Association between resting heart rate trajectory pattern and risk of cardiovascular and cerebrovascular diseases
10.3760/cma.j.issn.0253-3758.2019.04.010
- VernacularTitle: 静息心率轨迹对心脑血管事件的影响
- Author:
Hongmin LIU
1
;
Wei WEN
2
;
Xing LIU
3
;
Lu LI
4
;
Shuohua CHEN
5
;
Yinghui LIU
6
;
Xiaohong ZHAO
1
;
Haiyan ZHAO
1
;
Chunyu RUAN
1
;
Kai CUI
1
;
Shouling WU
1
Author Information
1. Department of Cardiology, Kailuan General Hosipital, Tangshan 063000, China
2. Hyperbaric Oxygen Center, Kailuan General Hospital, Tangshan 063000, China
3. Department of Endocrinology, Kailuan General Hosipital, Tangshan 063000, China
4. Department of Gastroenterology, Kailuan General Hosipital, Tangshan 063000, China
5. Employee Health Protection Center, Kailuan General Hosipital, Tangshan 063000, China
6. Pharmacy Department, Jinggezhuang Hospital Affiliated to Kailuan General Hospital, Tangshan 063000, China
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Stroke;
Resting heart rate trajectory
- From:
Chinese Journal of Cardiology
2019;47(4):318-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine whether the long-term resting heart rate (RHR) pattern can predict the risk of cardiovascular and cerebrovascular diseases (CVDs).
Methods:This prospective cohort study included 63 040 participants who took part in the health examination in 2006 and one of the health examinations on 2008 or 2010 and were free of myocardial infarction, stroke, arrhythmia, cancer and not treated with β-recepter blocker. The outcomes were the first occurrence of myocardial infarction and stroke during the follow up ended on December 31, 2015. RHRs were measured in 2006, 2008, and 2010. We used latent mixture modeling SAS Proc procedure to identify RHR trajectories. We identified 4 distinct RHR trajectory patterns based on the data derived from 2006 and on the pattern change during 2006 to 2010 (low-stable, moderate-stable, moderate-increasing, elevated-decreasing). Collected the general clinical data of the patients. Cox regression model was used to determine the association between RHR trajectory patterns and the risk of CVDs during follow up. Hazard ratio (HR) with 95% confidence intervals (CI) were calculated using Cox regression modeling.
Results:There were statistical significance among the 4 distinct RHR trajectory patterns on the following variables: age, gender, smoking status, drinking status, physical activity, education status, history of use antihypertensive drugs, history of hypertension,history of diabetes, body mass index, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, and the level of high-sensitivity C-reactive protein (all P<0.01). The moderate-increasing pattern experienced the highest risk of developing stroke and CVDs among all 4 patterns. The cumulative incidence of cerebral infarction, cerebral hemorrhage and CVDs in the order of low-stable trajectory, moderate-stable trajectory and moderate-increasing trajectory. The cumulative incidences of cerebral infarction, cerebral hemorrhage and CVDs in elevated-decreasing trajectory group were significantly lower than those in moderate-increasing trajectory group, but higher than those in moderate-stable trajectory group. Compared to the low-stable pattern, adjusted HR was 1.3 (95%CI 1.0-1.6) for the moderate-increasing pattern after adjustment for potential confounders.
Conclusion:Our study finds that individuals with moderate-increasing RHR trajectory pattern are associated with higher risk of cardiovascular and CVDs.
