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Cardiac risk factors and prevention
Original article
Variation in resting heart rate over 4 years and the risks of myocardial infarction and death among older adults
  1. James S Floyd1,2,
  2. Colleen M Sitlani1,2,
  3. Kerri L Wiggins1,2,
  4. Erin Wallace1,
  5. Astrid Suchy-Dicey1,
  6. Siddique A Abbasi4,
  7. Mercedes R Carnethon5,
  8. David S Siscovick1,2,6,7,
  9. Nona Sotoodehnia1,2,
  10. Susan R Heckbert1,6,7,
  11. Barbara McKnight1,3,
  12. Kenneth M Rice1,3,
  13. Bruce M Psaty1,2,6,7
  1. 1Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA
  2. 2Department of Medicine, University of Washington, Seattle, Washington, USA
  3. 3Department of Biostatistics, University of Washington, Seattle, Washington, USA
  4. 4Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  5. 5Northwestern University, Chicago, Illinois, USA
  6. 6Department of Epidemiology, University of Washington, Seattle, Washington, USA
  7. 7Group Health Research Institute, Group Health Cooperative, Seattle, Washington, USA
  1. Correspondence to Dr James Floyd, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA; jfloyd{at}uw.edu

Abstract

Objective Resting heart rate (RHR) is an established predictor of myocardial infarction (MI) and mortality, but the relationship between variation in RHR over a period of several years and health outcomes is unclear. We evaluated the relationship between long-term variation in RHR and the risks of incident MI and mortality among older adults.

Methods 1991 subjects without cardiovascular disease from the Cardiovascular Health Study were included. RHR was taken from resting ECGs at the first five annual study visits. RHR mean, trend and variation were estimated with linear regression. Subjects were followed for incident MI and death until December 2010. HRs for RHR mean, trend and variation are reported for differences of 10 bpm, 2 bpm/year and 2 bpm, respectively.

Results 262 subjects had an incident MI event (13%) and 1326 died (67%) during 12 years of median follow-up. In primary analyses adjusted for cardiovascular risk factors, RHR mean (HR 1.12; 95% CI 1.05 to 1.20) and variation (HR 1.08; 95% CI 1.03 to 1.13) were associated with the risk of death while trend was not. None of the RHR variables were significantly associated with the risk of incident MI events; however, CIs were wide and the MI associations with RHR variables were not significantly different from the mortality associations. Adjusting for additional variables did not affect estimates, and there were no significant interactions with sex.

Conclusions Variation in RHR over a period of several years represents a potential predictor of long-term mortality among older persons free of cardiovascular disease.

  • MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)

https://doi.org/10.1136/heartjnl-2014-306046

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