Abstract 12693: Influence of Resting Heart Rate and Changes in Resting Heart Rate on Cardiovascular Outcomes From the Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ali Vazir ◽  
Brian Claggett ◽  
Amil Shah ◽  
Hicham Skali ◽  
Susan Cheng ◽  
...  
Keyword(s):  
Heart Rate ◽  
Time Interval ◽  
Resting Heart Rate ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
All Cause Mortality ◽  
Increase Risk ◽  
Over Time

Background: Resting heart rate (HR) and change in resting heart rate (ΔHR) over time are associated with increased risk of adverse outcome in patients with established heart failure (HF). We assessed whether the most recent HR and ΔHR are associated with cardiovascular (CV) outcomes in participants enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Methods: We studied 15,680 participants with HR recorded at baseline (age 54±6 years, women 55%, African American 27%) and over 3 follow-up visits with a median time interval between visits of 3.0 (IQR 2.9-4.0) years. ΔHR from the preceding visit was calculated. Participants were followed up for a median of 22.7 (19.8-23.7) years. We related baseline and most recent resting HR and ΔHR to all cause mortality and CV outcomes adjusting for established baseline and time-updated risk factors and medications. Results: Baseline and most recent HR and ΔHR were associated with all-cause mortality and CV outcomes (table), however most recent HR and ΔHR were more strongly associated with outcomes compared to baseline HR. Every 10bpm increase in HR from the preceding visit was associated with a 29%, 30% 22% and 15% increase risk of all-cause mortality, incident HF, incident MI and stroke respectively. Every 10 bpm higher most recent HR was associated with a 34%, 41% 23% and 14% increase risk of all-cause mortality, incident HF, incident MI and stroke respectively. Conclusion: In a community-based cohort, the most recent resting HR and ΔHR are strongly associated with outcomes; higher resting HR and increases in HR over time are associated with the greatest magnitude of risk.

scholarly journals Association of Psychosocial Factors With Short‐Term Resting Heart Rate Variability: The Atherosclerosis Risk in Communities Study

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Anish S. Shah ◽  
Alvaro Alonso ◽  
Eric A. Whitsel ◽  
Elsayed Z. Soliman ◽  
Viola Vaccarino ◽  
...  
Keyword(s):  
Social Support ◽  
Heart Rate ◽  
Psychosocial Factors ◽  
Perceived Social Support ◽  
Low Frequency ◽  
Resting Heart Rate ◽  
Short Term ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Over Time

Background Psychosocial factors predict heart disease risk, but our understanding of underlying mechanisms is limited. We sought to evaluate the physiologic correlates of psychosocial factors by measuring their relationships with heart rate variability (HRV), a measure of autonomic health, in the ARIC (Atherosclerosis Risk in Communities) study. We hypothesize that increased psychosocial stress associates with lower HRV. Methods and Results We studied 9331 participants in ARIC with short‐term HRV data at visits 2 and 4. The mean (SD) age was 54.4 (5.7) years, 55% were women, and 25% were Black. Psychosocial factors included: (1) vital exhaustion (VE), (2) anger proneness, a personality trait, and (3) perceived social support. Linear models adjusted for sociodemographic and cardiovascular risk factors. Low frequency HRV (ln ms 2 ) was significantly lower in the highest versus lowest quartiles of VE (B=−0.14, 95% CI, −0.24 to −0.05). When comparing this effect to age (B=−0.04, 95% CI, −0.05 to −0.04), the difference was equivalent to 3.8 years of accelerated aging. Perceived social support associated with lower time‐domain HRV. High VE (versus low VE) also associated with greater decreases in low frequency over time, and both anger and VE associated with greater increases in resting heart rate over time. Survival analyses were performed with Cox models, and no evidence was found that HRV explains the excess risk found with high VE and low perceived social support. Conclusions Vital exhaustion, and to a lesser extent anger and social support, were associated with worse autonomic function and greater adverse changes over time.

scholarly journals Resting Heart Rate predicts all-cause mortality in sub-Saharan African Patients with Heart Failure: Insight from the Douala Heart failure registry (Do-HF)

2020 ◽  
Author(s):  
Anastase Dzudie ◽  
Blaise Barche ◽  
Sidick Mouliom ◽  
Ariane Nouko ◽  
Fogue Raissa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Cox Regression ◽  
Sub Saharan Africa ◽  
Resting Heart Rate ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Sub Saharan

AbstractBackgroundHigher resting heart rate (HR) is associated with mortality amongst Caucasians with heart failure (HF), but its significance has yet to be established in sub-Saharan Africans in whom HF differs in terms of characteristics and etiologies.ObjectivesWe assessed the association of HR with all-cause mortality in patients with HF in sub-Saharan Africa.MethodsThe Douala HF registry (Do–HF) is an ongoing prospective data collection on patients with HF receiving care at four cardiac referral services in Douala, Cameroon. Patients included in this report were followed-up for 12 months from their index admission, for all-cause mortality. We used Cox-regression analysis to study the association of HR with all-cause mortality during follow-up.ResultsOf 347 patients included, 343 (98.8%) completed follow-up. The mean age was 64±14 years, 176 (50.7%) were female, and median admission HR was 85 bpm. During a median follow-up of 12 months, 78 (22.7%) patients died. Mortality increased steadily with HR increase and ranged from 12.2% in the lower quartile of HR (≤69 bpm) to 34.1% in the upper quartile of HR (>100 bpm). Hazard ratio of 12-month death per 10 bpm higher heart rate was 1.16 (1.04–1.29), with consistent effects across most subgroups, but a higher effect in participants with hypertension vs those without (interaction p=0.044).ConclusionHeart rate was independently associated with increased risk of all-cause mortality in this study, particularly among participants with hypertension. The implication of this finding for risk prediction or reduction should be actively investigated.

Abstract 158: Progression of Microvascular Brain Disease and Stroke Incidence in the Atherosclerosis Risk in Communities Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Silvia Koton ◽  
Andrea L Schneider ◽  
B. Gwen Windham ◽  
Thomas H Mosley ◽  
Rebecca F Gottesman ◽  
...  
Keyword(s):  
Rating Scale ◽  
Brain Mri ◽  
Brain Disease ◽  
Cardiovascular Health Study ◽  
Stroke Incidence ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Unit Increase

Background and Purpose: Data on the significance of combined white matter hyperintensities (WMH)/lacunar brain infarcts measures progression for the incidence of clinical stroke are scarce. We aimed to study associations between the progression in measures of microvascular brain disease over time and risk of stroke in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: We analyzed data on 907 ARIC participants who underwent a brain MRI in 1993-95, a second brain MRI in 2004-6, and were subsequently followed for incident stroke through December 31 st , 2017 (median [IQR] follow-up of 12.6 [8.9-13.4] years from the second brain MRI in 2004-6). At each MRI, WMH was categorized according to the Cardiovascular Health Study 0-9 rating scale and scans were centrally reviewed for lacunar infarcts. A combined measure of microvascular brain disease was defined, and progression from the first to the second brain MRI, manifesting as new WMHs and lacunes at the second brain MRI, was categorized as: no progression; increase of ≥1 unit in WMH grade or incident lacune; increase of ≥1 unit in WMH grade and incident lacune. All fatal and non-fatal strokes occurring in the participants during the study period, and adjudicated as definite/probable ischemic or hemorrhagic incident stroke, were included in this analysis. Associations between progression of microvascular brain disease and incidence of stroke were studied with Cox proportional hazard models, adjusting for age, gender, race, education level, BMI, smoking, hypertension, diabetes and coronary heart disease. Results: At the second brain MRI (mean age 72y), no progression in the combined measure of microvascular disease was found in 38% of participants, while 57% showed ≥1 unit increase in WMH grade or new lacune, and 5% showed increased WMH grade and new lacune. Sixty-four incident strokes occurred during follow-up. Compared to no change in the combined measure, progression of microvascular brain disease expressed as ≥1 unit increase in WMH grade and incident lacune was significantly associated with higher risk of stroke (adjusted HR 3.01, 95% CI 1.30-6.95). Conclusion: Progression of combined measures of microvascular brain disease over a decade is associated with a significant increased risk of stroke.

Relation of Resting Heart Rate to Incident Atrial Fibrillation (From ARIC [Atherosclerosis Risk in Communities] Study)

2018 ◽  
Vol 121 (10) ◽  
pp. 1169-1176 ◽  
Author(s):  
Weijia Wang ◽  
Alvaro Alonso ◽  
Elsayed Z. Soliman ◽  
Wesley T. O'Neal ◽  
Hugh Calkins ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Resting Heart Rate ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Abstract MP34: The Association Between Periodontal Disease And Incident Heart Failure: The Atherosclerosis Risk In Communities Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Rebecca L Molinsky ◽  
Faye L Norby ◽  
Bing Yu ◽  
Amil M Shah ◽  
Pamela L Lutsey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Periodontal Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Incident Heart Failure

Introduction: Periodontal disease, resulting from inflammatory host-response to dysbiotic subgingival microbiota, has been associated with incident hypertension, heart attack, stroke and diabetes. Limited data exist investigating the prospective relationship between periodontal disease and incident heart failure (HF) and HF subtypes. We hypothesize that periodontal disease is associated with increased risk for heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Methods: We studied 6,707 participants enrolled in the Atherosclerosis Risk in Communities Study who received a full-mouth clinical periodontal examination at visit 4 (1996-1998) and had longitudinal follow-up starting in 2005. Participants were classified as being periodontally healthy, having periodontal disease (based on the Periodontal Profile Classification (PPC)), or being edentulous. Hospitalization records were reviewed, and HF events were adjudicated and classified as HFpEF, HFrEF or HF of unknown ejection fraction (HFunknownEF) from 2005-2018. We used multivariable-adjusted Cox proportional hazards models to assess the association between periodontal disease or edentulism and incident HF. Results: Among participants 58% had periodontitis and 19% were edentulous. During a median follow-up time of 13 years, 1,178 cases of incident HF occurred (350 HFpEF, 319 HFrEF and 509 HFunknownEF). Periodontal disease and being edentulous were both associated with increased risk for both HFpEF and HFrEF (Table). Conclusion: Periodontal disease measured in mid-life was associated with both incident HFpEF and HFrEF. Adverse microbial exposures underlying periodontal disease might represent a modifiable risk factor for inflammation-induced heart failure pathophysiology.

Abstract MP75: Glycemia (Hemoglobin A1c) is Not Related to Incident Venous Thromboembolism in the Atherosclerosis Risk in Communities Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Elizabeth J Bell ◽  
Pamela L Lutsey ◽  
Vijay Nambi ◽  
Mary Cushman ◽  
Elizabeth Selvin ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Smoking Status ◽  
Cox Proportional Hazards ◽  
Self Report ◽  
Diabetes Diagnosis ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Diagnosed Diabetes

Introduction— Diabetes has been inconsistently associated with increased risk of venous thromboembolism (VTE). Glycemia is positively associated with coagulation activation and hypofibrinolysis, resulting in a procoagulant state. However, there is little direct evidence on associations of glycemia with VTE. Hypothesis— Glycemia, as measured by hemoglobin A 1c (A 1c ), is positively associated with incident VTE over a follow-up period of 15 years. Methods— The Atherosclerosis Risk in Communities (ARIC) study is a population-based cohort study of middle-aged adults followed for 15 years after visit 2, when A 1c was measured. Because A 1c is affected by treatment in diagnosed diabetics, separate analyses were conducted for individuals with diagnosed diabetes. Diagnosed diabetes was defined as taking diabetes medication or a history of diabetes (self-report). We assessed the relation between A 1c and incident VTE during follow-up using Cox proportional hazards models, controlling for potential confounders: age, sex, race, smoking status and amount, hormone use, body mass index, and waist-to-hip ratio. Results— The cohort free of VTE and/or anticoagulant use in 1990-1992 included 11,976 participants without a diagnosis of diabetes (317 VTE events) and 1,040 participants with a diagnosis of diabetes (45 VTE events). As shown in the figure, the adjusted hazard ratio estimates, using participants with an A 1c < 5.70 % and without diagnosed diabetes as the referent, were close to 1, regardless of A 1c level and diabetes diagnosis status. Further, there was no relation in analyses conducted by VTE type (provoked and unprovoked) or in participants with diabetes (both diagnosed and undiagnosed) relative to those without diabetes. Conclusions— In conclusion, although a modest association cannot be ruled out, our findings do not support an association between A 1c and VTE.

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