Higher Levels of Inflammation Factors and Greater Insulin Resistance Are Independently Associated with Higher Heart Rate and Lower Heart Rate Variability in Normoglycemic Older Individuals: The Cardiovascular Health Study

Introduction: Covert brain infarction (CBI) and worsening white matter grade (WMG) on serial MRI are associated with increased risk for ischemic stroke and dementia. Hypothesis: We sought to evaluate the association of various measures of blood pressure and heart rate with these MRI findings. Methods: In the Cardiovascular Health Study, a longitudinal cohort study of cardiovascular disease in older adults, we used relative risk regression to assess the risk of incident CBI and worsening WMG associated with mean, variability, and trend in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) measured at four or more annual clinic visits between two brain MRIs. We included participants who underwent both brain MRIs and had no change in antihypertensive medication status, no CBI on the initial MRI, and no stroke before the follow-up MRI. Results: Among 897 eligible participants, incident CBI occurred in 15% and worsening WMG in 27%. Mean SBP mean was strongly associated with increased risk for incident CBI (RR per 10 mmHg 1.29; 95% CI, 1.13-1.47), and DBP mean was strongly associated with increased risk for worsening WMG (RR per 10 mmHg 1.43; 95% CI, 1.23-1.67). DBP variability may be associated with incident CBI (RR per 10 mmHg 1.71; 95% CI, 1.10-2.65), The HR measures were not associated with these MRI findings. Conclusions: Elevated mean levels of blood pressure contribute to covert cerebrovascular diseases. Control of mean blood pressure levels, even in older adults, remains a high priority for prevention of vascular brain injury.

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Influence of Insulin Resistance on the Association Between Physical Activity and Heart Rate Variability: The Toon Health Study

Journal of Physical Activity and Health ◽

10.1123/jpah.2020-0110 ◽

2020 ◽

Vol 17 (11) ◽

pp. 1075-1082

Author(s):

Isao Saito ◽

Koutatsu Maruyama ◽

Tadahiro Kato ◽

Yasunori Takata ◽

Kiyohide Tomooka ◽

...

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Heart Rate ◽

Heart Rate Variability ◽

Frequency Standard ◽

Population Based ◽

Health Study ◽

Model Assessment ◽

Partial Regression Coefficient ◽

Validated Questionnaire

Background: Autonomic activity is possibly influenced by physical activity (PA). However, it remains unclear whether this association is modified by insulin resistance. Methods: This population-based study between 2009 and 2012 included 2016 men and women aged 30–79 years. The PA was assessed using a validated questionnaire based on sleep, occupation, transportation, household characteristics, and leisure-time PA. Heart rate (HR) and heart rate variability (HRV) in the sitting position were determined from 5-minute recordings of pulse waves detected by a fingertip sensor. The HRV was calculated as frequency (standard deviation of normal-to-normal [NN] intervals [SDNN]), root mean square of successive differences (RMSSD), and percentage differences between normal NN intervals >50 milliseconds [pNN50]) and time domains. Insulin resistance was evaluated using the homeostasis model assessment index (HOMA-IR). Results: HR, RMSSD, and pNN50 were related to the total and moderate/vigorous PA tertiles in models that included HOMA-IR. The partial regression coefficient of total PA per 1-SD increase was .05 (P = .019) for log-transformed RMSSD and 1.86 (P = .001) for pNN50. No interactive associations were observed between PA and HOMA-IR. Conclusions: Low total PA was associated with increased HR and low levels of RMSSD and pNN50, reflecting parasympathetic modulation that was not modified by insulin resistance.

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Circulating 25-hydroxyvitamin D is associated with insulin resistance cross-sectionally but not longitudinally in older adults: The Cardiovascular Health Study

Metabolism ◽

10.1016/j.metabol.2013.07.008 ◽

2013 ◽

Vol 62 (12) ◽

pp. 1788-1794 ◽

Cited By ~ 4

Author(s):

John Danziger ◽

Mary L. Biggs ◽

Matt Niemi ◽

Joachim H. Ix ◽

Jorge R. Kizer ◽

...

Keyword(s):

Insulin Resistance ◽

Older Adults ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

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Abstract MP47: The Epidemiology of Sick Sinus Syndrome: The Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study

Circulation ◽

10.1161/circ.127.suppl_12.amp47 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Paul N Jensen ◽

Susan R Heckbert ◽

Noelle N Gronroos ◽

Lin Y Chen ◽

Aaron R Folsom ◽

...

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Fixed Effects ◽

Cardiovascular Health ◽

Sick Sinus Syndrome ◽

Incidence Rates ◽

Health Study ◽

Cardiovascular Health Study ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk

Objectives. Little is known about the epidemiology of sick sinus syndrome (SSS). The goals of this study were to determine the age and sex-specific incidence of SSS in white and black participants in the Atherosclerosis Risk In Communities (ARIC) study and the Cardiovascular Health Study (CHS), and to investigate associations of CV risk factors with incident SSS. Methods. From among ARIC (n=15,792) and CHS (n=5,888) participants, we included those who at baseline were free of prevalent atrial fibrillation and pacemaker, had a heart rate of ≥50bpm unless using beta blockers, and reported white or black race. Potential incident SSS cases were identified by ICD9 hospital discharge diagnosis code 427.81 and validated by medical record review. Incidence rates of SSS were calculated for each age-sex-race category. Age, sex, race, and clinic adjusted Cox models were used to assess associations of risk factors with incident SSS; estimates were combined across cohorts using fixed-effects meta-analysis. Results. At baseline, the average age of included participants (n=19,146) was 60 years. Traditional CV risk factors were more prevalent among blacks. During 324,505 person years of follow-up (mean 17 years), 291 incident SSS cases were identified, 246 in whites and 45 in blacks. Incidence estimates and associations with CV risk factors were similar in ARIC and CHS. SSS incidence increased with age (Table), and blacks had a 44% lower risk of SSS than whites (age, sex, and clinic adjusted HR: 0.56, 95%CI: 0.27, 1.20). In multivariate models, incident SSS was associated with greater BMI, height, NT-proBNP, cystatin C, and QRS interval, with lower heart rate and HDL cholesterol, and with prevalent hypertension, diabetes, right bundle branch block, CHD, and HF. Conclusions. The incidence of hospitalized SSS increased with age, and was lower for blacks than whites. Several modifiable CV risk factors were associated with incident hospitalized SSS.

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