Physicians' Academy for Cardiovascular Education

Increased resting heart rate and changes therein over time associated with adverse outcomes

Association of Resting Heart Rate and Temporal Changes in Heart Rate With Outcomes in Participants of the Atherosclerosis Risk in Communities Study

Literature - Vazir A, Claggett B, Cheng S, et al. - JAMA Cardiol 2018; published online ahead of print


Time-updated heart rate (HR) is the most recent HR value measured before the occurrence of an event or at the end of a study. ΔHR is the change in HR over time. Both measures have been associated with adverse cardiovascular (CV) outcomes in patients with heart failure (HF). More specifically; an increase in HR was associated with adverse outcomes and a decrease in HR was associated with better outcomes [1,2].

This analysis of the Atherosclerosis Risk in Communities (ARIC) study [3,4] evaluated whether time-updated HR and ΔHR are also associated with outcomes in a community-based cohort including 15,680 participants.

HR was recorded at baseline and during 3 follow-up visits from 1987 to 1998. The median interval between visits was 3.0 years (IQR: 2.9-4.0), and the follow-up duration was 28 years. Adjustments were made for established baseline and time-updated risk factors and treatments. The main outcome measures were all-cause mortality, incident HF, incident myocardial infarction (MI), stroke, as well as CV and non-CV death.

Main results


In a community-based cohort, increased time-updated HR and ΔHR were associated with mortality and non-fatal outcomes of incident HF, MI, and stroke. These results support the importance of measuring HR in every-day clinical practice, to identify individuals who might be at greater risk of adverse outcomes.


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