Significant associations were observed between RHR and several established cardiovascular risk factors. Prospective studies are needed in sub-Saharan African populations to establish the potential value of RHR in cardiovascular risk assessment.
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Bakhoya VN, Kurl S, Laukkanen JA. T-wave inversion on electrocardiogram is related to the risk of acute coronary syndrome in the general population. Eur J Prev Cardiol 2012; 21:500-6. [PMID: 22952285 DOI: 10.1177/2047487312460022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND T-wave inversion (TWI) is a frequently encountered electrocardiographic (ECG) finding during routine medical examination of asymptomatic individuals, and of patients with various clinical conditions. However, the role of isolated TWI in the prediction of acute coronary syndrome (ACS) in the community has not been extensively studied. We investigated the relationship between TWI in routine ECG and the risk for ACS in the general population. METHODS This study is based on a random sample of 1997 men aged 42-60 years in Eastern Finland. Electrocardiograms recorded at rest were classified using the Minnesota codes. The association between isolated TWI and ACS was determined using a multivariable adjusted Cox proportional hazard model. RESULTS Negative T-waves were present in 3.6% of the participants. During an average follow-up of 20 years, a total of 493 ACS events were registered. After adjusting for age, TWI was associated with a 3.10-fold (95% confidence interval (CI) 2.21-4.32) risk for ACS. After additional adjustment for previously known coronary risk factors, TWI remained statistically significant in predicting ACS (relative risk 2.23; 95% CI 1.57-3.15). Negative T-waves was one of the strongest risk markers for ACS compared with other ECG-based variables such as left ventricular hypertrophy, previous Q-wave and prolonged QRS duration. CONCLUSION TWI has a strong and independent predictive value for ACS in the general population.
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Affiliation(s)
- Victor N Bakhoya
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Finland
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Woodward M, Webster R, Murakami Y, Barzi F, Lam TH, Fang X, Suh I, Batty GD, Huxley R, Rodgers A. The association between resting heart rate, cardiovascular disease and mortality: evidence from 112,680 men and women in 12 cohorts. Eur J Prev Cardiol 2012; 21:719-26. [PMID: 22718796 DOI: 10.1177/2047487312452501] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Multiple studies have examined the relationship between heart rate and mortality; however, there are discrepancies in results. Our aim was to describe the relationship between resting heart rate (RHR) and both major cardiovascular (CV) outcomes, as well as all-cause mortality in the Asia-Pacific region. DESIGN AND METHODS Individual data from 112,680 subjects in 12 cohort studies were pooled and analysed using Cox models, stratified by study and sex, and adjusted for age and systolic blood pressure. RESULTS During a mean 7.4 years follow-up, 6086 deaths and 2726 fatal or nonfatal CV events were recorded. There was a continuous, increasing association between having a RHR above approximately 65 beats/min and the risk of both CV and all-cause mortality, yet there was no evidence of associations below this threshold. The hazard ratio (95% CI) comparing the extreme quarters of RHR (80+ v <65 beats/min) was 1.44 (1.29-1.60) for CV and 1.54 (1.43-1.66) for total mortality. These associations were not materially changed by adjustment for other risk factors and exclusion of the first 2 years of follow-up. Hazard ratios of a similar magnitude were found for ischemic and hemorrhagic stroke, but the hazard ratio for heart failure was higher (2.08, 95% CI 1.07-4.06) and for Coronary Heart Disease (CHD) was lower (1.11, 95% CI 0.93-1.31) than for stroke. CONCLUSIONS RHR of above 65 beats/min has a strong independent effect on premature mortality and stroke, but a lesser effect on CHD. Lifestyle and pharmaceutical regimens to reduce RHR may be beneficial for people with moderate to high levels of RHR.
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Affiliation(s)
- Mark Woodward
- The George Institute for Global Health, University of Sydney, Australia Department of Epidemiology, Johns Hopkins University, Baltimore, USA
| | - Ruth Webster
- The George Institute for Global Health, University of Sydney, Australia
| | - Yoshitaka Murakami
- The George Institute for Global Health, University of Sydney, Australia Shiga University of Medical Science, Japan
| | - Federica Barzi
- The George Institute for Global Health, University of Sydney, Australia
| | - Tai-Hing Lam
- School of Public Health, University of Hong Kong, China
| | - Xianghua Fang
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Il Suh
- Department of Preventive Medicine, Yonsei University College of Medicine, Korea
| | - G David Batty
- The George Institute for Global Health, University of Sydney, Australia Department of Epidemiology and Public Health, University College London, UK
| | - Rachel Huxley
- The George Institute for Global Health, University of Sydney, Australia Division of Epidemiology and Public Health, University of Minnesota, USA
| | - Anthony Rodgers
- The George Institute for Global Health, University of Sydney, Australia
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Plichart M, Thomas F, Empana JP, Bean K, Périer MC, Celermajer DS, Hanon O, Danchin N, Pannier B, Jouven X. Gender-specific trends in heart rate in the general population from 1992-2007: a study of 226,288 French adults. Eur J Prev Cardiol 2012; 20:61-72. [PMID: 22345675 DOI: 10.1177/2047487311434231] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Heart rate (HR) has been associated with cardiovascular (CV) risk factors and with CV mortality. Trends in CV risk factors have been described in recent decades, but HR changes over time have been less studied. We thus aimed to examine the secular trends in HR and interrelationships between HR and traditional CV risk factors and mortality. METHODS We studied 226,288 consecutive participants (141,533 men and 84,755 women) aged 44.7 ± 12.7 years who had a free standard health check up, between 1992 and 2007. Each had resting HR measured systematically on a 10-cycle electrocardiogram, and assessment of lipoproteins, blood pressure, smoking, glycemic status, body mass index, and physical activity. Sex-specific trends in mean HR were estimated by a general linear model adjusted for traditional CV risk factors and CV treatment. In that model, year was considered as a continuous variable. RESULTS Crude mean HR decreased over the study period (from 68.9 ± 10.4 to 63.7 ± 9.0 beats/min in men; from 72.2 ± 10.3 to 65.2 ± 9.0 beats/min in women; p < 0.001 for both). The amplitude of the HR decrease was similar after full adjustment and across the pre-cited risk factors categories. On multivariate analysis, higher HR (≥ 80 beats/min vs. <60 beats/min) was associated with higher mortality rate over 5 years in men (hazard ratio 2.11, 95% CI 1.79-2.49) and women (hazard ratio 1.58, 95% CI 1.16-2.15). CONCLUSION In this large population-based study of 226,288 middle-aged participants, heart rate declined over 16 years independently of traditional CV risk factors.
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