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Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study (CHS).
Tuesday,2012-11-06 12:10 America/Los_Angeles — eenright
| Title | Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study (CHS). |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Stein, PK, Barzilay, JI, Chaves, PHM, Mistretta, SQ, Domitrovich, PP, Gottdiener, JS, Rich, MW, Kleiger, RE |
| Journal | J Cardiovasc Electrophysiol |
| Volume | 19 |
| Issue | 11 |
| Pagination | 1169-74 |
| Date Published | 2008 Nov |
| ISSN | 1540-8167 |
| Keywords | Aged, Aged, 80 and over, Arrhythmias, Cardiac, Death, Sudden, Cardiac, Electrocardiography, Ambulatory, Female, Heart Rate, Humans, Male, Maryland, Reproducibility of Results, Risk Assessment, Risk Factors, Sensitivity and Specificity, Survival Analysis, Survival Rate |
| Abstract | <p><b>UNLABELLED: </b>Novel HRV Predicts CV Mortality in the Elderly.</p><p><b>BACKGROUND: </b>It is unknown whether abnormal heart rate turbulence (HRT) and abnormal fractal properties of heart rate variability identify older adults at increased risk of cardiovascular death (CVdth).</p><p><b>METHODS: </b>Data from 1,172 community-dwelling adults, ages 72 +/- 5 (65-93) years, who participated in the Cardiovascular Health Study (CHS), a study of risk factors for CV disease in people >or=65 years. HRT and the short-term fractal scaling exponent (DFA1) derived from 24-hour Holter recordings. HRT categorized as: normal (turbulence slope [TS] and turbulence onset [TO] normal) or abnormal (TS and/or TO abnormal). DFA1 categorized as low (<or=1) or high (>1). Cox regression analyses stratified by Framingham Risk Score (FRS) strata (low = <10, mid = 10-20, and high >20) and adjusted for prevalent clinical cardiovascular disease (CVD), diabetes, and quartiles of ventricular premature beat counts (VPCs).</p><p><b>RESULTS: </b>CVdths (N = 172) occurred over a median follow-up of 12.3 years. Within each FRS stratum, low DFA1 + abnormal HRT predicted risk of CVdth (RR = 7.7 for low FRS; 3.6, mid FRS; 2.8, high FRS). Among high FRS stratum participants, low DFA1 alone also predicted CVdth (RR = 2.0). VPCs in the highest quartile predicted CVdth, but only in the high FRS group. Clinical CV disease predicted CVdth at each FRS stratum (RR = 2.9, low; 2.6, mid; and 1.9, high). Diabetes predicted CVdth in the highest FRS group only (RR = 2.2).</p><p><b>CONCLUSIONS: </b>The combination of low DFA1 + abnormal HRT is a strong risk factor for CVdth among older adults even after adjustment for conventional CVD risk measures and the presence of CVD.</p> |
| DOI | 10.1111/j.1540-8167.2008.01232.x |
| Alternate Journal | J Cardiovasc Electrophysiol |
| PubMed ID | 18631274 |
| PubMed Central ID | PMC3638897 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States R01 HL062181 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R0-1 HL62181 / HL / NHLBI NIH HHS / United States |