Article

Resting heart rate is an established risk factor for cardiovascular
disease, but long-term individual resting heart rate trajectories and their
effect on cardiovascular disease morbidity and mortality have not yet been
described. Methods : This large population-based longitudinal study included 14,208
men and women aged 20 years or older, not pregnant and not using blood pressure
medications, who attended at least two of the three Tromso Study surveys
conducted between 1986-2001. Resting heart rate was measured using an automated
Dinamap device. Participants were followed up from 2001 to 2012 with respect to
myocardial infarction, atrial fibrillation, ischaemic stroke, cardiovascular
disease death and total death. The Proc Traj statistical procedure was used to
identify resting heart rate trajectories. Results Five common long-term resting
heart rate trajectories were identified: low, moderate, decreasing, increasing
and elevated. In men, an elevated resting heart rate trajectory was independently
associated with an increased risk of myocardial infarction when low resting heart
rate trajectory was used as a reference (hazard ratio 1.83, 95% confidence
interval 1.11-3.02). Risk of total death in men was lowest in the low resting
heart rate trajectory group and highest in the increasing and elevated resting
heart rate trajectory groups. In women, the association between resting heart
rate trajectories and myocardial infarction was similar to that in men, but it
was not significant. Conclusions Among the five long-term resting heart rate
trajectories we identified, increasing and elevated trajectories were associated
with an increased risk of myocardial infarction and total death in men. Our
results suggest that changes in long-term individual resting heart rate in the
general population may provide additional prognostic information.

Langue : ANGLAIS