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Background: We evaluated the association between higher resting heart rates (RHRs) and adverse events in COVID-19 patients. Methods: One hundred and thirty-six patients with laboratory-confirmed COVID-19 were admitted. Outcomes of patients with different RHRs were compared. Results: Twenty-nine patients had RHRs of 2) and higher temperatures, and there was a higher proportion of men upon admission (all P < 0.05). Patients with higher RHRs showed higher white blood cell counts and D-dimer, cardiac troponin I (TnI), N-terminal pro-B-type natriuretic peptide and hypersensitive C-reactive protein levels, but lower albumin levels (all P < 0.05) after admission. During follow-up, 26 patients died (mortality rate, 19.1%). The mortality rate was significantly higher among patients with tachycardia than among the moderate and low RHR groups (all P < 0.001). Kaplan–Meier survival curves showed that the risks of death and ventilation use increased for patients with tachycardia (P < 0.001). Elevated RHR as a continuous variable and a mean RHR as tachycardia were independent risk factors for mortality and ventilator use (all P < 0.05) in the multivariable adjusted Cox proportional hazards regression model. Conclusions: Elevated average RHRs during the first 3 days of hospitalisation were associated with adverse outcomes in COVID-19 patients. Average RHRs as tachycardia can independently predict all-cause mortality.

Background: This study aimed to compare and correlate the resting heart rate, body composition and heart rate variability among judo and wushu players. Method: 40 athletes (20 judo and 20 wushu players) were included in the study. Body composition (BMI, subcutaneous body mass, skeletal body mass, body fat %, body density, Visceral fat, Lean body mass) was evaluated with the help of 7 skinfold thickness and body circumferences with the help of Harpenden calliper and measuring tape respectively. HRV (RMSSD, SDNN, LF/HF, LFnu and HFnu) was recorded in resting state (~5min) with the help of Heart wear shimmer ECG device. Result: No significant difference of body composition and HRV variables (p> 0.05) was found between the two groups except Body fat % and body density (p

Aims: To investigate the effect of elevated resting heart rate (RHR), hypertension (HTN) and associated risk factors on the prevalence of stroke among Sudanese adults. Study Design: This is a cross-sectional study based on a survey conducted by Sudanese society of hypertension during the May Month of Measurement (MMM), 2018 campaign. Methods: A total of 12281 respondents (mean age: 32.5±14.5 years, 49% men) were included. Structured questionnaires of demographic data, and self-reported medical history were filled by all respondents and analyzed. Blood pressure and RHR were measured using an Omron BP monitor. Participants were divided into two main cohorts: normotensive (n=9497, 77.3%) and hypertensive (n=2784, 22.7%) participants. Each cohort was then segregated into three sub-cohorts using RHR tertiles (T1: 100 bpm). Results: Multivariate logistic regression analyses were performed to assess the individual and combined effect of RHR and HTN on prevalence of stroke. Hypertensive patients were more likely to develop stroke compared to normotensive participants (OR= 2. 968, 95% CI 2.028-4.345). Within the hypertensive cohort, RHR T3 participants had a significantly increased risk of stroke compared to RHR T1-T2 combined (OR= 2.35, 95% CI1.043-5.323). Individuals of RHR T3 sub-cohort were more likely to be younger, leaner and displayed significantly higher level of both systolic & diastolic blood pressure compared to RHR T1 and T2 groups. Diabetes Mellitus and smoking increased the odds of stroke among both normotensives (OR (95% CI):5.6 (2.24- 14.09), 3.17 (1.71-6.08 respectively), and hypertensives (OR (95% CI): 4.40 (2.26-8.58), 2.03 (0.95-4.32) respectively). Female gender and older age also increases the odds of stroke among hypertensives (OR (95% CI): 1.85 (1.00- 3.45) and 2.00 (1.02- 4.17) respectively. In conclusion, this study demonstrated that HTN was an independent risk factor of stroke. The effect of elevated RHR on stroke was only prominent when joined to high blood pressure. Prevalence of tachycardia was higher among the young participants which make them more prone to stroke if the condition is associated with HTN. Our results highlight the importance of addressing elevated RHR to reduce the risk of stroke particularly among hypertensive patients.

The purpose of this meta-analysis was to examine the effects of blood flow restriction training on resting blood pressure and heart rate. A meta-analysis was completed in May 2020 including all previously published papers on blood flow restriction and was analyzed using a random effects model. To be included, studies needed to implement a blood flow restriction protocol compared to the same exercise protocol without restriction. A total of four studies met the inclusion criteria for quantitative analysis including four effect sizes for resting systolic blood pressure, four effect sizes for resting diastolic blood pressure, and three effect sizes for resting heart rate. There was evidence of a difference [mean difference (95 CI)] in resting systolic blood pressure between training with and without blood flow restriction [4.2 (0.3, 8.0) mmHg, p = 0.031]. No significant differences were observed when comparing resting diastolic blood pressure [1.2 (-1, 3.5) mmHg p = 0.274] and resting heart rate [-0.2 (-4.7, 4.1) bpm, p = 0.902] between chronic exercise with and without blood flow restriction. These results indicate that training with blood flow restriction may elicit an increase in resting systolic blood pressure. However, lack of data addressing this topic makes any conclusion speculative. Based on the results of the present study along with the overall lack of long-term data, it is suggested that future research on this topic is warranted. Recommendations include making changes in resting blood pressure a primary outcome and increasing the sample size of the interventions.

Human life quality is related to the density of daily physical activity. Human diseases are related to how many steps to take within a day. The level of human physical activity can be measured using the IPAQ scoring protocol, created by WHO in 1988. The relationship between IPAQ score and health problems show to be correlated. Nevertheless, the relationship between the level of physical activity using the IPAQ score instrument and resting heart rate is not known yet. This researcher conducted this study to determine the relationship between physical activity level using the IPAQ scoring protocol and rest heart rate. This study is an observative analytic with a cross-sectional study design using a simple random sampling technique. This study was conducted in Surabaya from November 2019 until March 2020 using primary data in the form of the IPAQ scoring method and resting heart rate examination using the Polar Heart Rate tool, which is then processed using IBM SPSS Statistics 22. The IPAQ score and resting heart rate measurement results using polar heart rate tools showed that the most college student has a high degree of physical activity level (72%) and a normal level of resting heart rate (90%). When measured with the Pearson correlation test, the correlation of those two components has a negative and weak correlation (r= -0,337, p

To track blood pressure (BP) and resting heart rate (RHR) in children and adolescents is important due to its associations with cardiovascular outcomes in the adulthood. Therefore, the aim of this study was to examine BP and RHR over a decade among children and adolescents living in Germany using national examination data. Cross-sectional data from 3- to 17-year-old national survey participants (KiGGS 2003–06, n = 14,701; KiGGS 2014–17, n = 3509) including standardized oscillometric BP and RHR were used for age- and sex-standardized analysis. Measurement protocols were identical with the exception of the cuff selection rule, which was accounted for in the analyses. Different BP and RHR trends were observed according to age-groups. In 3- to 6-year-olds adjusted mean SBP and DBP were significantly higher in 2014–2017 compared to 2003–2006 (+2.4 and +1.9 mm Hg, respectively), while RHR was statistically significantly lower by −3.8 bpm. No significant changes in BP or in RHR were observed in 7- to 10-year-olds over time. In 11- to 13-year-olds as well as in 14- to 17-year-olds lower BP has been observed (SBP −2.4 and −3.2 mm Hg, respectively, and DBP −1.8 and −1.7 mm Hg), while RHR was significantly higher (+2.7 and +3.7 bpm). BP trends did not parallel RHR trends. The downward BP trend in adolescents seemed to follow decreasing adult BP trends in middle and high-income countries. The increase in BP in younger children needs confirmation from other studies as well as further investigation. In school-aged children and adolescents, the increased RHR trend may indicate decreased physical fitness.

Higher resting heart rate was shown to correlate with worse prognosis both in general population and in various disease groups. Scientific societies dealing with patients with hypertension propose assessment of resting heart rate as a standard risk factor. In patients with uncomplicated hypertension and elevated resting heart rate they propose use of cardioselective β1-adrenolytics. This decision should be preceded by careful examination of potential modified reasons. In the paper we express several concerns regarding standard provision of heart rate lowering drugs in particular clinical situations. The algorithm showing proposed steps in assessment of elevated heart rate is provided.

Increased heart rate is a predictor of cardiovascular disease, heart failure, and all‐cause mortality. In those with high heart rates, interventions for heart rate reduction have been associated with reductions in coronary events. Asia is a diverse continent, and the prevalences of hypertension and cardiovascular disease differ among its countries. The present analysis of AsiaBP@Home study data investigated differences among resting heart rates (RHRs) in 1443 hypertensive patients from three Asian regions: East Asia (N = 595), Southeast Asia (N = 680), and South Asia (N = 168). This is the first study to investigate self‐measured RHR values in different Asian countries/regions using the same validated home BP monitoring device (Omron HEM‐7130‐AP/HEM‐7131‐E). Subjects in South Asia had higher RHR values compared with the other two regions, and the regional tendency found in RHR values was different from that found in BP values. Even after adjusting for age, sex, BMI, habitual alcohol consumption, current smoking habit, shift worker, hyperlipidemia, diabetes, chronic kidney disease, history of heart failure, and beta‐blocker use, both office and home RHR values in South Asia were the highest among Asia (mean values ± SE of office: East Asia [E] 75.2 ± 1.5 bpm, Southeast Asia [Se] 76.7 ± 1.5 bpm, South Asia [S] 81.9 ± 1.4 bpm; home morning: [E] 69.0 ± 1.2 bpm, [Se] 72.9 ± 1.2 bpm, [S] 74.9 ± 1.1 bpm; home evening: [E] 74.6 ± 1.2 bpm, [Se] 78.3 ± 1.2 bpm, [S] 83.8 ± 1.1 bpm). Given what is known about the impact of RHR on heart disease, our findings suggest the possible benefit of regionally tailored clinical strategies for cardiovascular disease prevention.

PURPOSE:Although resting heart rate variability (HRV) and chronotropic responses (CR) are common prognostic factor for cardiovascular disease, it is still unknown whether relationships between two variables are affected by exercise. The current study was aimed to identify correlations between resting cardiac autonomic regulation and graded exercise test-derived CR.METHODS:We recruited apparently healthy men college students aged between 20 and 29 years (n=46). They were assigned to Lowand High groups which have been determined for medians involved in resting heart rate (HR) or HRV indices such as rMSSD, HF, and LF/HF ratio, respectively. CR and post-exercise heart rate recovery (HRR) were calculated from HR fluctuations during and after symptom-limited graded exercise test using the Bruce protocol.RESULTS: In HRR, there were no significant differences between all Low and High groups separated by resting levels of HR or HRV indices. However, all Low groups assigned according to resting cardiac vagal-related HRV indices such as rMSSD and HF showed significantly lower CR levels than those of High groups, respectively. Moreover, CRs derived from stage 1-3 of Bruce protocol were positively correlated resting rMSSD and HF levels, respectively.CONCLUSIONS:The findings of the current study suggest that resting levels of cardiac vagal-related HRV indices may have an impact on CR derived from a graded exercise test, as well as there is a significant association between resting cardiac vagal activity and HR response during incremental exercise.

Little is known about the varied resting heart rate (RHR) trajectory patterns from childhood to young adulthood and their clinical significance. We aim to identify RHR trajectories from childhood to young adulthood, and to determine their relationship with left ventricular mass (LVM) index.RHR was measured up to 15 times over a 21-year period in 759 participants from childhood to young adulthood. LVM was measured using echocardiography and was normalised to body surface area to obtain LVM index in 546 participants.Using latent class models, three trajectory groups in RHR from childhood to young adulthood were identified, including high-decreasing group (HDG), moderate-decreasing group (MDG), and low-decreasing group (LDG). We found that trajectory of RHR was a significant predictor of LVM index with faster decrease of RHR associated with higher levels of total peripheral resistance (Our findings show an association between RHR trajectories from childhood to young adulthood with cardiac mass, suggesting that monitoring RHR may help identify subpopulation at high cardiovascular risk.

Background: Higher resting heart rate (HR) is associated with mortality amongst Caucasians with heart failure (HF), but its significance has yet to be established in sub-Saharan Africans in whom HF differs in terms of characteristics and etiologies. We assessed the association of HR with all-cause mortality in patients with HF in sub-Saharan Africa. Methods: The Douala HF registry (Do-HF) is an ongoing prospective data collection on patients with HF receiving care at four cardiac referral services in Douala, Cameroon. Patients included in this report were followed-up for 12 months from their index admission, for all-cause mortality. We used Cox-regression analysis to study the association of HR with all-cause mortality during follow-up. Results: Of 347 patients included, 343 (98.8%) completed follow-up. The mean age was 64±14 years, 176 (50.7%) were female, and median admission HR was 85 bpm. During a median follow-up of 12 months, 78 (22.7%) patients died. Mortality increased steadily with HR increase and ranged from 12.2% in the lower quartile of HR (≤69 bpm) to 34.1% in the upper quartile of HR (>100 bpm). Hazard ratio of 12-month death per 10 bpm higher HR was 1.16 (1.04–1.29), with consistent effects across most subgroups, but a higher effect in participants with hypertension vs. those without (interaction P=0.044). Conclusions: HR was independently associated with increased risk of all-cause mortality in this study, particularly among participants with hypertension. The implication of this finding for risk prediction or reduction should be actively investigated.

This study is a pre-experiment with a posttest-only design research design using 16 obese women aged 19-23 years old, body mass index (BMI) 25-35 kg/m2, percentage body fat (PBF) above 30% and fasting blood glucose (FBG) below 100 mg/dL, normal hemoglobin (Hb), normal systolic and diastolic blood pressure, normal resting heart rate, VO2max25-30 mL/kg/min and randomly divided into two groups, namely IE (n=8, interval exercise) and CE (n=8, continuous exercise). Interval exercise and continuous exercise interventions were carried out at 08.00 a.m. for 40-45 minutes using a treadmill. The measurement of energy expenditure was using OMRON Caloriscan HJA-306-EW. Data analysis techniques used the Independent-Samples T Test with the Statistical Package for Social Science (SPSS). The results obtained mean energy expenditure on IE (251.750±19.775) kcal and CE (278.750±23.334) kcal (p=0.026). Based on the results of the study concluded that continuous exercise increases energy expenditure compared to interval exercise in obese women.

Heart rate variability (HRV) is a useful and powerful non-invasive tool for quantitative assessment of cardiac autonomic function. Recent studies have shown that low heart rate variability is an indication of increased risk for cardiac diseases and sudden cardiac death. Yoga has been associated with improved cardio-respiratory performance. Thirty male regular yoga practitioners doing yoga for more than 3 years, age between 25-45 years (yoga group) and 30 male non-yoga practitioners, age-matched (control group) were included. A computerized Niviqure ECG system with HRV software was used for heart rate variability recording. Our results show that frequency-domain parameters like LF power, LF n.u, and LF/HF ratio were significantly lower in yoga group compared to control group. Time-domain parameters like mean RR, NN50, pNN50 were significantly higher in yoga group compared to control group. We conclude that the yoga increases heart rate variability by optimizing the autonomic functions, which is a good indicator of cardiac autonomic activity during rest.

Aims This study aims to investigate the association of resting heart rate (RHR) measured in late adolescence with long‐term risk of cause‐specific heart failure (HF) and subtypes of cardiomyopathy (CM), with special attention to cardiorespiratory fitness. Methods and results We performed a nation‐wide, register‐based cohort study of all Swedish men enrolled for conscription in 1968–2005 (n = 1 008 363; mean age = 18.3 years). RHR and arterial blood pressure were measured together with anthropometrics as part of the enlistment protocol. HF and its concomitant diagnoses, as well as all CM diagnoses, were collected from the national inpatient, outpatient, and cause of death registries. Risk estimates were calculated by Cox‐proportional hazards models while adjusting for potential confounders. During follow‐up, there were 8400 cases of first hospitalization for HF and 3377 for CM. Comparing the first and fifth quintiles of the RHR distribution, the hazard ratio (HR) for HF associated with coronary heart disease, diabetes, or hypertension was 1.25 [95% confidence interval (CI) = 1.13–1.38] after adjustment for body mass index, blood pressure, and cardiorespiratory fitness. The corresponding HR was 1.43 (CI = 1.08–1.90) for HF associated with CM and 1.34 (CI = 1.16–1.54) for HF without concomitant diagnosis. There was an association between RHR and dilated CM [HR = 1.47 (CI = 1.27–1.71)] but not hypertrophic, alcohol/drug‐induced, or other cardiomyopathies. Conclusions Adolescent RHR is associated with future risk of HF, regardless of associated aetiological condition. The association was strongest for HF associated with CM, driven by the association with dilated CM. These findings indicate a causal pathway between elevated RHR and myocardial dysfunction that warrants further investigation.

Background. Resting heart rate (RHR) is considered as a strong predictor of total mortality and hospitalization due to heart failure in hypertension patients. Bisoprolol fumarate, a second-generation beta-adrenoreceptor blockers (β-blocker) is commonly prescribed drug to manage hypertension. The present study was to retrospectively evaluate changes in the average RHR and its association with cardiovascular outcomes in bisoprolol-treated coronary artery disease (CAD) patients from the CAD treated with bisoprolol (BISO-CAD) study who had comorbid hypertension. Methods. We performed ad-hoc analysis for hypertension sub-group of the BISO-CAD study (n = 866), which was a phase IV, multination, multi-center, single-arm, observational study carried out from October 2011 to July 2015 across China, South Korea, and Vietnam. Multivariate regression analysis was used to identify factors associated with incidence of composite cardiac clinical outcome (CCCO), the results were presented as adjusted odds ratio (OR) along with 95% confidence interval (CI) and adjusted P value. Results. A total of 681 patients (mean age: 64.77 ± 10.33 years) with hypertension from BISO-CAD study were included in the analysis. Bisoprolol improved CCCOs in CAD patients with comorbid hypertension, with RHR

Traditionally, resting heart rate variability (rHRV) is measured for 10 min using the last 5 min for analyses (e.g., criterion period). It is unknown whether the measurement period can be shortened in pregnant women as there are currently no established standards. We aimed to compare shorter time segments (e.g., from the 1st to 10th minutes) of the parasympathetic index natural logarithm transformation of root mean square of successive R–R differences (Ln rMSSD) with the criterion period in pregnant and nonpregnant women. Twelve pregnant (age: 30.8 ± 3.4 years; gestational age: 20.1 ± 5.0 weeks) and 15 nonpregnant women (age: 29.8 ± 4.0 years) were included. rHRV was measured using a portable heart rate monitor for 10 min while sitting. Ln rMSSD difference/agreement between shorter time segments and criterion period was analyzed. The result observed between the 4th–5th minutes was the shortest time segment not different from/highly agreed with the criterion period in pregnant women (difference [95% confidence interval (CI)]: −0.10 [−0.22 to 0.02]/bias ± 1.96 × SD: −0.06 [−0.38 to 0.25]). In nonpregnant women, the 2nd–3rd-minute segment was the shortest with similar results (difference [95% CI]: −0.04 [−0.15 to 0.07]/bias ± 1.96 × SD: −0.03 [−0.39 to 0.32]). The Ln rMSSD was found to be stable from the 5th–10th minutes and the 3rd–10th minutes in pregnant and nonpregnant women, respectively. A shortened rHRV assessment can increase its applicability in clinical/exercise-training settings.Novelty Ln rMSSD can be measured for 5 min in pregnant women, with the last 1-min segment analyzed. The last 1-min segment from 3 min can be used for rHRV measurement in nonpregnant women. The shortened rHRV assessment can facilitate its applicability in clinical/exercise-training settings.

Aims Cancer patients suffer from impaired cardiovascular function. Elevated resting heart rate (RHR) has been identified as a marker for increased long‐term mortality in cancer patients prior to the receipt of anticancer treatment. We aimed to establish whether RHR is associated with survival in treatment‐naïve cancer patients. Methods and results This prospective study enrolled 548 unselected treatment‐naïve cancer patients between 2011 and 2013. The median age of the cohort was 62 years; 40.9% were male and 32.7% had metastatic disease. Median RHR was 72 b.p.m. Most patients were in sinus rhythm (n = 507, 92.5%). Clinical heart failure was noted in 37 (6.8%) patients. RHR was not related to cancer stage (P = 0.504). Patients in the highest RHR tertile had higher levels of high‐sensitivity troponin (P = 0.003) and N‐terminal pro‐B‐type natriuretic peptide (P = 0.039). During a median follow‐up of 25 months (interquartile range: 16–32 months; range: 0–40 months), 185 (33.8%) patients died from any cause [1‐year‐mortality: 17%, 95% confidence interval (CI) 13–20%]. In univariate survival analysis, RHR predicted all‐cause mortality [crude hazard ratio (HR) for a 5 b.p.m. increase in RHR: 1.09, 95% CI 1.04–1.15; P

The aim of this study was to investigate the relationship between heart rate and heart rate variability (HRV) with respect to individual characteristics and acute stressors. In particular, the relationship between heart rate, HRV, age, sex, body mass index (BMI), and physical activity level was analyzed cross-sectionally in a large sample of 28,175 individuals. Additionally, the change in heart rate and HRV in response to common acute stressors such as training of different intensities, alcohol intake, the menstrual cycle, and sickness was analyzed longitudinally. Acute stressors were analyzed over a period of 5 years for a total of 9 million measurements (320±374 measurements per person). HRV at the population level reduced with age (p < 0.05, r = −0.35, effect size = moderate) and was weakly associated with physical activity level (p < 0.05, r = 0.21, effect size = small) and not associated with sex (p = 0.35, d = 0.02, effect size = negligible). Heart rate was moderately associated with physical activity level (p < 0.05, r = 0.30, effect size = moderate) and sex (p < 0.05, d = 0.63, effect size = moderate) but not with age (p = 0.35, r = −0.01). Similar relationships between BMI, resting heart rate (p < 0.05, r = 0.19, effect size = small), and HRV (p < 0.05, r = −0.10, effect size = small) are shown. In response to acute stressors, we report a 4.6% change in HRV (p < 0.05, d = 0.36, effect size = small) and a 1.3% change in heart rate (p < 0.05, d = 0.38, effect size = small) in response to training, a 6% increase in heart rate (p < 0.05, d = 0.97, effect size = large) and a 12% reduction in HRV (p < 0.05, d = 0.55, effect size = moderate) after high alcohol intake, a 1.6% change in heart rate (p < 0.05, d = 1.41, effect size = large) and a 3.2% change in HRV (p < 0.05, d = 0.80, effect size = large) between the follicular and luteal phases of the menstrual cycle, and a 6% increase in heart rate (p < 0.05, d = 0.97, effect size = large) and 10% reduction in HRV (p < 0.05, d = 0.47, effect size = moderate) during sickness. Acute stressors analysis revealed how HRV is a more sensitive but not specific marker of stress. In conclusion, a short resting heart rate and HRV measurement upon waking using a smartphone app can effectively be used in free-living to quantify individual stress responses across a large range of individuals and stressors.

BackgroundPhotoplethysmography (PPG) sensors, typically found in wrist-worn devices, can continuously monitor heart rate (HR) in large populations in real-world settings. Resting heart rate (RHR) is an important biomarker of morbidities and mortality, but no universally accepted definition nor measurement criteria exist. In this study, we provide a working definition of RHR and describe a method for accurate measurement of this biomarker, recorded using PPG derived from wristband measurement across a 24 hour cycle. Methods433 healthy subjects wore a wrist device that measured activity and HR for up to 3 months. HR during inactivity was recorded and the duration of inactivity needed for HR to stabilise was ascertained. We identified the lowest HR during each 24-hour cycle (true RHR) and examined the time of day or night this occurred. The variation of HR during inactivity through the 24-hour cycle was also assessed. The sample was also subdivided according to daily activity levels for subset analysis. FindingsAdequate data was obtained for 19,242 days and 18,520 nights. HR stabilised in most subjects after 4 minutes of inactivity. Mean (SD) RHR for the sample was 54.5 (8.0) bpm (day) and 50.5 (7.6) bpm (night). RHR values were highest in the least active group (lowest MET quartile). A circadian variation of HR during inactivity was confirmed, with the lowest values being between 0300 and 0700 hours for most subjects. InterpretationRHR measured using a PPG-based wrist-worn device is significantly lower at night than in the day, and a circadian rhythm of HR during inactivity was confirmed. Since RHR is such an important health metric, clarity on the definition and measurement methodology used is important. A minimum rest time of 4 minutes provides a reliable measurement of HR during inactivity and true RHR in a 24-hour cycle is best measured between 0300 and 0700 hours. FundingThis study was funded by Google. O_TEXTBOXResearch In contextResting heart rate is one of the most fundamental and relevant biomarkers in health and disease. Its measurement, particularly in large population studies, is increasingly reliant on sensor devices. No universally accepted definition nor measurement criteria exist. In this study, we provide a working definition of RHR and describe a method for measurement of RHR recorded using PPG derived from wristband measurement. We make recommendations to support future studies of resting heart rate using wearable sensors. C_TEXTBOX

Objective Resting heart rate (RHR) independently predicts cardiovascular death. Increased RHR is related to chronic diseases, but community-based studies are rare. We investigated this population and factors related to RHR. Methods In total, 374 participants underwent medical examinations from March 2019 to December 2019. Participants were divided into groups with low RHR (LRHR; Results The incidence of type 2 diabetes mellitus (T2DM) and HbA1c values were both significantly higher in the HRHR group than in the LRHR group. Spearman correlation analysis showed RHR had a positive correlation with low-density lipoprotein, BMI, FPG, and HbA1c (r = 0.104574, 0.117266, 0.116041, and 0.311761, respectively). Multiple linear regression analysis showed age, hypertension, T2DM, and HbA1c were factors influencing RHR. Conclusion RHR showed strong correlation with T2DM and HbA1c in our community population, suggesting that RHR may be a risk factor for cardiovascular disease.

Background and Study Aim. This study was to investigate the effects of low-intensity interval training on the physiological variables of university students. Material and Methods. Forty male sports science students aged 18-25 years were randomly assigned to the Experimental group (n=20) and the Control group (n=20). The Experimental group underwent low-intensity interval training for eight weeks, whereas the Control group did not. Measurements of physiological variables such as resting heart rate, respiratory rate, recovery heart rate, breath-hold time, maximal oxygen uptake, and blood pressure were obtained for all subjects before and after the intervention. To compare the mean physiological variables between the experimental and control groups, an independent samples t-test was used. Results. Statistical significance was set at p 0.05. After the training intervention, the experimental group showed significantly better improvements than the control group in resting heart rate, respiratory rate, recovery heart rate, breath-holding time, maximal oxygen uptake, and blood pressure (p 0.05). Post intervention maximum oxygen uptake was statistically significant with t (38) = 3.086, p value 0.004. Post experiment systolic blood pressure was statistically significant with t (38) = -2.405, p value 0.021 for low intensity interval training and control group. Post experiment diastolic blood pressure was statistically highly significant with t (38) = 0.569, p value 0.001 for low intensity interval training and control group. The result of the study showed that there was a significant difference in post rest heart rate, respiratory rate, recovery heart rate, systolic blood pressure, diastolic blood pressure, breath holding and maximal oxygen uptake between the low intensity interval training and the control group (p 0.05). Conclusions. Thus, it was concluded that eight weeks of low-intensity interval training show significant improvement in physiological variables of university students., Передумови та мета дослідження. Це дослідження мало вивчити вплив інтервальних тренувань низької інтенсивності на фізіологічні параметри студентів університетів.Матеріал і методи. Сорок студентів-юнаків, які вивчають спортивні науки, у віці 18-25 років були випадковим чином розподілені в експериментальну групу (n = 20) і контрольну групу (n = 20). Експериментальна група проходила малоінтенсивне інтервальні тренування протягом восьми тижнів, а контрольна група - немає. Вимірювання фізіологічних змінних, таких як частота пульсу в стані спокою, частота дихання, частота пульсу відновлення, час затримки дихання, максимальне споживання кисню і артеріальний тиск, були отримані для всіх суб'єктів до і після втручання. Для порівняння середніх фізіологічних змінних між експериментальною і контрольною групами використовувався t-критерій для незалежних вибірок.Результати. Статистична значимість була встановлена ​​на рівні p 0,05. Після тренувального втручання експериментальна група показала значно кращі поліпшення, ніж контрольна група, щодо частоти пульсу в стані спокою, частоти дихання, частоти пульсу відновлення, часу затримки дихання, максимального споживання кисню і артеріального тиску (p 0,05). Максимальне споживання кисню після втручання було статистично значущим з t (38) = 3,086, значення p 0,004. Систолічний артеріальний тиск після експерименту було статистично значущим з t (38) = -2,405, значення p 0,021 для низькоінтенсивних інтервальних тренувань і контрольної групи. Постексперіментальний діастолічний артеріальний тиск був статистично значущим з t (38) = 0,569, значення p 0,001 для низькоінтенсивних інтервальних тренувань і контрольної групи. Результат дослідження показали, що існує значна різниця в частоті серцевих скорочень після відпочинку, частоти дихання, частоти пульсу відновлення, систолічним артеріальним тиску, артеріальному тиску, затримці дихання і максимальному споживанні кисню між інтервальними тренуваннями низької інтенсивності і контрольною групою (р 0,05) .Висновки. Таким чином, був зроблений висновок, що вісім тижнів інтервальних тренувань низької інтенсивності показують значне поліпшення фізіологічних показників у студентів вузів.

Background Diagnostic parameters measured in implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy defibrillators (CRTD) have been shown to change before and after heart failure (HF) events with fluid overload. Purpose We investigated the temporal characteristics of nighttime heart rate, as a surrogate of resting heart rate, before and after HF events in a large real-world cohort of patients with ICD/CRTD devices. Methods We linked a de-identified database of aggregated electronic health record (EHR) data (2007–2017) to a manufacturer's device database with continuous diagnostic monitoring data. Patients with ICD/CRTD implants with HF related diagnostics were included for this study. The device computes nighttime heart rate as the average heart rate between midnight and 4 am. HF event was defined as an inpatient, emergency department, or observation unit stay in a hospital with primary diagnosis of HF and intravenous diuretics administration. Temporal ensemble average of night heart rate in the 60 days pre and post HF events were compared between HF events with and without readmission within 60 days as well as with periods with no HF events. Results A total of 17,886 patients with 1.8±1.2 years of follow-up met inclusion criteria. The average age of patients was 66.6±12.3 years, with 72% being males, and 51% with ICD devices. The average night heart rate pre and post HF events with and without readmission and in follow-ups with no events is shown in Figure. A total of 1174 patients had 1425 HF events with no readmission for HF within 60 days and 282 patients had 295 HF events which were followed by readmission for HF within 60 days. A total of 17,839 patients had no HF events over 86,858 follow-up months. A 3-day average night heart rate increased by >3 bpm in a large proportion of patients in the 30-day period before HF event compared to 30-day periods with no events (28% vs 16%; Odds Ratio: 2.08; p Conclusions In a large real-world population of patients with ICD/CRTD devices, the average night heart rate increases before HF events. Patients who are readmitted are more likely to have higher night heart rate after discharge. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Medtronic Plc

BackgroundElevated resting heart rate (RHR) is associated with an increased risk for cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum ALB levels in a Japanese general population.MethodsIn total, 8363 individuals without a history of CVD were followed-up for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1-Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated.ResultsWe found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR: 1.27 [95% confidence interval, CI: 1.02-1.57]) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR: 0.61 [95% CI: 0.47-0.79]) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (p

Background Higher resting heart rate (RHR) has been proved as a risk factor for all-cause and cardiovascular disease (CVD) mortality. However, few studies discussed its synergy with other markers on mortality prediction. Our study focused on whether the impact of RHR on CVD mortality is affected by serum albumin (SA) in Japanese general population. Methods We followed 8,307 participants without history of CVD from a Japanese general population. We divided participants according to quartiles of RHR [Q1(76)], then we used Cox proportional hazard model adjusting for age, gender, BMI, blood glucose, blood pressure, anti-hypertensive treatment, total cholesterol, smoking and alcohol drinking status for estimating CVD mortality. Furthermore, we stratified the participants according to median value of SA (4.4 mg/dL) to conduct subgroup analysis. Results During a 29-year follow-up, 1,030 deaths due to CVD were detected. Compared to Q1 group, hazard ratios [95% confidence interval] in each RHR group for CVD mortality was Q2: 0.87 [0.74-1.04], Q3: 1.01 [0.85-1.20], Q4: 0.98 [0.83-1.16]. In lower SA group, Q2: 0.90[0.72-1.13], Q3: 0.99 [0.80-1.25], Q4: 1.27 [1.03-1.58], meanwhile in higher SA group, Q2: 0.83 [0.63-1.09], Q3: 0.99 [0.77-1.29], Q4: 0.65 [0.49-0.85]. Conclusions Higher RHR was associated with increased risk for CVD mortality in individuals with lower SA, meanwhile the reversed relationship shown in those with higher SA. Key messages The impact of RHR on CVD mortality might be influenced by SA in a Japanese general population.

We appreciate the interest and comments from Dr. Jiang and colleagues and Dr. Aloia regarding our work on the association of diastolic blood pressure (DBP) and resting heart rate (RHR) with all-cause mortality in patients with chronic hemodynamically significant aortic regurgitation (AR) ([1][1]).

PURPOSE: Resting heart rate[RHR] is a simple, inexpensive, non-invasive, and ubiquitously collected vital sign. Further, heart rate information is now more readily accessible to the general population due to the popularity of wearable devices, capable of measuring RHR. Purpose of the current review paper are to summarize 1) literature which report associations between RHR and health outcomes, and 2) to suggest the use of RHR as a new health indicatorMETHODS: We performed a search, including reviews and original papers, on the PubMed and Korean Information Service System (KISS) electronic databases of articles assessing the association between RHR and the risk and prognosis of diseases. For our search strategy, we used combinations of the following key terms: resting heart rate, cardiovascular disease, hypertension and cancer.RESULTS: RHR’s prognostic value as a marker of general health, has received considerable attention recently. Studies have consistently shown clear associations of elevated RHR with cardiovascular disease [CVD], type 2 diabetes, and even cancer [prevalence, incidence and mortality]. Due to strong association between RHR and health outcomes, RHR may be used as a preliminary health indicator, to detect undiagnosed cardiometabolic diseases and cancer. However, it is still unclear whether elevated RHR is one of the risk markers or risk factors in diseases of our interest. Factors associated with RHR include aerobic fitness, physical activity, body mass, smoking, drinking, sleep duration, and stress. Changing these modifiable lifestyle components coincide with general health recommendations, which would improve one’s health.CONCLUSIONS: RHR may reflect disease risk and changes lifestyles which may affect health outcomes. Therefore, due to the ease of measurement, lowering RHR may be a new target for better health.

In a previous meta-analysis, it was demonstrated that the resting heart rate (RHR) is a potential risk factor for atrial fibrillation (AF). However, the results of that meta-analysis were conflicting, and the relationship between the RHR and AF is still not well established. In the current meta-analysis, our aim is to update evidence with a better statistical model. We searched the Cochrane Library, PubMed, and Embase databases for relevant studies and used a "one-stage approach" with a restricted cubic spline model to summarize the dose-specific relationships between the RHR and AF. Relative risk (RR) was used to measure the effects. In total, 10 studies were included, with a total of 18,630 cases of AF among 431,432 participants. In the dose-response analysis, there was evidence of a nonlinear association between the RHR and the risk of AF (nonlinearity, P 70 bpm (per 10 bpm increase) (RR = 1.06, 95% CI = 1.03-1.08; P < 0.001). Our dose-response meta-analysis revealed a significant J-shaped association between the RHR and AF. Both low RHR and high RHR were associated with an increased risk of AF compared with a modest RHR of 68-80 bpm.

Objective: Resting heart rate is a physiological parameter that has been reported to be associated with endothelial dysfunction. Endocan and thrombomodulin are mediators released from endothelium, which are determined to increase in blood with endothelial damage. We aimed to investigate the relationship between resting heart rate and these biomarkers. Material and Methods: 68 healthy volunteers (28 females; mean age: 44.2 ± 6.3 years) were included in the study. Subjects divided into two groups according to heart rate quartiles: lower two quartiles as group 1 (n = 35,) and upper two quartiles as group 2 (n = 33). Endocan and thrombomodulin levels in blood of the individuals were measured. Results: Clinical features and laboratory findings were similar in both groups (p> 0.05 for all variables). Mean resting heart rates were 70.9 ± 4.9 in group 1 and 84.8 ± 4.3 in group 2. No statistically significant difference was found in endocan and thrombomodulin levels in both groups (p> 0.05 for all variables). No significant correlation was detected between resting heart rate and these molecules. Conclusion: Resting heart rate was not associated with endothelium derived biomarkers endocan and thrombomodulin.

Objectives The purpose of this study was to determine orthopaedic surgery residents' and attending surgeons' resting heart rate (RHR) and heart rate variability (HRV) and if there is a correlation between subject-specific variables (age, attending surgeon, resident, postgraduate year (PGY) level, gender, number of calls, total hours worked, and total hours of sleep) and surgeon RHR and HRV. Methods Orthopaedic surgery residents and attending surgeons at a single institution were prospectively enrolled and provided a validated wearable device to determine hours of sleep, RHR and HRV. Demographic information, hours worked and overnight calls were recorded. Bivariate correlations were determined using the Spearman rank correlation. Multiple linear regression models were constructed to determine the effect of relevant variables. All p values were reported, and a significance level of α=0.05 was used (p Results Twenty-one of 26 enrolled subjects completed the 4-week study. The average RHR and HRV for orthopaedic surgeons was 61.8+10.0 bpm and 42.96+21.2ms, respectively. Residents had a significantly higher RHR (66.4+8.4 vs 55.6+8.9, p=0.011) compared with attending surgeons. Overnight calls had the strongest association with decreased HRV (r=−0.447; p=0.038), moderate positive correlation with RHR (r=0.593; p=0.005) and weak negative correlation with HRV (r=−0.469; p=0.032). There was no significant correlation between PGY level, gender, total hours worked and total hours of sleep with RHR or HRV. Conclusion Orthopaedic surgeons have poor RHR and HRV. Additionally, the number of overnight calls had the strongest correlation with worse RHR and HRV. Level of evidence Level II; diagnostic, individual cross-sectional study with a consistently applied reference standard.

RATIONALE: Pulse wave velocity (PWV), as a measure of arterial stiffness, has been shown to be associated with resting heart rate (RHR) in general population studies. Yet, the evidence on this rela...

Introduction: Although resting heart rate (RHR) and oxidative stress are risk factors for cardiovascular morbidity and mortality, the association between them has not been fully understood. The aim of the present study was to investigate the relationship between RHR and oxidative/antioxidative stress markers. Patients and Methods: The study consisted of 56 healthy volunteers (33 males; mean age: 44.1 ± 9.0 years). Subjects were divided into two groups according to heart rate quartiles: lower two quartiles as group 1 (n= 29) and upper two quartiles as group 2 (n= 27). We measured total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and ceruloplasmin (CP) levels of subjects. Results: There was no any significant difference in baseline clinical characteristics and laboratory measurements between the groups (p> 0.05 for all variables). Mean RHRs were 71.3 ± 4.6 in group 1 and 82.4 ± 4.1 in group 2. The TAC, TOS, OSI, and CP levels were similar between the two groups (p> 0.05 for all variables). We did not detect any significant association between RHR and oxidative/antioxidative parameters. Conclusion: RHR was not associated with TOS, TAC, OSI, and CP levels in our study.

Whether heart rate change is associated with cardiovascular disease (CVD) in the general population is unclear. We conducted a prospective cohort study to assess the association of resting heart rate and its change with incident CVD in the middle-aged and older Chinese. Resting heart rate was measured during the baseline survey (September 2008 to June 2010) and the resurvey (2013). Incident CVD was followed up until December 31, 2016. Finally, a total of 20,828 participants were included in the analyses of baseline heart rate and 9132 participants were included in the analyses of heart rate change. The associations of baseline heart rate and heart rate change with incident CVD were assessed with multivariable Cox proportional hazards models. Compared with moderate baseline heart rate (65 to 80 bpm), low baseline heart rate (15 bpm) in high baseline heart rate group (>80 bpm) (HR, 1.67; 95% CI, 1.02–2.71) or a decrease of heart rate (

Yoga is a science that facilitates homeostasis, also alters the autonomic nervous system as well as cardiovascular functioning. It is recommended as a non-pharmacological tool for managing stress by “National Centre for Complementary and Alternative Medicine India. Heart rate variability (HRV) a temporal variation in consecutive heart beats measured from a standard electrocardiogram. Being non-invasive technique has increased its use to measure the work load of individual. We assessed the effect of yogic exercise on resting HRV by using HRV software (AD-Instrument) in 20 healthy males of 18–20 years age both pre and post interventional. Practice of yogic exercise consist set of physical postures (asana), breathing techniques (pranayama) and meditation (dhyana). These were practised 35mins, 5times /wk for 6 months guided by certified yoga trainer. Analysis done by Student’s paired ‘t’ test of HRV revealed that all time domain parameters were increased while frequency domain parameters like low-frequency (LF) and LF/HF ratio were found to be decreased after practice of yogic exercise. Practicing yogic exercise has shown better improvement in autonomic balance by shifting towards parasympathetic predominance as suggested by resting HRV

Elevated resting heart rate (RHR) is associated with risk of type 2 diabetes mellitus (T2DM). However, the association of change in RHR (ΔRHR) and incident T2DM is not fully elucidated. We aimed to assess the dose-response association between 6-year ΔRHR and T2DM.A total of 12155 non-T2DM participants ≥18 years old were enrolled during 2007-2008 and followed up during 2013-2014. ΔRHR was calculated by subtracting the baseline RHR from the RHR value at 6-year follow-up. Age-, sex-, and RHR-specific relative risks (RRs) and 95% confidence intervals (CIs) for the effect of ΔRHR on incident T2DM were calculated by using modified Poisson regression models. As compared with ΔRHR of 0 beats/min, the adjusted risk of T2DM was significantly increased with RHR increment and reduced with RHR reduction. ΔRHR was positively associated with future risk of T2DM [RR per unit increase: 1.03 (1.03-1.04)]. As compared with stable change in RHR group (-5ΔRHR5 beats/min), for ΔRHR ≤ -10 beats/min, -10ΔRHR ≤ -5 beats/min, 5≤ΔRHR10 beats/min, and ΔRHR ≥10 beats/min groups, the pooled adjusted RR (95% CI) of T2DM was 0.69 (0.55-0.86), 0.90 (0.73-1.11), 1.31 (1.07-1.61), and 1.90 (1.59-2.26), respectively. This significant association still existed on subgroup analyses based on age, sex, and baseline RHR and sensitivity analyses.Dynamic RHR change was significantly associated with incident T2DM. Our study suggests that RHR may be a non-invasive clinical indicator for interventions aiming to reduce incident T2DM in the general population.

Regular fish consumption, a rich source of long-chain omega-3 (ω-3) docosahexaenoic acid (DHA), modifies cardiac electrophysiology. However, human studies investigating fish oil and cardiac electrophysiology have predominantly supplemented therapeutic (high) doses of fish oil (often ω-3 eicosapentaenoic acid (EPA) rich sources). This study examined whether non-therapeutic doses of DHA-rich fish oil modulate cardiac electrophysiology at rest and during cardiovascular reflex challenges to the same extent, if at all, in young healthy adults.Participants (N = 20) were supplemented (double-blinded) with (2x1g.dayThe baseline O3I (Control: 5.1 ± 1.0; FO: 5.4 ± 0.9;In young healthy adults, dietary achievable doses of ω-3 DHA-rich fish oil exerted a direct slowing effect on resting HR, without compromising the HR response to either dominant sympathetic or parasympathetic modulation.

Introduction: In a normal healthy adult, sympathetic and parasympathetic system should be in synergy. Measuring resting heart rate is a one of the methods to assess health condition. It can be affected by different factors such as exercise, mental health, any disease, etc. Normal subjects with reduced heart rate are associated with better cardiovascular health. Physical inactivity is associated with high level of inflammatory markers. Increased inflammatory markers are related to inflammation and chronic diseases. The C-Reactive Protein (CRP) is a biomarker of inflammatory diseases. High CRP level is a potent risk factor for obesity, diabetes, atherosclerosis, etc. Aim: To study the effect of short term resistance and endurance exercise training on resting heart rate in healthy young adults, CRP, Body Mass Index (BMI) and also to compare the changes between two exercise groups. Materials and Methods: A cross-sectional study was conducted from May 2019 to May 2020 in the Department of Physiology at King George’s Medical University, Lucknow, Uttar Pradesh, India. The study included 60 healthy young adults with normal BMI (18.5-24.9 kg/m2) and age between 18-25 years. Subjects were equally divided into Group I- Resistance exercise and Group II endurance groups. Subjects did moderate intensity exercise (based on maximum heart rate) for five days in a week for eight weeks. Endurance group did jogging. Resistance group did push-up, pull-up and squats. Target heart rate during moderate intensity of activities was 64-76% of maximum heart rate. Heart rate measurement was done before the start of exercise and after five to seven minutes of exercise when it reached 64-76% of maximum heart rate. It was measured by pulse oximeter. Follow-up was done after eight weeks of exercise training in both the groups. Evaluation was done by comparing resting heart rate and CRP level before the start of training and after the completion of training programme. Statistical analysis was done using student t-test and paired t-test. Results: Mean age of subjects of group I was found to be higher (19.98±1.26 years) as compared to group II (19.97±0.98 years). Mean pre intervention BMI of both the groups was found to be similar (21.97±1.78 kg/m2). No statistically significant change in resting heart rate was found in both resistance group (p=0.096) and endurance group (p=0.326) after exercise training. Statistically significant increase in CRP was found in resistance group (p

BackgroundThoracic irradiation is one of the cornerstones of Hodgkin lymphoma (HL) treatment, which contributes to high rates of long-term survivorship, but begets a life-long increased risk of heart disease including heart failure. At the cardio-oncology (CO) clinic, persistent sinus tachycardia or elevated resting heart rate (RHR) is frequently observed in these patients. The aim of this study was to evaluate the relation between RHR and left ventricular (LV) dysfunction.MethodsIn 75 HL survivors visiting our CO-clinic echocardiographic evaluation of LV systolic and diastolic function including global longitudinal strain (GLS) was performed to assess subclinical LV dysfunction.ResultsMedian age of HL diagnosis was 24 [25th-75th percentile: [19], [29]] years with a 17 [12], [25] year interval to CO-clinic visit and 31 patients (41%) were male. Average RHR was 78 ± 14 bpm and 40% of patients (N = 30) had an elevated RHR defined as ≥ 80 bpm. While there was no difference in LV ejection fraction (55.6 ± 4.3 vs. 54.8 ± 6.6; p = 0.543), patients with elevated RHR had abnormal GLS (-15.9% vs. −18.3%, p = 0.045) and higher prevalence of diastolic dysfunction (73.3% vs. 46.7%; p = 0.022). GLS, E/e’ ratio and presence of diastolic dysfunction were independently associated with RHR when correcting for age, sex and mantle field irradiation. A significant improvement was observed of the RHR-association model with solely extracardiac confounders when LV-function parameters were added to the model (F-statistic = 6.36, p = 0.003).ConclusionsThis study indicates RHR as a possible marker for subclinical LV-dysfunction in HL survivors.

High resting heart rate (RHR) is associated with multiple morbidity in chronic obstructive pulmonary disease (COPD) patients. Factors regarding the effectiveness of exercise training (ET) on RHR in COPD patients are unclear. The main objective of the current study is to determine the predictors of the eventual change in RHR after ET. One hundred and ten COPD patients (mean age: 63.1 ± 8.1 years, FEV1%: 43.6 ± 16.6) who participated in the ET program that consisted of supervised breathing, aerobic, strengthening, and stretching exercises for 8 weeks, 2 days a week, were included in the study. RHR, pulmonary functions, 6-min walk distance (6-MWD), Modified Medical Research Council Dyspnea Scale, St. George Respiratory Questionnaire, and Hospital Anxiety and Depression scores were compared before and after ET. Multivariate regression analysis was performed to correlate factors related to changes in RHR before and after exercise. There was a significant improvement in RHR after the ET program (p

Objectives Resting heart rate has been increasingly identified as a marker of cardiovascular risk and has been extensively studied as a predictor of coronary artery disease progression. In peripheral artery disease, the prognostic impact of resting heart rate remains elusive. Methods Consecutive patients undergoing invasive peripheral procedures were included. Data included resting heart rate determination by averaging manual radial pulse palpation measurements taken 24 h before and after an invasive peripheral procedure. Results A total of 1720 patients were included (mean age 70±11 years, 38% were female, 39% had critical limb ischemia). During a median follow-up of 729 days, 364 (21.2%) patients died. Resting heart rate emerged as an independent predictor of mortality, even after adjusting for clinical characteristics, peripheral artery disease manifestation and anatomic extent, traditional risk factors, co-morbidities, and disease-modifying therapies: hazard ratio for heart rate >75 bpm was 1.010 (95% confidence interval 1.001–1.109), with each bpm increase in resting heart rate conferring a 1.1% increase in the risk of all-cause mortality (95% confidence interval 0.1–10.9%, adjusted p = 0.030). Conclusions Resting heart rate is an independent predictor of mortality in patients with peripheral artery disease; our findings extend heart rate as a possible marker of prognosis to non-coronary atherosclerotic vascular disease.

Introduction: Elevated resting heart rate (RHR) has been shown to be associated with both all-cause and cardiovascular mortality. Prior studies have provided conflicting estimates of the strength of each association. To explore the relationship between RHR and competing mortality risks, we sought to compare the association between RHR and cardiovascular and non-cardiovascular mortality among participants in the Systolic Blood Pressure Intervention Trial (SPRINT). Methods: Eligible SPRINT participants had baseline RHR, longitudinal follow-up, and were not using beta blockers or non-dihydropyridine calcium channel blockers. Mortality was classified by a treatment-blinded adjudication committee as cardiovascular if secondary to coronary heart disease, stroke, sudden cardiac death, or congestive heart failure. Multivariable Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CI) for cardiovascular and non-cardiovascular mortality, separately, associated with a 10 beats per minute increase in RHR. Results: Among 5,571 eligible SPRINT participants (67.1 ± 9.4 years, 33.8% female, 63.8% white, mean RHR 70.4±11.8 beats per minute) over a median 3.8 years of follow-up, there were 56 cardiovascular deaths and 176 non-cardiovascular deaths. In models adjusted for age, sex, race, prior cardiovascular disease, smoking, systolic blood pressure, creatinine, total cholesterol, high-density lipoprotein cholesterol, and trial treatment assignment, higher RHR (per ten beat-per-minute increase) was associated with both cardiovascular (HR 1.17, 95% CI 1.02-1.35) and non-cardiovascular mortality (HR 1.27, 95% CI 1.13-1.43). Conclusions: Elevated RHR was associated with both cardiovascular and non-cardiovascular mortality, suggesting that RHR may serve as a marker of both global health rather and cardiovascular health. Higher RHR may reflect imbalance in autonomic tone and further studies are needed to explore the mechanisms of these associations.4

The aim of our study was to determine how being overweight (OW) affects measures of ejection duration (ED), subendocardial viability ratio (SEVR), and central arterial health in a sample of adolescent children. Thirty‐four sex and age‐matched adolescent children (n = 34, 17 OW, age = 14 ± 2 years) participated in one laboratory visit. Anthropometric measures, body composition, and cardiovascular measures including resting heart rate, aortic systolic blood pressure (ASBP), carotid‐femoral pulse wave velocity (cf‐PWV), ED (EDms absolute vs. relative ED%), and the SEVR were ascertained. Transfer functions were applied to obtain ASBP. ED was measured as the time from the beginning of the upstroke of the pulse wave and the dicrotic notch, SEVR as the quotient of the diastolic pressure‐time area to the systolic pressure‐time area, and cf‐PWV as the quotient of distance between carotid‐femoral measurement sites and the transit time of the pulse wave. cf‐PWV was significantly higher in OW compared to normal weight participants (5.13 ± 0.85 vs. 4.53 ± 0.46 m/s respectively; p = 0.015, d = 0.51). OW adolescents also reported significantly higher values for ASBP (103.1 ± 11.8 vs. 95.7 ± 8.2 mmHg respectively; p = 0.043, d = 0.72) and significantly lower values of SEVR (114.4 ± 25.9% vs. 132.2 ± 22.0% respectively; p = 0.038; d = 0.33). Overweight adolescents demonstrated higher cf‐PWV, ASBP, and SEVR then normal weight peers., Employing non‐invasive measures of cardiac function to identify detrimental changes in cardiovascular health shows promising value in pediatric populations. This study investigated how being overweight affects measures of ejection duration, subendocardial viability ratio, and central arterial health in a sample of adolescent children. Overweight adolescents demonstrate higher cf‐PWV, ASBP, and SEVR then normal weight peers.

Background Pulmonary embolism (PE) response teams (PERT) have been developed to improve in-hospital mortality. Identifying intermediate risk PE patients that will progress despite anticoagulation is difficult, especially because outcomes with modern anticoagulation are quite good. Objective The primary aim of this study was to evaluate the rate of anticoagulation failure (new deep vein thrombosis or PE, right ventricular failure resulting in shock, cardiac arrest, or PE-attributable death) in intermediate risk PE patients managed by PERT. The secondary objective was to determine whether there was a significant decrease in heart rate 24 h after initiation of anticoagulation in intermediate risk PE. Methods This was a retrospective observational study of patients treated for acute intermediate risk PE at the University of Rochester Medical Center who also had outpatient followup between November 2016–June 2019. Results Ninety-two patients presented as intermediate-risk PE and had outpatient followup. Seventy-four patients were initially treated with anticoagulation. None of these patients failed anticoagulation. Of the eighteen intermediate risk patients that underwent advanced intervention, none failed anticoagulation first. There was significant decrease in resting heart rate 24 h after starting therapeutic anticoagulation, 107 beats/min vs 89 beats/min, p = 0.0001. Conclusion We did not observe anticoagulation failure in the management of acute, intermediate risk PE. Reductions in heart rate may reflect improvements in right ventricular function; we hypothesize that those whose heart rate does not fall may be optimal candidates for advanced intervention.

Objectively measurable biomarkers have not been applied for suicide risk prediction. Resting heart rate (HR) and heart rate variability (HRV) showed potential as trans-diagnostic markers associated with suicide. This study aimed to investigate the associations of resting HR and HRV on proximal suicide risk in patients with diverse psychiatric diagnoses. This chart review study used the medical records of psychiatric patients who visited the outpatient clinic at an academic tertiary hospital. A total of 1,461 patients with diverse psychiatric diagnoses was included in the analysis. Proximal suicide risk was measured using the Mini-International Neuropsychiatric Interview (MINI) suicidal score. Linear regression analyses with the MINI suicidal score as a dependent variable and binary logistic regression analyses with moderate-to-high suicide risk (MINI suicidal risk score ≥6) as a dependent variable were conducted to explore the effects of resting HR and HRV parameters on acute suicide risk after adjusting for age, sex, presence of major depressive disorder (MDD) and bipolar disorder (BD), severity of depression and anxiety severity. We found that 55 (34.6%) patients in the MDD group, 40 (41.7%) in the BD group and 36 (3.9%) in the others group reported moderate-to-high suicide risk. Linear regression analysis revealed that both resting HR and root-mean-square of successive difference (RMSSD) had significant associations with the MINI suicidal score (P = 0.037 with HR, P = 0.003 with RMSSD). In logistic regression, only RMSSD showed a significant association with moderate-to-high suicide risk (P = 0.098 with HR, P = 0.019 with RMSSD), which remained significant in subgroup analysis with patients who reported any suicide-related symptom (MINI suicidal score >0; n = 472; P = 0.017 with HR, P = 0.012 with RMSSD). Our study findings suggest the potential for resting HR and RMSSD as biomarkers for proximal suicide risk prediction. Further research with longitudinal evaluation is needed to confirm our study findings.

This work was aimed to synthetize the evidence available about the relationship between resting heart rate (RHR) and the risk of cancer mortality. A computerized search in the Medline, EMBASE, Web of Science, and Cochrane Library databases from their inception to 24 September 2020 was performed. We performed three meta-analyses: (1) cancer mortality comparing the “less than 60 bpm” and “more than 60 bpm” categories; (2) cancer mortality comparing “less than 60 bpm”, “60 to 80 bpm”, and “more than 80 bpm” categories; and (3) analysis for 10–12 and 20 bpm increase in RHR and risk of cancer mortality. Twenty-two studies were included in the qualitative review, and twelve of them met the inclusion criteria for the meta-analysis. Our results showed a positive association between RHR and the risk of cancer mortality. This association was shown in a meta-analysis comparing studies reporting mean RHR values below and above 60 bpm, when comparing three RHR categories using less than 60 bpm as the reference category and, finally, in dose response analyses estimating the effect of an increase of 10–12 bpm in RHR, both in men and in women. In conclusion, a low RHR is a potential marker of low risk of cancer mortality.

The role of leukocyte inflammatory markers and toll like receptors (TLRs)2/4 in pathologies associated with elevated resting heart rate (RHR) levels in healthy obese (HO) individuals is not well elucidated. Herein, we investigated the relationship of RHR with expression of leukocyte-inflammatory markers and TLRs in HO individuals. 58-obese and 57-lean participants with no history of a major medical condition, were recruited in this study. In HO individuals, the elevated-RHR correlated positively with diastolic blood pressure, cholesterol, pro-inflammatory monocytes CD11b + CD11c + CD206-phenotype (r=0.52,P=0.0003) as well as with activated T cells CD8 + HLA-DR + phenotype (r=0.27,P=0.039). No association was found between RHR and the percentage of CD16 + CD11b + neutrophils. Interestingly, elevated RHR positively correlated with cells expressing TLR4 and TLR2 (CD14 + TLR4 + , r=0.51,P≤ 0.0001; and CD14 + TLR2 + ,r =0.42,P=0.001). TLR4 + expressing cells also associated positively with the plasma concentrations of proinflammatory or vascular permeability/matrix modulatory markers including TNF-α (r=0.36,P=0.005), VEGF (r= 0.47,P=0.0002), and MMP-9 (r=0.53,P≤0.0001). Multiple regression revealed that RHR is independently associated with CD14 + TLR4 + monocytes and VEGF. We conclude that in HO individuals, increased CD14 + TLR4 + monocytes and circulatory VEGF levels associated independently with RHR, implying that RHR monitoring could be used as a non-invasive clinical indicator to identify healthy obese individuals at risk for inflammation and cardiovascular disease.

Heart rate is a parameter that is very easy to measure and is widely used both in clinic and during daily life activities. Its value gained more relevance with the evidence, in prospective studies and meta-analysis, of association between elevated heart rate values and diseases and outcomes.The increased knowledge of physiological mechanisms of heart rate control and the pathophysiological mechanisms responsible for its dysfunction allows to identify the cut-off value of normalcy providing info for non-pharmacological and pharmacological treatments to reduce the cardiovascular risk both in general population and in pathophysiological conditions. This paper overviews the knowledges of the role of resting heart rate as predictor of cardiovascular risk.