Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis
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Olatokunbo Osibogun1, Oluseye Ogunmoroti2, Erica S Spatz3
1Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States of America.
Insights
Achieving ideal cardiovascular health (CVH) through Life's Simple 7 metrics is linked to a lower resting heart rate (RHR). This association holds across diverse populations, suggesting CVH promotion may reduce elevated RHR and cardiovascular disease risk.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Elevated resting heart rate (RHR) is a known risk factor for cardiovascular disease (CVD).
- The association between ideal cardiovascular health (CVH), defined by Life's Simple 7 (LS7) metrics, and RHR is not well understood.
- Understanding this relationship can inform strategies for CVD prevention.
Purpose of the Study:
- To investigate the association between ideal CVH and RHR in a cohort without clinical CVD.
- To determine if achieving optimal scores across LS7 metrics is linked to a lower RHR.
Main Methods:
- Cross-sectional analysis of 6457 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
- LS7 metrics (smoking, physical activity, diet, BMI, blood pressure, cholesterol, glucose) were scored to define CVH categories: inadequate (0-8), average (9-10), and optimal (11-14).
- Multinomial logistic regression was used to assess the association between CVH score and RHR categories (<60, 60-69, 70-79, ≥80 bpm), adjusting for covariates.
Main Results:
- Favorable CVH was significantly associated with lower odds of elevated RHR.
- Participants with optimal CVH had substantially lower adjusted odds ratios for RHR categories of 60-69, 70-79, and ≥80 bpm compared to those with RHR <60 bpm.
- These associations were consistent across strata of sex, race/ethnicity, and age.
Conclusions:
- Achieving ideal cardiovascular health is associated with a lower resting heart rate.
- Promoting ideal CVH may be a viable strategy to reduce elevated RHR, a modifiable risk factor for cardiovascular disease.
- Further research is warranted to confirm the clinical utility of CVH promotion for RHR management.
Abstract:
Elevated resting heart rate (RHR) is associated with an increased cardiovascular disease (CVD) risk, but little is known about its association with cardiovascular health (CVH), assessed by the Life's Simple 7 (LS7) metrics. We explored whether ideal CVH was associated with RHR in a cohort free from clinical CVD. We conducted a cross-sectional analysis of baseline data (2000-2002) of 6457 Multi-Ethnic Study of Atherosclerosis participants in 2018. Each LS7 metric (smoking, physical activity, diet, body mass index, blood pressure, cholesterol and glucose) was scored 0-2. Total score ranged from 0 to 14. Scores of 0-8 indicate inadequate, 9-10 average, and 11-14 optimal CVH. RHR was categorized as <60, 60-69, 70-79 and ≥80 bpm. We used multinomial logistic regression to determine associations between CVH score and RHR, adjusting for age, sex, race/ethnicity, education, income, health insurance, and atrioventricular nodal blockers. Mean age of participants (standard deviation) was 62 (10) years; 53% were women; 47% had inadequate CVH, 33% average, and 20% optimal. Favorable CVH was associated with lower odds of having higher RHR. Compared to RHR <60 bpm, participants with optimal CVH had adjusted odds ratio (95% CI) of 0.55 (0.46-0.64) for RHR of 60-69 bpm, 0.34 (0.28-0.43) for 70-79 bpm, and 0.14 (0.09-0.22) for ≥80 bpm. A similar pattern was observed in the stratified analysis by sex, race/ethnicity and age. Favorable CVH was less likely to be associated with elevated RHR irrespective of sex, race/ethnicity and age. More research is needed to explore the usefulness of promoting ideal CVH to reduce elevated RHR, a known risk factor for CVD.
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