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Heart rate and ischemic stroke: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

TitleHeart rate and ischemic stroke: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
Publication TypeJournal Article
Year of Publication2015
AuthorsO'Neal, WT, Qureshi, WT, Judd, SE, Meschia, JF, Howard, VJ, Howard, G, Soliman, EZ
JournalInt J Stroke
Volume10
Issue8
Pagination1229-35
Date Published2015 Dec
ISSN1747-4949
KeywordsAged, Brain Ischemia, Female, Follow-Up Studies, Heart Rate, Humans, Incidence, Male, Middle Aged, Rest, Risk Factors, Stroke, United States
Abstract

BACKGROUND: The association between resting heart rate and ischemic stroke remains unclear.AIM: To examine the association between resting heart rate and ischemic stroke.METHODS: A total of 24 730 participants (mean age: 64 ± 9·3 years; 59% women; 41% blacks) from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who were free of stroke at the time of enrollment (2003-2007) were included in this analysis. Resting heart rate was determined from baseline electrocardiogram data. Heart rate was examined as a continuous variable per 10 bpm increase and also as a categorical variable using tertiles ( <61 bpm, 61 to 70 bpm, and >70 bpm). First-time ischemic stroke events were identified during follow-up and adjudicated by physician review.RESULTS: Over a median follow-up of 7·6 years, a total of 646 ischemic strokes occurred. In a Cox regression model adjusted for socio-demographics, cardiovascular risk factors, and potential confounders, each 10 bpm increase in heart rate was associated with a 10% increase in the risk of ischemic stroke (hazard ratio = 1·10, 95% confidence interval = 1·02, 1·18). In the categorical model, an increased risk of ischemic stroke was observed for heart rates in the middle (hazard ratio = 1·29, 95% confidence interval = 1·06, 1·57) and upper (hazard ratio = 1·37, 95% confidence interval = 1·12, 1·67) tertiles compared with the lower tertile. The results were consistent when the analysis was stratified by age, gender, race, exercise habits, hypertension, and coronary heart disease.CONCLUSION: In REGARDS, high resting heart rates were associated with an increased risk of ischemic stroke compared with low heart rates. Further research is needed to examine whether interventions aimed to reduce heart rate decrease stroke risk.

DOI10.1111/ijs.12620
Alternate JournalInt J Stroke
PubMed ID26306564
PubMed Central IDPMC4938895
Grant ListU01 NS041588 / NS / NINDS NIH HHS / United States