Background: Although it has been somewhat overlooked, resting heart rate is an established predictor of cardiovascular and noncardiovascular outcome. We assessed the determinants and mortality associations of heart rate measured during ambulatory blood pressure monitoring (ABPM) to evaluate its informativeness during activity and sleep.
Methods: We studied a cohort of 3957 patients aged 55 +/- 16 (mean +/- SD) years (58% treated for hypertension) who were referred for ABPM during 1991 to 2005. Heart rate nondipping was defined as follows: (awake value - sleep value)/awake value < 0.1. Linear and logistic regression models assessed covariate associations with ambulatory heart rate indices. All-cause mortality was analyzed by Cox proportional hazards modeling.
Results: Female sex, body mass index (calculated as weight in kilograms divided by height in meters squared), and treated diabetes were positively related to awake and sleep heart rate, whereas age and treated hypertension were inversely associated. All these variables were associated with lower sleep-related heart rate dipping magnitude. Multivariate-adjusted odds ratios (95% confidence intervals) for heart rate nondipping were 1.02 (1.02-1.03) per year of age; 1.05 (1.03-1.06) for body mass index; 1.39 (1.20-1.60) for women; 1.30 (1.12-1.51) for nappers; 2.19 (1.87-2.57) for treated hypertensive patients; and 1.38 (1.09-1.76) for treated diabetic patients. Mortality analysis according to deciles of the different heart rate variables showed a robust linear relationship only for heart rate dip and a hazard ratio of 2.67 (1.31-5.47) for the lowest vs the highest decile.
Conclusions: In clinical practice, ambulatory heart rate adds prognostic information beyond that of other ABPM predictors. Heart rate measures during sleep, and in particular the absence of dipping of heart rate to sleep levels, were independently associated with all-cause mortality.
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http://dx.doi.org/10.1001/archinte.167.19.2116 | DOI Listing |
Arch Bone Jt Surg
January 2024
Özel Medicabil Hastanesi, Bursa.
Objectives: Despite the widely recognised high mortality rate among patients with hip fracture, the variation in death rates by gender and cause has been less explored. This study aimed to investigate mortality rates and causes of death in patients who underwent hip fracture surgery, and to compare them with those of the general population. A secondary objective was to compare the results of Internal Fixation versus Arthroplasty in these patients.
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January 2025
Department of Neurology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, China.
Background: Autonomic dysfunction plays an essential role in dementia, however, it is not known whether electrocardiogram autonomic dysfunction-related indicators are associated with the severity of dementia. In this study, we attempted to investigate whether these indicators are correlated in patients with vascular dementia and Alzheimer's disease compared with normal health individuals. For this purpose, we measured and analyzed the predictive value of heart rate deceleration capacity (DC), heart rate deceleration runs (DRs), heart rate acceleration capacity (AC) along with the plasma levels of lipoprotein-associated phospholipase A2 (Lp-PLA2).
View Article and Find Full Text PDFPrev Med Rep
January 2025
Institute of General Practice, Friedrich-Alexander University Erlangen, Nuernberg, Germany.
Objective: HAPpEN aims to implement and evaluate a holistic general practitioner-centered, interdisciplinary obesity management strategy in rural Germany, focusing on feasibility, health outcomes, and economic benefits.
Methods: HAPpEN is a 12-month, pragmatic single-arm, multicenter trial, informed by a formative survey, and initiated in April 2023 with 98 obese participants (body mass index, BMI ≥ 30 kg/m) in Kulmbach, Germany. The program integrates nutritional counseling, physical activity, and behavior change techniques, including smartphone-based self-monitoring.
Front Neurosci
January 2025
Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Introduction: Delirium, frequently experienced by ischemic stroke patients, is one of the most common neuropsychiatric syndromes reported in the Intensive Care Unit (ICU). Stroke patients with delirium have a high mortality rate and lengthy hospitalization. For these reasons, early diagnosis of delirium in the ICU is critical for better patient prognosis.
View Article and Find Full Text PDFHeliyon
January 2025
Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Identifying asymptomatic patients with atrial fibrillation (AF) poses a challenge, and their optimal management is less certain, despite similar outcomes to symptomatic AF patients. The 'Atrial fibrillation Better Care' (ABC) pathway has been recently proposed as a holistic or integrated care approach for the comprehensive management of symptomatic patients with AF. We aimed to determine the use of the ABC pathway on clinical outcomes in asymptomatic patients with AF.
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