title: Resting Heart Rate Is Not a Good Predictor of a Clustered Cardiovascular Risk Score in Adolescents: The HELENA Study.
abstract: BACKGROUND
  Resting heart rate (RHR) reflects sympathetic nerve activity a significant association between RHR and all-cause and cardiovascular mortality has been reported in some epidemiologic studies.
  
  
  METHODS
  To analyze the predictive power and accuracy of RHR as a screening measure for individual and clustered cardiovascular risk in adolescents. The study comprised 769 European adolescents (376 boys) participating in the HELENA cross-sectional study (2006-2008) were included in this study. Measurements on systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO2máx and the sum of four skinfolds were obtained, and a clustered cardiovascular disease (CVD) risk index was computed. The receiver operating characteristics curve was applied to calculate the power and accuracy of RHR to predict individual and clustered CVD risk factors.
  
  
  RESULTS
  RHR showed low accuracy for screening CVD risk factors in both sexes (range 38.5%-54.4% in boys and 45.5%-54.3% in girls). Low specificity's (15.6%-19.7% in boys; 18.1%-20.0% in girls) were also found. Nevertheless, the sensitivities were moderate-to-high (61.4%-89.1% in boys; 72.9%-90.3% in girls).
  
  
  CONCLUSIONS
  RHR is a poor predictor of individual CVD risk factors and of clustered CVD and the estimates based on RHR are not accurate. The use of RHR as an indicator of CVD risk in adolescents may produce a biased screening of cardiovascular health in both sexes.
authors.affiliation: YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, School of Medicine of the University of São Paulo, São Paulo, Brazil; GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud de la Universidad de Zaragoza, Zaragoza, Spain; Department of Preventive Medicine, School of Medicine of the University of São Paulo, São Paulo, Brazil.
authors.forename: Augusto César Ferreira
authors.initials: AC
authors.lastname: de Moraes
authors.affiliation: Department of Infectious and Parasitic Diseases, School of Medicine of the University of São Paulo, São Paulo, Brazil.
authors.forename: Alex Jones Flores
authors.initials: AJ
authors.lastname: Cassenote
authors.affiliation: National Institute for Food and Nutrition Research, Rome, Italy.
authors.forename: Catherine
authors.initials: C
authors.lastname: Leclercq
authors.affiliation: Institut Pasteur de Lille, Lille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.affiliation: Department of Nutrition & Dietetics, Harokopio University, Athens, Greece.
authors.forename: Odysseas
authors.initials: O
authors.lastname: Androutsos
authors.affiliation: Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Török
authors.affiliation: Faculty of Physical Activity and Sport-INEF, Technical University of Madrid, Department of Health and Human Performance, Madrid, Spain; Institut für Ernährungs-und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms, Universität Bonn, Dortmund, Germany.
authors.forename: Marcela
authors.initials: M
authors.lastname: González-Gross
authors.affiliation: Department of Paediatrics, Private Medical University Salzburg, Salzburg, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.affiliation: Preventive Medicine & Nutrition Unit, School of Medicine, University of Crete Heraklion, Crete, Greece.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.affiliation: YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, School of Medicine of the University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine of the University of São Paulo, São Paulo, Brazil.
authors.forename: Heráclito Barbosa
authors.initials: HB
authors.lastname: Carvalho
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud de la Universidad de Zaragoza, Zaragoza, Spain; Department of Preventive Medicine, School of Medicine of the University of São Paulo, São Paulo, Brazil.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D002319:Cardiovascular System / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides