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High resting heart rate linked to poor functional status in older adults
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Higher resting heart rate and lower heart rate variability appear to be linked to poorer functional status in older adults, regardless of CV risk factors and comorbidities, according to recent findings.
Researchers evaluated data on 5,042 patients enrolled in PROSPER, a randomized controlled trial assessing pravastatin in a cohort of adults aged 70 to 82 years (mean age, 75.3 years) with vascular disease or associated risk factors.
The researchers measured participants’ resting heart rates and heart rate variations from a 10-second, 12-lead ECG recorded the morning of the initial study visit. They calculated the standard deviation of normal-to-normal RR intervals (SDNN), a commonly used index of heart rate variability.
Participants’ functional status was evaluated using the Barthel Index and the Lawton Instrumental Activities of Daily Living (IADL) scale. The Barthel Index assesses the ability to perform basic daily living tasks (ADL) and the Lawton IADL evaluates more complex instrumental activities, with higher scores indicating a greater degree of independence and functional status. These questionnaires were administered at baseline, after 9, 18 and 30 months, and at the end of the study, with a mean follow-up of 3.2 years.
Patients had a median resting heart rate of 65 beats/minute and a median standard deviation of normal-to-normal RR intervals of 18.6 ms. Over the course of follow-up, ADL score declined in 15.5% of patients and IADL score declined in 22.4%.
Higher baseline heart rate was linked to worse ADL and IADL score, and lower SDNN was associated with worse IADL (all P values < .05). Among those in the highest heart rate tertile (71-117 beats per minute), there was a 1.79-fold higher risk for decline in ADL (95% CI, 1.45-2.22) and a 1.35-fold higher risk for decline in IADL (95% CI, 1.12-1.63). There was a 1.21-fold (95% CI, 1-1.46) higher risk for decline in ADL in the lowest SDNN tertile (range, 1.7-13.3 ms) and a 1.25-fold higher risk for decline in IADL in this tertile (95% CI, 1.05-1.48) (both P for trends < .05). These associations were independent of gender, medications, CV risk factors and comorbidities.
“This study provides insight into the role of cardiac autonomic function in the development of functional decline,” the researchers wrote. “Because functional disability has a long preclinical phase, it is crucial to identify potential interventions to delay it. Further research is needed to establish whether heart rate and heart rate variability are risk markers and/or potentially modifiable risk factors for functional decline.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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