Background/Objectives: Higher resting heart rate is a risk factor for arterial cardiovascular diseases. We assessed whether higher heart rate is a risk factor for venous thromboembolism (VTE). Methods: In a prospective epidemiologic cohort, the Atherosclerosis Risk in Communities (ARIC) Study, we associated resting heart rate by electrocardiogram with physician-validated incident hospitalized VTE through 2015. We also examined whether lower heart rate variability (HRV), a marker of cardiac autonomic imbalance, might be a risk factor for VTE. Results: Resting heart rate at Visit 1 (1987-1989), when participants were 45 to 64 years old (mean, 54 years), was not associated with incidence of VTE (n = 882 cases). However, heart rate at Visit 4 (1996-1998; mean age, 63 years) was associated positively with VTE (n = 557 cases). The adjusted hazard ratios (95% confidence intervals) of VTE across Visit 4 heart rate categories of <60, 60 to 69, 70 to 79, and ≥80 bpm were 1 (reference), 1.22 (1.01-1.49), 1.39 (1.09-1.78), and 1.44 (1.01-2.06), respectively, and when evaluated continuously 1.11 (1.02-1.21) per 10 bpm greater heart rate. For the most part, HRV indices were not associated with VTE or associations were explained by inverse correlations of HRV indices with heart rate. Conclusion: We found a significant positive and independent association of resting heart rate at ARIC Visit 4 with incidence of VTE. The reason why high heart rate is a risk marker for VTE warrants further exploration.
|Original language||English (US)|
|Number of pages||9|
|Journal||Research and Practice in Thrombosis and Haemostasis|
|State||Published - Feb 1 2020|
Bibliographical noteFunding Information:
Funding information The National Heart, Lung, and Blood Institute provided support for venous thromboembolism identification via R01 HL059367, for training of Dr Pope via T32HL007779, and for the Atherosclerosis Risk in Communities Study via contracts HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I.Essentials Higher resting heart rate may be associated with increased risk of venous thromboembolism (VTE). We tested this hypothesis in a prospective population-based cohort followed nearly 2 decades. VTE incidence showed a dose-response with heart rate: 1.44-fold higher risk for ?80 versus <60. Why high heart rate is a risk marker for VTE warrants further exploration. Higher resting heart rate may be associated with increased risk of venous thromboembolism (VTE). We tested this hypothesis in a prospective population-based cohort followed nearly 2 decades. VTE incidence showed a dose-response with heart rate: 1.44-fold higher risk for ?80 versus <60. Why high heart rate is a risk marker for VTE warrants further exploration. We thank the ARIC participants and staff for their important contributions to ARIC research.
© 2019 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals, Inc on behalf of International Society on Thrombosis and Haemostasis.
- heart rate
- heart rate variability
- prospective study
- pulmonary embolism
- venous thromboembolism