title: Electrocardiographic PR interval and adverse outcomes in older adults: the Health, Aging, and Body Composition study.
abstract: BACKGROUND
  The electrocardiographic PR interval increases with aging, differs by race, and is associated with atrial fibrillation (AF), pacemaker implantation, and all-cause mortality. We sought to determine the associations between PR interval and heart failure, AF, and mortality in a biracial cohort of older adults.
  
  
  RESULTS
  The Health, Aging, and Body Composition (Health ABC) Study is a prospective, biracial cohort. We used multivariable Cox proportional hazards models to examine PR interval (hazard ratios expressed per SD increase) and 10-year risks of heart failure, AF, and all-cause mortality. Multivariable models included demographic, anthropometric, and clinical variables in addition to established cardiovascular risk factors. We examined 2722 Health ABC participants (aged 74±3 years, 51.9% women, and 41% black). We did not identify significant effect modification by race for the outcomes studied. After multivariable adjustment, every SD increase (29 ms) in PR interval was associated with a 13% greater 10-year risk of heart failure (95% confidence interval, 1.02-1.25) and a 13% increased risk of incident AF (95% confidence interval, 1.04-1.23). PR interval >200 ms was associated with a 46% increased risk of incident heart failure (95% confidence interval, 1.11-1.93). PR interval was not associated with increased all-cause mortality.
  
  
  CONCLUSIONS
  We identified significant relationships of PR interval to heart failure and AF in older adults. Our findings extend prior investigations by examining PR interval and associations with adverse outcomes in a biracial cohort of older men and women.
authors.affiliation: Cardiology Section, Whitaker Cardiovascular Institute, Evans Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA. jmagnani@bu.edu
authors.forename: Jared W
authors.initials: JW
authors.lastname: Magnani
authors.forename: Na
authors.initials: N
authors.lastname: Wang
authors.forename: Kerrie P
authors.initials: KP
authors.lastname: Nelson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Connelly
authors.forename: Rajat
authors.initials: R
authors.lastname: Deo
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.forename: Erik B
authors.initials: EB
authors.lastname: Schelbert
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Garcia
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Phillips
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Ellinor
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000208:ethnology; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013714:Tennessee / Q000453:epidemiology; D013997:Time Factors; D044465:White People