Resting heart rate and incidence of venous thromboembolism

• Main Authors: Aaron R. Folsom, Pamela L. Lutsey, Zachary C. Pope, Oluwaseun E. Fashanu, Jeffrey R. Misialek, Mary Cushman, Erin D. Michos, the Atherosclerosis Risk in Communities (ARIC) Study Investigators
• Format: Article
• Language: English
• Published: Wiley 2020-02-01
• Series: Research and Practice in Thrombosis and Haemostasis
• Subjects: heart rate; heart rate variability; prospective study; pulmonary embolism; venous thromboembolism
• Online Access: https://doi.org/10.1002/rth2.12288

Abstract Background/Objectives Higher resting heart rate is a risk factor for arterial cardiovascular diseases. We assessed whether higher heart rate is a risk factor for venous thromboembolism (VTE). Methods In a prospective epidemiologic cohort, the Atherosclerosis Risk in Communities (ARIC) Study, we associated resting heart rate by electrocardiogram with physician‐validated incident hospitalized VTE through 2015. We also examined whether lower heart rate variability (HRV), a marker of cardiac autonomic imbalance, might be a risk factor for VTE. Results Resting heart rate at Visit 1 (1987‐1989), when participants were 45 to 64 years old (mean, 54 years), was not associated with incidence of VTE (n = 882 cases). However, heart rate at Visit 4 (1996‐1998; mean age, 63 years) was associated positively with VTE (n = 557 cases). The adjusted hazard ratios (95% confidence intervals) of VTE across Visit 4 heart rate categories of <60, 60 to 69, 70 to 79, and ≥80 bpm were 1 (reference), 1.22 (1.01‐1.49), 1.39 (1.09‐1.78), and 1.44 (1.01‐2.06), respectively, and when evaluated continuously 1.11 (1.02‐1.21) per 10 bpm greater heart rate. For the most part, HRV indices were not associated with VTE or associations were explained by inverse correlations of HRV indices with heart rate. Conclusion We found a significant positive and independent association of resting heart rate at ARIC Visit 4 with incidence of VTE. The reason why high heart rate is a risk marker for VTE warrants further exploration.