Resting Heart Rate and Long-term Outcomes Among the African American Population

Parikh, Kishan S.; Greiner, Melissa A.; Suzuki, Takeki; DeVore, Adam D.; Blackshear, Chad; Maher, Joseph F.; Curtis, Lesley H.; Hernandez, Adrian F.; O’Brien, Emily C.; Mentz, Robert J.

doi:10.1001/jamacardio.2016.3234

Cited by 25 publications

(10 citation statements)

References 32 publications

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“…bisoprolol) in African Americans: A subgroup analysis of 207 Black patients in the Metoprolol CR/XL Randomized Intervention trial in Congestive Heart Failure (MERIT-HF) found no significant differences for various outcomes of all-cause and CV-related death (p > 0.05 for all). 31 Furthermore, direct comparisons of BBs to other therapies such as hydralazine/ISDN in African Americans would provide more evidence and guidance for place in therapy of BBs.…”

Section: Review Of Notable Clinical Trialsmentioning

confidence: 99%

“…25,26 The earlier Jackson Heart Study found that elevated heart rate is associated with increased HF hospitalizations in African Americans, thus conferring an even greater necessity to evaluate the clinical utility of nonbeta-blocking agents, particularly ivabradine. 31 Considering the ambiguity of beta-blocker benefit to African American HF r EF patients as seen in the BEST Trial, further evaluation of alternate mechanisms of ventricular rate reduction is especially warranted in this population. Further evaluation of these rate-reducing agents is vital to the clinical understanding of reducing hospitalizations, improving symptomology, and enhancing quality of life in African American HF r EF patients, especially in patients with sustained elevated heart rate despite optimal beta-blocker therapy.…”

Section: Review Of Notable Clinical Trialsmentioning

confidence: 99%

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A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans

Tillman

Kim

Makhlouf

et al. 2019

Therapeutic Advances in Cardiovascular Disease

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Background: Our aim was to review the published literature evaluating treatment approaches for chronic heart failure (HF), notably as it relates to African American patients. Method: We undertook a comprehensive database search (1986–2017) of PubMed, EMBASE, and Ovid/MEDLINE utilizing terms ‘African American’, ‘black’, ‘chronic heart failure’, ‘heart failure’, ‘medication’, ‘chronic therapy’, and ‘clinical trials’. Additional notable studies were obtained from ClinicalTrials.gov . Studies published in English that examine treatment modalities of chronic HF in African American and non-African American patients were included. Results: Examples of current gaps worthy of investigation include whether to maximize thiazides and calcium-channel blockers prior to adding renin–angiotensin system (RAS) inhibitors or beta blockers in HF with preserved ejection fraction; whether hydralazine/isosorbide dinitrate (ISDN) should be initiated during earlier HF stages; whether to prioritize hydralazine/ISDN over other agents such as RAS inhibitors; varying response of African Americans to different agents within drug classes; and the role of mineralocorticoid receptor antagonists. Conclusion: Further studies are needed in order for consensus guidelines to clarify how best to treat this population.

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Section: Review Of Notable Clinical Trialsmentioning

confidence: 99%

Section: Review Of Notable Clinical Trialsmentioning

confidence: 99%

A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans

Tillman

Kim

Makhlouf

et al. 2019

Therapeutic Advances in Cardiovascular Disease

View full text Add to dashboard Cite

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“…Heart rate (HR) is an easily measured and modifiable clinical parameter. Previous studies have demonstrated that HR was an independent risk factor for total and cardiovascular (CV) mortality in general population as well as in patients with CV disease [ 1 – 5 ]. In a post hoc analysis of the Platelet Glycoprotein IIb-IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, elevated HR was associated with 30-day death among patients with non-ST-segment elevation myocardial infarction (MI) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Presence versus Absence of Hypertension on Admission Heart Rate-Associated Cardiovascular Risk in Patients with Acute Coronary Syndrome

Xia

Wang

Gao

et al. 2022

International Journal of Hypertension

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Background and Aims. Heart rate (HR) and hypertension are both important risk factors for adverse cardiovascular (CV) events in patients with established coronary artery disease (CAD). We sought to evaluate whether hypertension can modify the effect of admission HR on adverse CV events in patients with acute coronary syndrome (ACS). Methods. A total of 1056 patients with ACS undergoing percutaneous coronary intervention (PCI) were analyzed. All patients were classified into three groups according to the tertiles of admission HR (T1: ≤66 bpm, n = 369; T2: 67–73 bpm, n = 322; and T3: ≥74 bpm, n = 365). The primary endpoint was defined as major adverse CV events (MACEs), including all-cause death, stroke, myocardial infarction, or unplanned repeat revascularization. The multivariate Cox regression model was performed to evaluate the association of admission HR with MACE stratified by hypertension. Results. During the median follow-up of 30 months, a total of 232 patients developed at least one event. After adjusting for other covariates, elevated admission HR was significantly associated with an increased risk of MACE only in patients with hypertension (when T1 was taken as a reference, the adjusted HR of T2 was 1.143 [95% CI: 0.700–1.864] and that of T3 was 2.062 [95% CI: 1.300–3.270]); however, in patients without hypertension, admission HR was not associated with the risk of MACE (when T1 was taken as a reference, the adjusted HR of T2 was 0.744 [0.406–1.364] and that of T3 was 0.614 [0.342–1.101]) ( P = 0.025 for interaction). Conclusions. In patients with ACS undergoing PCI, the association of elevated admission HR with an increased risk of MACE was present in individuals with hypertension but not in those without hypertension. This finding suggests a potential benefit of HR control for ACS patients when they concomitantly have hypertension.

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“…Higher RHR is associated with higher levels of oxidative stress, endothelial dysfunction and atheromatous plaque formation 12. Previous studies conducted in mainly Western populations have reported conflicting results, both qualitatively and quantitatively, about the associations of RHR with HF,13–16 with some studies reporting J-shaped associations between RHR and HF 15 16. It is unclear the extent to which the associations of RHR with HF may be an artefact of incomplete adjustment for confounding by established risk factors, reverse causality or both.…”

Section: Introductionmentioning

confidence: 99%

Resting heart rate and risk of left and right heart failure in 0.5 million Chinese adults

et al. 2022

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ObjectivesTo compare the shape and strength of the associations of resting heart rate (RHR) with incident heart failure (HF) and pulmonary heart disease (PHD) in Chinese adults.MethodsThe prospective China Kadoorie Biobank recruited >0.5 million adults from 10 geographically diverse regions (5 urban, 5 rural) of China during 2004–2008. After an 11-year follow-up, 6082 incident cases of HF and 5572 cases of PHD, were recorded among 491 785 participants with no prior history of heart disease or use of beta-blockers at baseline. Cox regression yielded HRs for each disease associated with usual RHR after adjustment for confounding factors.ResultsThe mean (SD) baseline RHR was 79 (12) (men 78 (12); women 80 (11)) bpm, and these decreased with increasing age (by about 1 bpm per 10 years). Usual RHR showed J-shaped associations with HF and log-linear associations PHD. For HF, each 10 bpm higher usual RHR was associated with an adjusted HR of 1.25 (95% CI 1.17 to 1.34) for RHR>75 bpm. For PHD, each 10 bpm higher RHR was associated with HR of 1.74 (1.67–1.81) across the full range of usual RHR. For HF at RHR>75 bpm but not PHD, the HRs per 10 bpm higher RHR were approximately halved by further adjustment for diabetes and hypertension.ConclusionsRHR was strongly positively associated with PHD throughout the range studied, but was only associated with HF at RHR>75 bpm, and the strength of the associations with HF were only one-third of those with PHD.

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Resting Heart Rate and Long-term Outcomes Among the African American Population

Cited by 25 publications

References 32 publications

A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans

A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans

Effect of Presence versus Absence of Hypertension on Admission Heart Rate-Associated Cardiovascular Risk in Patients with Acute Coronary Syndrome

Resting heart rate and risk of left and right heart failure in 0.5 million Chinese adults

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