Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
BackgroundHeart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify...
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| Format: | Article |
| Language: | English |
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Wiley
2017-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.005505 |
| _version_ | 1818315122946342912 |
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| author | Shanhu Qiu Xue Cai Zilin Sun Ling Li Martina Zuegel Juergen Michael Steinacker Uwe Schumann |
| author_facet | Shanhu Qiu Xue Cai Zilin Sun Ling Li Martina Zuegel Juergen Michael Steinacker Uwe Schumann |
| author_sort | Shanhu Qiu |
| collection | DOAJ |
| description | BackgroundHeart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify these associations in the general population. Methods and ResultsA literature search using 3 databases up to August 2016 was conducted for studies that reported hazard ratios with 95% CIs for the association between baseline HRR and outcomes of interest. The overall hazard ratios were calculated using a random‐effects model. There were 9 eligible studies in total, with 5 for cardiovascular events enrolling 1061 cases from 34 267 participants, and 9 for all‐cause mortality enrolling 2082 cases from 41 600 participants. The pooled hazard ratios associated with attenuated HRR versus fast HRR that served as the referent were 1.69 (95% CI 1.05–2.71) for cardiovascular events and 1.68 (95% CI 1.51–1.88) for all‐cause mortality. For every 10 beats per minute decrements in HRR, the hazard ratios were 1.13 (95% CI 1.05–1.21) and 1.09 (95% CI 1.01–1.19), respectively. Further analyses suggested that the associations observed between attenuated HRR and risk of fatal cardiovascular events and all‐cause mortality were independent of traditional metabolic factors for cardiovascular disease (all P<0.05). ConclusionsAttenuated HRR is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording HRR for risk assessment in clinical practice as a routine. |
| first_indexed | 2024-12-13T09:00:31Z |
| format | Article |
| id | doaj.art-80db5157129948848719292b3d746f71 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:00:31Z |
| publishDate | 2017-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-80db5157129948848719292b3d746f712022-12-21T23:53:11ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-05-016510.1161/JAHA.117.005505Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort StudiesShanhu Qiu0Xue Cai1Zilin Sun2Ling Li3Martina Zuegel4Juergen Michael Steinacker5Uwe Schumann6Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, ChinaDepartment of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, ChinaDepartment of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, ChinaDepartment of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, ChinaDivision of Sports‐ and Rehabilitation Medicine, Department of Internal Medicine II, University of Ulm, GermanyDivision of Sports‐ and Rehabilitation Medicine, Department of Internal Medicine II, University of Ulm, GermanyDivision of Sports‐ and Rehabilitation Medicine, Department of Internal Medicine II, University of Ulm, GermanyBackgroundHeart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify these associations in the general population. Methods and ResultsA literature search using 3 databases up to August 2016 was conducted for studies that reported hazard ratios with 95% CIs for the association between baseline HRR and outcomes of interest. The overall hazard ratios were calculated using a random‐effects model. There were 9 eligible studies in total, with 5 for cardiovascular events enrolling 1061 cases from 34 267 participants, and 9 for all‐cause mortality enrolling 2082 cases from 41 600 participants. The pooled hazard ratios associated with attenuated HRR versus fast HRR that served as the referent were 1.69 (95% CI 1.05–2.71) for cardiovascular events and 1.68 (95% CI 1.51–1.88) for all‐cause mortality. For every 10 beats per minute decrements in HRR, the hazard ratios were 1.13 (95% CI 1.05–1.21) and 1.09 (95% CI 1.01–1.19), respectively. Further analyses suggested that the associations observed between attenuated HRR and risk of fatal cardiovascular events and all‐cause mortality were independent of traditional metabolic factors for cardiovascular disease (all P<0.05). ConclusionsAttenuated HRR is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording HRR for risk assessment in clinical practice as a routine.https://www.ahajournals.org/doi/10.1161/JAHA.117.005505cardiovascular eventsheart rate recoverymortality |
| spellingShingle | Shanhu Qiu Xue Cai Zilin Sun Ling Li Martina Zuegel Juergen Michael Steinacker Uwe Schumann Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular events heart rate recovery mortality |
| title | Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies |
| title_full | Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies |
| title_fullStr | Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies |
| title_full_unstemmed | Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies |
| title_short | Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies |
| title_sort | heart rate recovery and risk of cardiovascular events and all cause mortality a meta analysis of prospective cohort studies |
| topic | cardiovascular events heart rate recovery mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.005505 |
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