Relation of Elevated Resting Heart Rate in Mid-Life to Cognitive Decline Over 20 Years (from the Atherosclerosis Risk in Communities [ARIC] Study)

Wang, Stephanie; Fashanu, Oluwaseun E.; Zhao, Di; Güallar, Eliseo; Gottesman, Rebecca F.; Schneider, Andrea L.C.; McEvoy, John W.; Norby, Faye L.; Aladin, Amer I.; Alonso, Álvaro; Michos, Erin D.

doi:10.1016/j.amjcard.2018.10.013

Cited by 29 publications

(39 citation statements)

References 22 publications

(23 reference statements)

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“…18 According to studies evaluating resting HR and target organ damage, elevated resting HR is associated with higher frequencies of albuminuria, 16 progression to chronic kidney disease, 15 accelerated arterial stiffness, 14,25 and cognitive decline. 26,27 On the basis of currently available evidence, it is plausible that subjects with an elevated resting HR would be more likely to develop ECG-LVH.…”

Section: Discussionmentioning

confidence: 99%

Development of Electrocardiographic Left Ventricular Hypertrophy and Resting Heart Rate Over Time: Findings From the OGHMA Study

et al. 2019

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Both elevated resting heart rate (HR) and electrocardiographic left ventricular hypertrophy (ECG-LVH) are signs of a poor prognosis. Although elevated resting HR is a known risk factor for cardiovascular disease and target organ damage, the association between resting HR and the development of ECG-LVH is unclear. In the present study, 6860 subjects (4203 men, 2657 women, 19-89 years of age) without ECG-LVH at baseline were evaluated and followed for a mean duration of 3.7±1.4 years. During the follow-up period, 484 (7.1%) subjects developed ECG-LVH. Cox regression analysis revealed that each 10 beats/min increase in resting HR was associated with a 22% reduction in the development of ECG-LVH (95% confidence interval: 12%-30%, P < .0001) in men. While an increase in HR tended to be associated with the development of ECG-LVH in women, the relationship was not significant. In contrast to the concept that an elevated resting HR is a cardiovascular risk factor, these findings revealed that resting HR was negatively associated with the development of ECG-LVH in men.

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Section: Discussionmentioning

confidence: 99%

Development of Electrocardiographic Left Ventricular Hypertrophy and Resting Heart Rate Over Time: Findings From the OGHMA Study

et al. 2019

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“…Nevertheless, despite robust adjustment, residual confounding may still explain associations see with incident dementia. Finally, our method of dementia ascertainment may be more comprehensive than other studies because in addition to review of medical and death certificate records, an in-person neuropsychological assessment, informant interview, and expert review were all used to adjudicate the cases of dementia [31–35].…”

Section: Discussionmentioning

confidence: 99%

“…Incident dementia cases in ARIC were adjudicated by an expert dementia classification committee comprised of eight clinicians including four physicians and four neuropsychologists [31]. Dementia was ascertained using a pre-determined algorithm, incorporating data from the cognitive tests performed at ARIC visits 2, 4, and 5, the full neuropsychological assessment performed at visit 5, participant interviews, informant (family member) interviews, and also hospital discharge codes and diagnostic codes from death certificates, as has been previously described in ARIC [31–35]. Each dementia case was adjudicated by a physician (either a geriatrician or neurologist) and a neuropsychologist, and in cases of disagreement a third clinician confirmed the diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Mid-life serum Vitamin D concentrations were associated with incident dementia but not late-life neuropsychological performance in the Atherosclerosis Risk in Communities (ARIC) Study

et al. 2019

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BackgroundActivated Vitamin D has anti-inflammatory properties and adequate 25-hydroxyvitamin D [25(OH)D] concentrations may be important for neurocognitive function and protection against neurologic injury. We examined whether mid-life 25(OH) D concentrations were associated with later-life performance on neuropsychological testing, functional ability, depressive symptoms, and incident dementia.MethodsWe studied 13,039 white and black ARIC participants who had serum 25(OH) D measured mid-life at visit 2 (1990–1992). Over the next ~ 20 years through visit 5 (2011–2013), participants underwent 3 additional in-person visits, annual telephone calls, and hospitalization surveillance. An extensive battery of neuropsychological outcomes were assessed at visit 5 using standardized protocols. Incident dementia was ascertained through a formal algorithm that included data from in-person cognitive testing, telephone interviews, hospital discharge codes, and death certificate codes. Diagnoses of dementia were adjudicated by expert clinician committee. For the primary cognitive analyses, we imputed for missing covariates and outcomes and used linear regression to evaluate non-concurrent cross-sectional associations of mid-life 25(OH) D (visit 2) with late-life neuropsychological outcomes (visit 5). We also used Cox regression models to examine associations of mid-life 25(OH) D and incident dementia.ResultsIn mid-life, the mean (SD) age of participants was 57 (6) years, 57% were women, and 24% black. Mean (SD) 25(OH) D was 24.3 (8.6) ng/mL; 33% had deficient (< 20 ng/mL), 44% intermediate (20- < 30 ng/mL), and 23% sufficient (≥30 ng/mL) 25(OH) D concentrations. Association between mid-life 25(OH) D and late-life performance on neuropsychological testing were mostly null. There was no significant association with functional ability or depressive symptoms. Results were similar in a sensitivity analysis using complete-case data (no imputation). However, after a median follow-up of 20 years, low 25(OH) D concentrations were associated with increased risk for incident dementia (p = 0.01 for trend across categories), with HR of 1.26 (95% CI 1.06, 1.49) for participants with deficient 25(OH) D, compared to sufficient concentrations.ConclusionIn this community cohort, mid-life serum 25(OH) D concentrations were associated with incident dementia but not with performance on neuropsychological testing, functional ability, or depressive symptoms, 20 years later. Whether serum 25(OH) D concentrations are causally related to dementia or confounded by poorer health status remains uncertain.Trial registrationRegistered on clinicaltrials.gov NCT00005131.

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“…RHR is a vital sign that is routinely measured at most clinical encounters, as well as self-monitored by individuals using fitness trackers and mobile devices. Prior studies have demonstrated that elevated RHR is associated with an increased risk of CVD, all-cause mortality,6–10 valvular heart disease25 26 and cognitive decline 24. However, there is little literature available on its role with VTE.…”

Section: Discussionmentioning

confidence: 99%

“…We used two samples t-test, Mann-Whitney test or X 2 test to describe differences between groups as appropriate. We used multivariable-adjusted Cox proportional hazards regression models to determine the HRs and 95% CIs of incident VTE by RHR groups categorised by previously established cut points (<60, 60–69, 70–79 and ≥80 bpm) 10 24 25. We tested for trends across RHR categories by using an ordinal variable for each RHR category and modelling this as a continuous variable for association with VTE.…”

Section: Methodsmentioning

confidence: 99%

Resting heart rate and incident venous thromboembolism: the Multi-Ethnic Study of Atherosclerosis

et al. 2020

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ObjectiveVenous thromboembolism (VTE) is associated with significant morbidity and mortality. Resting heart rate (RHR), which may be modifiable through lifestyle changes, has been shown to be associated with cardiovascular disease risk and with inflammatory markers that have been predictive of VTE incidence.MethodsWe examined whether RHR is also associated with VTE incidence independent of these risk factors. We studied 6479 Multi-Ethnic Study of Atherosclerosis participants free from clinical VTE at baseline who had baseline RHR ascertained by 12-lead ECG. VTE events were recorded from hospital records and death certificates using International Classification of Diseases (ICD)-9 and ICD-10 codes. We categorised RHR as <60, 60–69, 70–79 and ≥80 bpm. We used Cox hazard models to determine the association of incident VTE by RHR.ResultsParticipants had mean (SD) age of 62 (10) years and RHR of 63 (10) bpm. RHR was cross-sectionally correlated with multiple inflammatory and coagulation factors. There were 236 VTE cases after a median follow-up of 14 years. Compared with those with RHR<60 bpm, the HR (95% CI) for incident VTE for RHR≥80 bpm was 2.08 (1.31 to 3.30), after adjusting for demographics, physical activity, smoking, diabetes and use of atrioventricular (AV)-nodal blockers, aspirin and anticoagulants, and remained significant after further adjustment for inflammatory markers (2.05 (1.29 to 3.26)). Results were similar after excluding those taking AV-nodal blocker medications. There was no effect modification of these associations by sex or age.ConclusionElevated RHR was positively associated with VTE incidence after a median of 14 years; this association was independent of several traditional VTE and inflammatory markers.

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Relation of Elevated Resting Heart Rate in Mid-Life to Cognitive Decline Over 20 Years (from the Atherosclerosis Risk in Communities [ARIC] Study)

Cited by 29 publications

References 22 publications

Development of Electrocardiographic Left Ventricular Hypertrophy and Resting Heart Rate Over Time: Findings From the OGHMA Study

Development of Electrocardiographic Left Ventricular Hypertrophy and Resting Heart Rate Over Time: Findings From the OGHMA Study

Mid-life serum Vitamin D concentrations were associated with incident dementia but not late-life neuropsychological performance in the Atherosclerosis Risk in Communities (ARIC) Study

Resting heart rate and incident venous thromboembolism: the Multi-Ethnic Study of Atherosclerosis

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