title: Association of resting heart rate with carotid and aortic arterial stiffness: multi-ethnic study of atherosclerosis.
abstract: Resting heart rate is an easily measured, noninvasive vital sign that is associated with cardiovascular disease events. The pathophysiology of this association is not known. We investigated the relationship between resting heart rate and stiffness of the carotid (a peripheral artery) and the aorta (a central artery) in an asymptomatic multi-ethnic population. Resting heart rate was recorded at baseline in the Multi-Ethnic Study of Atherosclerosis (MESA). Distensibility was used as a measure of arterial elasticity, with a lower distensibility indicating an increase in arterial stiffness. Carotid distensibility was measured in 6484 participants (98% of participants) using B-mode ultrasound, and aortic distensibility was measured in 3512 participants (53% of participants) using cardiac MRI. Heart rate was divided into quintiles and we used progressively adjusted models that included terms for physical activity and atrioventricular nodal blocking agents. Mean resting heart rate of participants (mean age, 62 years; 47% men) was 63 bpm (SD, 9.6 bpm). In unadjusted and fully adjusted models, carotid distensibility and aortic distensibility decreased monotonically with increasing resting heart rate (P for trend <0.001 and 0.009, respectively). The relationship was stronger for carotid versus aortic distensibility. Similar results were seen using the resting heart rate taken at the time of MRI scanning. Our results suggest that a higher resting heart rate is associated with an increased arterial stiffness independent of atrioventricular nodal blocker use and physical activity level, with a stronger association for a peripheral (carotid) compared with a central (aorta) artery.
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Seamus P
authors.initials: SP
authors.lastname: Whelton
authors.forename: Ron
authors.initials: R
authors.lastname: Blankstein
authors.forename: Mouaz H
authors.initials: MH
authors.lastname: Al-Mallah
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014463:Ultrasonography; D059289:Vascular Stiffness / Q000502:physiology*
keywords: cardiovascular diseases; heart rate; magnetic resonance imaging; ultrasonography; vascular stiffness