Dataset Information

Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study.

ABSTRACT:

Objective

To evaluate resting heart rate as an independent predictor of cardiovascular risk in women.

Design

Prospective cohort study.

Setting

The Women's Health Initiative was undertaken at 40 research clinics in the United States.

Participants

129 135 postmenopausal women.

Main outcome measure

Clinical cardiovascular events.

Results

During a mean of 7.8 (SD 1.6) years of follow up, 2281 women were identified with myocardial infarction or coronary death and 1877 with stroke. We evaluated associations between resting heart rate and cardiovascular events in Cox regression models adjusted for multiple covariates. Higher resting heart rate was independently associated with coronary events (hazard ratio 1.26, 95% confidence interval 1.11 to 1.42 for highest [>76 beats per minute] v lowest quintile [ConclusionResting heart rate, a low tech and inexpensive measure of autonomic tone, independently predicts myocardial infarction or coronary death, but not stroke, in women.

Trial registration

ClinicalTrials.gov NCT00000611.

SUBMITTER: Hsia J

PROVIDER: S-EPMC2640113 | biostudies-literature | 2009 Feb

REPOSITORIES: biostudies-literature

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Publications

Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study.

Hsia Judith J Larson Joseph C JC Ockene Judith K JK Sarto Gloria E GE Allison Matthew A MA Hendrix Susan L SL Robinson Jennifer G JG LaCroix Andrea Z AZ Manson JoAnn E JE

BMJ (Clinical research ed.) 20090203

<h4>Objective</h4>To evaluate resting heart rate as an independent predictor of cardiovascular risk in women.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>The Women's Health Initiative was undertaken at 40 research clinics in the United States.<h4>Participants</h4>129 135 postmenopausal women.<h4>Main outcome measure</h4>Clinical cardiovascular events.<h4>Results</h4>During a mean of 7.8 (SD 1.6) years of follow up, 2281 women were identified with myocardial infarction or coronary deat ...[more]

PMID: 19193613

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Project description:BackgroundCurrent guidelines recommend maintaining a resting heart rate below 100-110 beats per minute (bpm) for patients with atrial fibrillation (AF). However, there is a lack of research on various treatment approaches for patients with both atrial fibrillation and coronary heart disease (AF&CHD). We have discussed the primary therapeutic options for controlling resting heart rate in patients with AF&CHD.MethodsWe conducted a post hoc analysis of the AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) trial. Our study included 3986(98.2%) participants with AF, of which 1522 had AF&CHD. The primary outcome was all-cause mortality. We utilized the chi-squared test to identify significant differences in categorical variables. Multivariate Cox regression analysis was performed to compare the risk of death by standard deviation of heart rate visit to visit variability quartile.ResultsCompared to the AF group, a higher proportion of patients in the AF&CHD group had histories of smoking, hypertension, diabetes, heart failure, cardiomyopathy, valvular heart disease, peripheral vascular disease, bradycardia, hepatic or renal disease, pulmonary disease, and stroke (all P < 0.001). Additionally, patients with AF&CHD were more likely to undergo coronary artery bypass grafting (CABG) and pacemaker surgeries than those with AF alone. After adjusting for multiple clinical variables, patients with AF&CHD had a significantly higher risk of all-cause mortality compared to the AF group (RR = 1.79, 95% CI: 1.49-2.60; P < 0.01). Nonlinear multivariate curve-fitting analysis identified an optimal resting heart rate of 70 bpm for patients with AF&CHD (P < 0.001). Subgroup analysis revealed that patients with a resting heart rate below 70 bpm had lower all-cause mortality than those with a resting heart rate above 70 bpm (P < 0.001).ConclusionsFor resting heart rates below 70 bpm, our results suggest an inverse causal relationship between genetically determined resting heart rate and all-cause mortality in patients with AF&CHD.Clinical trial numberNot applicable.

Dataset Information

Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study.

Objective

Design

Setting

Participants

Main outcome measure

Results

Trial registration

Publications

Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study.

Similar Datasets

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