Article Impact Level: HIGH Data Quality: STRONG Summary of Circulation, 150(Suppl_1). https://doi.org/10.1161/circ.150.suppl_1.4121890 Dr. Ning Meng et al.
Points
- Four resting heart rate (RHR) trajectories were identified: stable/slight decline (88.4%), stable-slight increase (9.2%), increase-decrease (2.0%), and stable-sharp increase (0.4%).
- The stable-increase trajectory was associated with significantly higher risks of heart failure (HR = 1.65) and all-cause mortality (HR = 1.96). At the same time, stable-slight increase was linked to elevated heart failure risk (HR = 1.54).
- Factors like obesity, smoking history, lower education, and a prior heart failure diagnosis predicted atypical RHR trajectories.
- Tracking long-term RHR trajectories provides critical insights into cardiovascular risk, with atypical patterns signaling higher risks for adverse outcomes.
- Most participants with a stable/slight decline trajectory experienced minimal cardiovascular risk, underscoring its relative safety.
Summary
This study used data from the Atherosclerosis Risk in Communities (ARIC) study to examine long-term resting heart rate (RHR) trajectories and their associations with cardiovascular outcomes and mortality using data from the Atherosclerosis Risk in Communities (ARIC) study. Five thousand seven hundred ninety-four participants were followed for 25 years, with RHR measurements taken across five visits from 1987 to 2013. The analysis identified four distinct RHR trajectories: 1) stable/slight decline (88.4%), 2) stable-slight increase (9.2%), 3) increase-decrease (2.0%), and 4) stable-sharp increase (0.4%). Atypical RHR trajectories, particularly the stable-increase pattern, were associated with poorer health outcomes, including heart failure (HF) and all-cause mortality.
Using multinomial logistic regression, the study identified predictors for atypical RHR trajectories, including obesity, smoking history, a prior heart failure diagnosis, and lower education levels. Cox regression models revealed that the stable-increase trajectory was significantly associated with an increased risk of heart failure (hazard ratio [HR] = 1.65, 95% CI, 1.06-2.56) and all-cause mortality (HR = 1.96, 95% CI, 1.40-2.74). Similarly, the stable-slight increase pattern showed an increased risk for heart failure (HR = 1.54, 95% CI, 1.19-2.00). In contrast, the increase-decrease trajectory showed an elevated risk for coronary heart disease (HR ~ 2.0), though this result lacked statistical significance in the fully adjusted model.
These findings highlight that monitoring long-term RHR trajectories provides valuable prognostic information regarding cardiovascular risk. At the same time, most participants exhibited a stable/slight decline trajectory, which carries minimal risk; those with atypical patterns, particularly the stable-increase trajectory, face substantially higher risks for cardiovascular events and mortality. This underscores the importance of using RHR trajectories for early identification and risk assessment in cardiovascular disease.
Link to the article: https://www.ahajournals.org/doi/10.1161/circ.150.suppl_1.4121890
References Meng, N., Mok, Y., Soliman, E., Chen, L., Ballantyne, C., Solomon, S., & Matsushita, K. (2024). Abstract 4121890: Resting heart rate trajectories over 25 years: patterns, predictors, and prognostic impact in the atherosclerosis risk in communities (Aric) study. Circulation, 150(Suppl_1). https://doi.org/10.1161/circ.150.suppl_1.4121890
