Dataset Information

Heart rate variability and the risk of Parkinson disease: The Atherosclerosis Risk in Communities study.

ABSTRACT: OBJECTIVE:Autonomic dysfunction frequently occurs in the context of Parkinson disease (PD) and may precede onset of motor symptoms. Limited data exist on the prospective association of heart rate variability (HRV), a marker of autonomic function, with PD risk. METHODS:We included 12,162 participants of the Atherosclerosis Risk in Communities study, a community-based cohort, without a diagnosis of PD at baseline (1987-1989) and with available HRV data (mean age?=?54 years, 57% women). A 2-minute electrocardiogram was used to measure HRV. Incident PD was identified through 2008 from multiple sources, and adjudicated. Multivariable Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of PD by quartiles of HRV measurements. RESULTS:During a mean follow-up of 18 years, we identified 78 incident PD cases. Lower values of the root mean square of successive differences in normal-to-normal R-R intervals (rMSSD) and standard deviation of normal-to-normal R-R intervals (SDNN), markers of parasympathetic activity and total variability, respectively, were associated with higher PD risk during follow-up. In multivariate models, the HR (95% CI) of PD in the bottom quartiles of rMSSD and SDNN compared to the top quartiles were 2.1 (1.0-4.3) and 2.9 (1.4-6.1), respectively. Other measures of cardiac autonomic function, including mean R-R interval and frequency-domain measurements, were not associated with PD risk. INTERPRETATION:In this prospective cohort, decreased HRV was associated with an increased risk of PD. Assessment of cardiac autonomic function may help identify individuals at risk for PD.

SUBMITTER: Alonso A

PROVIDER: S-EPMC4529999 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Heart rate variability and the risk of Parkinson disease: The Atherosclerosis Risk in Communities study.

Alonso Alvaro A Huang Xuemei X Mosley Thomas H TH Heiss Gerardo G Chen Honglei H

Annals of neurology 20150327 5

<h4>Objective</h4>Autonomic dysfunction frequently occurs in the context of Parkinson disease (PD) and may precede onset of motor symptoms. Limited data exist on the prospective association of heart rate variability (HRV), a marker of autonomic function, with PD risk.<h4>Methods</h4>We included 12,162 participants of the Atherosclerosis Risk in Communities study, a community-based cohort, without a diagnosis of PD at baseline (1987-1989) and with available HRV data (mean age = 54 years, 57% wome ...[more]

PMID: 25707861

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Project description:Importance:Time-updated heart rate (HR) and temporal change in HR (ΔHR) are associated with outcome in individuals with established heart failure (HF). Whether these factors are associated with outcomes in a community-based cohort is unclear. Objective:To determine whether the time-updated analysis of resting HR, defined as the most recent HR value measured before occurrence of an event or the end of study, and ΔHR over time are associated with outcomes in a community-based cohort. Design, Setting, and Participants:A total of 15 680 participants were enrolled in the Atherosclerosis Risk in Communities cohort study, with HR recorded at baseline and during 3 follow-up visits from 1987 to 1998, with a median interval between visits of 3.0 (interquartile range, 2.9-4.0) years. The ΔHR was calculated by assessing a change in HR from the preceding visit. Participants were followed up until December 31, 2014, equating to 28 years of follow-up. The present study was conducted from March 2014 to June 2016 with updated analysis. Main Outcomes and Measures:Baseline HR, time-updated HR, and ΔHR associated with outcomes, adjusted for established baseline and time-updated risk factors and medications. The main outcomes measures included all-cause mortality, incident HF, incident myocardial infarction, stroke, and cardiovascular and noncardiovascular death. Results:Of the 15 680 participants, 8656 (55.2%) were women, mean (SD) age was 54 (6) years, and 4218 (26.9%) were African American. Time-updated HR and ΔHR were associated with death, incident HF, incident myocardial infarction, stroke, and cardiovascular and noncardiovascular death compared with baseline HR. For example, a ΔHR from the preceding visit was significantly associated with increased risk of all-cause mortality (adjusted hazard ratio, 1.12; 95% CI, 1.10-1.15; P < .001 for every 5-bpm increase in HR from the preceding visit) and time-updated HR was also significantly associated with increased risk of all-cause mortality (adjusted hazard ratio, 1.14; 95% CI, 1.12-1.17; P < .001 for every 5-bpm higher time-updated HR). Conclusions and Relevance:In a community-based cohort, time-updated HR and ΔHR are associated with mortality and nonfatal outcomes of incident HF, myocardial infarction, and stroke.

Project description:BACKGROUND:Previous studies suggest that heart failure (HF) is an independent risk factor for cognitive decline. A better understanding of the relationship between HF, cognitive status, and cognitive decline in a community-based sample may help clinicians understand disease risk. OBJECTIVE:To examine whether persons with HF have a higher prevalence of cognitive impairment and whether persons developing HF have more rapid cognitive decline. DESIGN:This observational cohort study of American adults in the Atherosclerosis Risk in Communities (ARIC) study has two components: cross-sectional analysis examining the association between prevalent HF and cognition using multinomial logistic regression, and change over time analysis detailing the association between incident HF and change in cognition over 15 years. PARTICIPANTS:Among visit 5 (2011-2013) participants (median age 75 years), 6495 had neurocognitive information available for cross-sectional analysis. Change over time analysis examined the 5414 participants who had cognitive scores and no prevalent HF at visit 4 (1996-1998). MEASUREMENTS:The primary outcome was cognitive status, classified as normal, mild cognitive impairment [MCI], and dementia on the basis of standardized cognitive tests (delayed word recall, word fluency, and digit symbol substitution). Cognitive change was examined over a 15-year period. Control variables included socio-demographic, vascular, and smoking/drinking measures. RESULTS:At visit 5, participants with HF had a higher prevalence of dementia (adjusted relative risk ratio [RRR] = 1.60 [95% CI 1.13, 2.25]) and MCI (RRR = 1.36 [1.12, 1.64]) than those without HF. A decline in cognition between visits 4 and 5 was - 0.07 standard deviation units [- 0.13, - 0.01] greater among persons who developed HF compared to those who did not. Results did not differ by ejection fraction. CONCLUSION:HF is associated with neurocognitive dysfunction and decline independent of other co-morbid conditions. Further study is needed to determine the underlying pathophysiology.

Dataset Information

Heart rate variability and the risk of Parkinson disease: The Atherosclerosis Risk in Communities study.

Publications

Heart rate variability and the risk of Parkinson disease: The Atherosclerosis Risk in Communities study.

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