Relation of Resting Heart Rate to Incident Atrial Fibrillation (From ARIC [Atherosclerosis Risk in Communities] Study)

Weijia Wang, Alvaro Alonso, Elsayed Z. Soliman, Wesley T. O'Neal, Hugh Calkins, Lin Yee Chen, Marie Diener-West, Moyses Szklo

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The evidence on the association between resting heart rate (HR) and incident atrial fibrillation (AF) is conflicting. Whether change in resting HR is associated with incident AF is unknown. We evaluated 11,545 participants (mean [±standard deviation] age: 57 ± 5.7 years) free of AF at baseline (1990 to 1992). Resting HR was obtained from 10-second electrocardiograms at baseline and 3 years later. AF diagnosis was ascertained from visit electrocardiograms, hospital discharge records, and death certificates through 2013. High and low resting HR were defined as ≥80 and <55 beats/min, respectively. Increase and decrease in HR were defined as a 3-year HR difference >15 and <−15 beats/min, respectively. Over a median follow-up of 22.5 years, 1,746 (15%) participants developed AF. Both baseline high resting HR and increase in HR were independently associated with incident AF (hazard ratio = 1.2, 95% confidence interval = 1.0 to 1.5 and hazard ratio = 1.4, 95% confidence interval = 1.1 to 1.9). Increase in HR was no longer associated with incident AF after additional adjustment for incident heart failure. In stratified analyses, increase in HR was associated only with AF in participants <60 years, with bachelor's degree or above, without diabetes, and without hypertension (p values for interaction ≤0.05). In conclusion, in a middle-aged population, high resting HR is associated with higher AF risk. Increase in resting HR is also associated with higher AF risk, especially in individuals without traditional AF risk factors. Whether interventions to decrease HR can prevent AF remain to be examined.

Original languageEnglish (US)
Pages (from-to)1169-1176
Number of pages8
JournalAmerican Journal of Cardiology
Volume121
Issue number10
DOIs
StatePublished - May 15 2018

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, HHSN2682017000021). This work was also supported by American Heart Association grant 16EIA26410001 (Alonso) and NHLBI/NIH F32HL134290 (O'Neal WT).

Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute , National Institutes of Health , Department of Health and Human Services , under Contract nos. ( HHSN268201700001I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I , HHSN2682017000021 ). This work was also supported by American Heart Association grant 16EIA26410001 (Alonso) and NHLBI/NIH F32HL134290 (O'Neal WT).

Publisher Copyright:
© 2018 Elsevier Inc.

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