TY - JOUR
T1 - Resting heart rate and incident heart failure and cardiovascular mortality in older adults
T2 - Role of inflammation and endothelial dysfunction: The PROSPER study
AU - Nanchen, David
AU - Stott, David J.
AU - Gussekloo, Jacobijn
AU - Mooijaart, Simon P.
AU - Westendorp, Rudi G.J.
AU - Jukema, J. Wouter
AU - MacFarlane, Peter W.
AU - Cornuz, Jacques
AU - Rodondi, Nicolas
AU - Buckley, Brendan M.
AU - Ford, Ian
AU - Sattar, Naveed
AU - De Craen, Anton J.M.
PY - 2013/5
Y1 - 2013/5
N2 - AimsResting heart rate is a promising modifiable cardiovascular risk marker in older adults, but the mechanisms linking heart rate to cardiovascular disease are not fully understood. We aimed to assess the association between resting heart rate and incident heart failure (HF) and cardiovascular mortality, and to examine whether these associations might be attributable to systemic inflammation and endothelial dysfunction.Methods and resultsWe studied 4084 older adults aged 70-82 years with known cardiovascular risk factors or previous cardiovascular disease, without pre-existing HF or beta-blockers in the PROSPER study. Over a 3.2-year follow-up period, we examined incident HF hospitalization and cardiovascular mortality according to resting heart rate, along with C-reactive protein (CRP), interleukin-6 (IL-6), tissue plasminogen activator (tPA), and von Willebrand factor (vWf). Mean heart rate was 67 b.p.m. for men and 70 b.p.m. for women. CRP, IL-6, tPA, and vWf levels were all positively correlated with heart rate. After multivariate adjustment, heart rate was associated with HF hospitalization [hazard ratio (HR) 1.78 for highest vs. lowest distribution third, 95% confidence interval (CI) 1.21-2.63, P= 0.003] and cardiovascular mortality (HR 1.74, 95% CI 1.23-2.47, P= 0.002). Further adjustment for both IL-6 and vWf levels decreased HR to 1.60 (95% CI 1.08-2.38, P= 0.020) for HF and to 1.50 (95% CI 1.04-2.15, P= 0.028) for cardiovascular mortality.ConclusionIncreased heart rate is associated with increased systemic inflammation and endothelial dysfunction. These factors are likely to contribute to, but do not fully explain, the risk of HF and cardiovascular death associated with increased heart rate in older age. All rights reserved.
AB - AimsResting heart rate is a promising modifiable cardiovascular risk marker in older adults, but the mechanisms linking heart rate to cardiovascular disease are not fully understood. We aimed to assess the association between resting heart rate and incident heart failure (HF) and cardiovascular mortality, and to examine whether these associations might be attributable to systemic inflammation and endothelial dysfunction.Methods and resultsWe studied 4084 older adults aged 70-82 years with known cardiovascular risk factors or previous cardiovascular disease, without pre-existing HF or beta-blockers in the PROSPER study. Over a 3.2-year follow-up period, we examined incident HF hospitalization and cardiovascular mortality according to resting heart rate, along with C-reactive protein (CRP), interleukin-6 (IL-6), tissue plasminogen activator (tPA), and von Willebrand factor (vWf). Mean heart rate was 67 b.p.m. for men and 70 b.p.m. for women. CRP, IL-6, tPA, and vWf levels were all positively correlated with heart rate. After multivariate adjustment, heart rate was associated with HF hospitalization [hazard ratio (HR) 1.78 for highest vs. lowest distribution third, 95% confidence interval (CI) 1.21-2.63, P= 0.003] and cardiovascular mortality (HR 1.74, 95% CI 1.23-2.47, P= 0.002). Further adjustment for both IL-6 and vWf levels decreased HR to 1.60 (95% CI 1.08-2.38, P= 0.020) for HF and to 1.50 (95% CI 1.04-2.15, P= 0.028) for cardiovascular mortality.ConclusionIncreased heart rate is associated with increased systemic inflammation and endothelial dysfunction. These factors are likely to contribute to, but do not fully explain, the risk of HF and cardiovascular death associated with increased heart rate in older age. All rights reserved.
KW - Cardiovascular
KW - Endothelium
KW - Geriatrics
KW - Heart rate
KW - Inflammation
KW - Prevention/screening
UR - http://www.scopus.com/inward/record.url?scp=84877135139&partnerID=8YFLogxK
U2 - 10.1093/eurjhf/hfs195
DO - 10.1093/eurjhf/hfs195
M3 - Article
C2 - 23250912
AN - SCOPUS:84877135139
SN - 1388-9842
VL - 15
SP - 581
EP - 588
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 5
ER -