TY - JOUR
T1 - Relation of Resting Heart Rate to Incident Atrial Fibrillation (From ARIC [Atherosclerosis Risk in Communities] Study)
AU - Wang, Weijia
AU - Alonso, Alvaro
AU - Soliman, Elsayed Z.
AU - O'Neal, Wesley T.
AU - Calkins, Hugh
AU - Chen, Lin Yee
AU - Diener-West, Marie
AU - Szklo, Moyses
N1 - Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, HHSN2682017000021). This work was also supported by American Heart Association grant 16EIA26410001 (Alonso) and NHLBI/NIH F32HL134290 (O'Neal WT).
Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute , National Institutes of Health , Department of Health and Human Services , under Contract nos. ( HHSN268201700001I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I , HHSN2682017000021 ). This work was also supported by American Heart Association grant 16EIA26410001 (Alonso) and NHLBI/NIH F32HL134290 (O'Neal WT).
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/5/15
Y1 - 2018/5/15
N2 - The evidence on the association between resting heart rate (HR) and incident atrial fibrillation (AF) is conflicting. Whether change in resting HR is associated with incident AF is unknown. We evaluated 11,545 participants (mean [±standard deviation] age: 57 ± 5.7 years) free of AF at baseline (1990 to 1992). Resting HR was obtained from 10-second electrocardiograms at baseline and 3 years later. AF diagnosis was ascertained from visit electrocardiograms, hospital discharge records, and death certificates through 2013. High and low resting HR were defined as ≥80 and <55 beats/min, respectively. Increase and decrease in HR were defined as a 3-year HR difference >15 and <−15 beats/min, respectively. Over a median follow-up of 22.5 years, 1,746 (15%) participants developed AF. Both baseline high resting HR and increase in HR were independently associated with incident AF (hazard ratio = 1.2, 95% confidence interval = 1.0 to 1.5 and hazard ratio = 1.4, 95% confidence interval = 1.1 to 1.9). Increase in HR was no longer associated with incident AF after additional adjustment for incident heart failure. In stratified analyses, increase in HR was associated only with AF in participants <60 years, with bachelor's degree or above, without diabetes, and without hypertension (p values for interaction ≤0.05). In conclusion, in a middle-aged population, high resting HR is associated with higher AF risk. Increase in resting HR is also associated with higher AF risk, especially in individuals without traditional AF risk factors. Whether interventions to decrease HR can prevent AF remain to be examined.
AB - The evidence on the association between resting heart rate (HR) and incident atrial fibrillation (AF) is conflicting. Whether change in resting HR is associated with incident AF is unknown. We evaluated 11,545 participants (mean [±standard deviation] age: 57 ± 5.7 years) free of AF at baseline (1990 to 1992). Resting HR was obtained from 10-second electrocardiograms at baseline and 3 years later. AF diagnosis was ascertained from visit electrocardiograms, hospital discharge records, and death certificates through 2013. High and low resting HR were defined as ≥80 and <55 beats/min, respectively. Increase and decrease in HR were defined as a 3-year HR difference >15 and <−15 beats/min, respectively. Over a median follow-up of 22.5 years, 1,746 (15%) participants developed AF. Both baseline high resting HR and increase in HR were independently associated with incident AF (hazard ratio = 1.2, 95% confidence interval = 1.0 to 1.5 and hazard ratio = 1.4, 95% confidence interval = 1.1 to 1.9). Increase in HR was no longer associated with incident AF after additional adjustment for incident heart failure. In stratified analyses, increase in HR was associated only with AF in participants <60 years, with bachelor's degree or above, without diabetes, and without hypertension (p values for interaction ≤0.05). In conclusion, in a middle-aged population, high resting HR is associated with higher AF risk. Increase in resting HR is also associated with higher AF risk, especially in individuals without traditional AF risk factors. Whether interventions to decrease HR can prevent AF remain to be examined.
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U2 - 10.1016/j.amjcard.2018.01.037
DO - 10.1016/j.amjcard.2018.01.037
M3 - Article
C2 - 29576236
AN - SCOPUS:85044325295
SN - 0002-9149
VL - 121
SP - 1169
EP - 1176
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 10
ER -