Abstract 12693: Influence of Resting Heart Rate and Changes in Resting Heart Rate on Cardiovascular Outcomes From the Atherosclerosis Risk in Communities Study

Abstract

Background: Resting heart rate (HR) and change in resting heart rate (ΔHR) over time are associated with increased risk of adverse outcome in patients with established heart failure (HF). We assessed whether the most recent HR and ΔHR are associated with cardiovascular (CV) outcomes in participants enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Methods: We studied 15,680 participants with HR recorded at baseline (age 54±6 years, women 55%, African American 27%) and over 3 follow-up visits with a median time interval between visits of 3.0 (IQR 2.9-4.0) years. ΔHR from the preceding visit was calculated. Participants were followed up for a median of 22.7 (19.8-23.7) years. We related baseline and most recent resting HR and ΔHR to all cause mortality and CV outcomes adjusting for established baseline and time-updated risk factors and medications. Results: Baseline and most recent HR and ΔHR were associated with all-cause mortality and CV outcomes (table), however most recent HR and ΔHR were more strongly associated with outcomes compared to baseline HR. Every 10bpm increase in HR from the preceding visit was associated with a 29%, 30% 22% and 15% increase risk of all-cause mortality, incident HF, incident MI and stroke respectively. Every 10 bpm higher most recent HR was associated with a 34%, 41% 23% and 14% increase risk of all-cause mortality, incident HF, incident MI and stroke respectively. Conclusion: In a community-based cohort, the most recent resting HR and ΔHR are strongly associated with outcomes; higher resting HR and increases in HR over time are associated with the greatest magnitude of risk.