EFFECT OF CHILD-TO ADULT RESTING HEART RATE TRAJECTORY ON SUBCLINICAL RENAL DAMAGE IN MIDLIFE

Abstract

Objective: It has been well established that an elevated resting heart rate (RHR) is associated with the development of chronic kidney damage (CKD), but the relationship between the developmental patterns of RHR and CKD has not been studied before. Design and method: A total of 2339 participants enrolled in the large-scale Hanzhong Adolescent Hypertension cohort study, which was established in 1987 and was followed up over 30 years, were included in the final analysis. Latent mixture modelling was used to explore the child-to-adult trajectories of the RHR. Results: We identified four RHR trajectories from childhood to adulthood: a low-stable group (class 1, n = 1104), a moderate-stable group (class 2, n = 1098), an increasing-decreasing group (class 3, n = 78), and a decreasing-increasing group (class 4, n = 59). Individuals in class 4 had the highest risk ratio (RR) of incident subclinical renal damage (SRD) after they were fully adjusted compared with those in class 1 [RRs = 4.12 (1.65–10.33), P < 0.01], and individuals in class 3 had nearly 1.43 times the risk of prevalent SRD compared with those in class 1. Significant differences existed in body mass index (BMI) by RHR trajectory groups in prepuberty, puberty and middle-aged adulthood (all P < 0.05). In subjects who were overweight, those in class 2 and class 4 had significantly higher risk of prevalent SRD when compared with those in class 1 [RRs = 1.65 (1.09–2.50), RRs = 5.39 (1.45–20.11), respectively]. Conclusions: RHR lacks stability in middle-aged segments of the population. Elevated RHR and increasing RHR in midlife are independently associated with the development of SRD, particularly in overweight participants.