Dataset Information

Heart rate variability and lifetime risk of cardiovascular disease: the Atherosclerosis Risk in Communities Study.

ABSTRACT: PURPOSE:The purpose of this study was to estimate the heart rate variability (HRV)-related lifetime cardiovascular disease (CVD) risk. METHODS:We followed 9744 participants without baseline CVD and used a life-table approach to estimate lifetime CVD risk (coronary heart disease, heart failure, and stroke) from 45 through 85 years according to several HRV measures (the SD of RR intervals [SDNN], the root mean square of successive differences of successive RR intervals, the mean of all normal RR intervals [meanNN], low-frequency [LF] and high-frequency [HF] power, and the LF/HF ratio). RESULTS:During 192,110 person-years of follow-up, we documented 2856 CVD events. Cox regression analyses with the false discovery rate method correction showed independent associations of SDNN, meanNN, LF, and LF/HF in women with CVD. Lifetime CVD risks in the lowest compared with the highest tertile were significantly increased in men for LF/HF (51.3% [95% confidence interval, 47.3-54.7] vs. 43.9% [40.1-47.2]), and in women for SDNN (39.4% [36.0-43.0] vs. 29.9% [26.3-33.0]), meanNN (39.3% [35.7-42.7] vs. 28.9% [25.7-31.7]), LF (39.4% [35.9-43.0] vs. 30.0% [26.2-33.2]), and LF/HF (37.6% [33.9-40.9] vs. 30.0% [26.8-32.7]). CONCLUSIONS:Greater HRV was modestly associated with lower lifetime CVD risk.

SUBMITTER: Kubota Y

PROVIDER: S-EPMC5821272 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Heart rate variability and lifetime risk of cardiovascular disease: the Atherosclerosis Risk in Communities Study.

Kubota Yasuhiko Y Chen Lin Y LY Whitsel Eric A EA Folsom Aaron R AR

Annals of epidemiology 20171003 10

<h4>Purpose</h4>The purpose of this study was to estimate the heart rate variability (HRV)-related lifetime cardiovascular disease (CVD) risk.<h4>Methods</h4>We followed 9744 participants without baseline CVD and used a life-table approach to estimate lifetime CVD risk (coronary heart disease, heart failure, and stroke) from 45 through 85 years according to several HRV measures (the SD of RR intervals [SD<sub>NN</sub>], the root mean square of successive differences of successive RR intervals, t ...[more]

PMID: 29033120

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Project description:ImportanceEstimates of lifetime risk may help raise awareness of the extent to which educational inequalities are associated with risk of cardiovascular disease (CVD).ObjectiveTo estimate lifetime risks of CVD according to categories of educational attainment.Design, setting, and participantsParticipants were followed from 1987 through December 31, 2013. All CVD events (coronary heart disease, heart failure, and stroke) were confirmed by physician review and International Classification of Diseases codes. A total of 13 948 whites and African Americans who were 45 to 64 years old and free of CVD at baseline were included from 4 US communities (Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburbs of Minneapolis, Minnesota). The data analysis was performed from June 7 to August 31, 2016.ExposuresEducational attainment.Main outcomes and measuresWe used a life table approach to estimate lifetime risks of CVD from age 45 through 85 years according to educational attainment. We adjusted for competing risks of death from underlying causes other than CVD.ResultsThe sample of 13 948 participants was 56% female and 27% African American. During 269 210 person-years of follow-up, we documented 4512 CVD events and 2401 non-CVD deaths. Educational attainment displayed an inverse dose-response relation with cumulative risk of CVD, which became evident in middle age, with the most striking gap between those not completing vs completing high school. In men, lifetime risks of CVD were 59.0% (95% CI, 54.0%-64.1%) for grade school, 52.5% (95% CI, 47.7%-56.8%) for high school education without graduation, 50.9% (95% CI, 47.3%-53.9%) for high school graduation, 47.2% (95% CI, 41.5%-52.5%) for vocational school, 46.4% (95% CI, 42.8%-49.6%) for college with or without graduation, and 42.2% (95% CI, 36.6%-47.0%) for graduate/professional school; in women, 50.8% (95% CI, 45.7%-55.8%), 49.3% (95% CI, 45.1%-53.1%), 36.3% (95% CI, 33.4%-39.1%), 32.2% (95% CI, 26.0%-37.3%), 32.8% (95% CI, 29.1%-35.9%), and 28.0% (95% CI, 21.9%-33.3%), respectively. Educational attainment was inversely associated with CVD even within categories of family income, income change, occupation, or parental educational level.Conclusions and relevanceMore than 1 in 2 individuals with less than high school education had a lifetime CVD event. Educational attainment was inversely associated with the lifetime risk of CVD, regardless of other important socioeconomic characteristics. Our findings emphasize the need for further efforts to reduce CVD inequalities related to educational disparities.

Project description:BackgroundCardiovascular disease (CVD) is associated with a greater frailty risk, but it remains unknown if pathways that contribute to CVD are associated with the frailty risk. Thus, we aimed to investigate whether elevations in high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for those without known CVD at baseline are associated with a higher frailty risk.MethodsThis study used data from the Atherosclerosis Risk in Communities study. Cardiac biomarkers were measured from stored plasma samples collected at Visit 2 (1991-1993). Frailty was recorded at Visit 5 (2011-2013). Cox regression models were used to determine the association of cardiac biomarkers with frailty risk.ResultsOverall, 360/5199 (6.9%) participants aged 55.1 ± 5.1 years developed frailty during a median follow-up of 21.7 years. The incidence of frailty was significantly higher in participants with hs-cTnT ≥14 ng/L (vs. < 14 ng/L: 17.9% vs. 6.7%) or NT-proBNP ≥300 pg/ml (vs. < 300 pg/ml: 19.7% vs. 6.8%) (all P < 0.001). Comparing higher vs. lower cut-off levels of either hs-cTnT (14 ng/l) or NT-proBNP (300 pg/ml) demonstrated a greater than two-fold higher frailty risk, with hazard ratios (HRs) of 2.13 (95% confidence interval (CI): 1.130-4.01, P = 0.020) and 2.61 (95% CI: 1.28-5.33, P = 0.008), respectively. Individuals with both elevated hs-cTnT and NT-proBNP had a higher frailty risk than those without it (HR: 4.15; 95% CI: 1.50-11.48, P = 0.006).ConclusionsHigh hs-cTnT and NT-proBNP levels are strongly associated with incident frailty in the community-dwelling population without known CVD. Subclinical cardiac damage (hs-cTnT) and/or wall strain (NT-proBNP) may be the key pathway of CVD patients developing frailty. Detection of hs-cTnT and NT-proBNP may help for early screening of high-risk frailty and providing individualised intervention.Trial registrationURL: https://www.Clinicaltrialsgov ; Unique identifier: NCT00005131 .

Dataset Information

Heart rate variability and lifetime risk of cardiovascular disease: the Atherosclerosis Risk in Communities Study.

Publications

Heart rate variability and lifetime risk of cardiovascular disease: the Atherosclerosis Risk in Communities Study.

Similar Datasets

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