Association of heart rate trajectories with the risk of adverse outcomes in a community-based cohort in Taiwan

Cheng-Chun Wei; Pei-Chun Chen; Hsiu-Ching Hsu; Ta-Chen Su; Hung-Ju Lin; Ming-Fong Chen; Yuan-Teh Lee; Kuo-Liong Chien

doi:10.7717/peerj.8987

Association of heart rate trajectories with the risk of adverse outcomes in a community-based cohort in Taiwan

PeerJ. 2020 May 7:8:e8987. doi: 10.7717/peerj.8987. eCollection 2020.

Authors

Cheng-Chun Wei^{1

2}, Pei-Chun Chen³, Hsiu-Ching Hsu⁴, Ta-Chen Su⁴, Hung-Ju Lin⁴, Ming-Fong Chen^{4

5}, Yuan-Teh Lee⁴, Kuo-Liong Chien^{2

4}

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan.
² Institute of Epidemiology & Preventive Medicine, College of Public School, National Taiwan University, Taipei, Taiwan.
³ Department of Public Health, China Medical University, Taichung, Taiwan.
⁴ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁵ Cardiovascular Research Laboratory, Cardiovascular Center, Clinical Outcome Research and Training Center, Big Data Center, China Medical University Hospital, Taichung, Taiwan.

Abstract

Heart rate trajectory patterns integrate information regarding multiple heart rate measurements and their changes with time. Different heart rate patterns may exist in one population, and these are associated with different outcomes. Our study investigated the association of adverse outcomes with heart rate trajectory patterns. This was a prospective cohort study based on the Chin-Shan Community Cardiovascular Cohort in Taiwan. A total of 3,015 Chinese community residents aged > 35 years were enrolled in a prospective investigation of cardiovascular risk factors and outcomes from 1990 to 2013.The primary outcome was all-cause mortality, and the secondary outcome was a composite of coronary artery disease and cerebrovascular accidents. The following trajectory patterns were identified: stable, 61%; decreased, 5%; mildly increased, 32%; and markedly increased, 2%. During follow-up (median, 13.9 years), 557 participants died and 217 experienced secondary outcomes. The adjusted hazard ratios of primary and secondary outcomes for participants with a markedly increased trajectory pattern were 1.80 (95% CI [1.18-2.76]) and 1.45 (95% CI [0.67-3.12]), respectively, compared to those for participants with a stable trajectory pattern. A markedly increased heart rate trajectory pattern may be associated with all-cause mortality risks. Heart rate trajectory patterns demonstrated the utility of repeated heart rate measurements for risk assessment.

Keywords: All-cause mortality; Cardiovascular outcomes; Cerebrovascular accident; Heart rate trajectory; Resting heart rate.

Grants and funding

The study was supported by the Ministry of Science and Technology, Taiwan (MOST.103-2314-B-002-135-MY3) and the National Science Council in Taiwan (NSC.102-2314-B-002-080-MY2 and NSC.100-2314-B-002-113-MY3). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.