title: Variation in resting heart rate over 4 years and the risks of myocardial infarction and death among older adults.
abstract: OBJECTIVE
  Resting heart rate (RHR) is an established predictor of myocardial infarction (MI) and mortality, but the relationship between variation in RHR over a period of several years and health outcomes is unclear. We evaluated the relationship between long-term variation in RHR and the risks of incident MI and mortality among older adults.
  
  
  METHODS
  1991 subjects without cardiovascular disease from the Cardiovascular Health Study were included. RHR was taken from resting ECGs at the first five annual study visits. RHR mean, trend and variation were estimated with linear regression. Subjects were followed for incident MI and death until December 2010. HRs for RHR mean, trend and variation are reported for differences of 10 bpm, 2 bpm/year and 2 bpm, respectively.
  
  
  RESULTS
  262 subjects had an incident MI event (13%) and 1326 died (67%) during 12 years of median follow-up. In primary analyses adjusted for cardiovascular risk factors, RHR mean (HR 1.12; 95% CI 1.05 to 1.20) and variation (HR 1.08; 95% CI 1.03 to 1.13) were associated with the risk of death while trend was not. None of the RHR variables were significantly associated with the risk of incident MI events; however, CIs were wide and the MI associations with RHR variables were not significantly different from the mortality associations. Adjusting for additional variables did not affect estimates, and there were no significant interactions with sex.
  
  
  CONCLUSIONS
  Variation in RHR over a period of several years represents a potential predictor of long-term mortality among older persons free of cardiovascular disease.
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Floyd
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Sitlani
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Kerri L
authors.initials: KL
authors.lastname: Wiggins
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Wallace
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
authors.forename: Astrid
authors.initials: A
authors.lastname: Suchy-Dicey
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Siddique A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA Department of Epidemiology, University of Washington, Seattle, Washington, USA Group Health Research Institute, Group Health Cooperative, Seattle, Washington, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Nona
authors.initials: N
authors.lastname: Sotoodehnia
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Epidemiology, University of Washington, Seattle, Washington, USA Group Health Research Institute, Group Health Cooperative, Seattle, Washington, USA.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Biostatistics, University of Washington, Seattle, Washington, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: McKnight
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Biostatistics, University of Washington, Seattle, Washington, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Rice
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA Department of Epidemiology, University of Washington, Seattle, Washington, USA Group Health Research Institute, Group Health Cooperative, Seattle, Washington, USA.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012146:Rest / Q000502:physiology*; D012307:Risk Factors; D013995:Time; D014861:Washington / Q000453:epidemiology
keywords: MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)