Skip to main content
SpringerLink
Log in

Associations between elevated resting heart rate and subclinical atherosclerosis in asymptomatic Korean adults undergoing coronary artery calcium scoring

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Elevated resting heart rate (RHR) and the presence of coronary artery calcium (CAC) are closely related with inflammatory activity and cardiovascular disease outcomes. To date, however, the relationship between a high RHR and CAC has not been well studied, especially in non-western populations. We therefore aimed to examine the cross-sectional relationship between high RHR and the burden of subclinical atherosclerosis as measured by CAC score in a large sample of Korean adults. A total 26,018 subjects were enrolled and underwent CAC screening as part of a broader general health examination. RHR was categorized into four groups as: <60, 60–69, 70–79, and ≥80 beats per minute. Multivariable logistic regression models were employed to estimate the odds of having a CAC score of either >0, >100, or >400 based on RHR. Mean age of the study population was 53.9 ± 8.2 years, and 79.7 % were male. After adjustment, each 10 beat per minute increment in RHR was associated with greater odds of having a CAC score above 100 (OR 1.13, 95 % CI 1.08–1.18) or 400 (OR 1.22, 95 % CI 1.13–1.31). Likewise, following adjustment, the odds of having a CAC >100 or >400 for those with a RHR ≥80 beats per minute were 1.42 (95 % CI 1.19–1.69) and 1.86 (95 % CI 1.42–2.47), respectively, compared with those who had a RHR <60 beats per minute. In a large cohort of Korean adults, elevations in the RHR, particularly above 80 beats per minute, were found to be independently associated with the presence of subclinical atherosclerosis as measured by CAC scoring.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Palatini P, Julius S (1997) Association of tachycardia with morbidity and mortality: pathophysiological considerations. J Hum Hypertens 11(Suppl 1):S19–S27

    PubMed  Google Scholar 

  2. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetiere P (2005) Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 352(19):1951–1958. doi:10.1056/NEJMoa043012

    Article  CAS  PubMed  Google Scholar 

  3. o Hartaigh B, Bosch JA, Pilz S, Loerbroks A, Kleber ME, Grammer TB, Fischer JE, Boehm BO, Thomas GN, Marz W (2012) Influence of resting heart rate on mortality in patients undergoing coronary angiography (from the Ludwigshafen Risk and Cardiovascular Health [LURIC] study). Am J Cardiol 110(4):515–520. doi:10.1016/j.amjcard.2012.03.050

    Article  PubMed  Google Scholar 

  4. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A (2007) 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens 25(9):1751–1762. doi:10.1097/HJH.0b013e3282f0580f

    Article  CAS  PubMed  Google Scholar 

  5. Cooney MT, Vartiainen E, Laatikainen T, Juolevi A, Dudina A, Graham IM (2010) Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women. Am Heart J 159(4):612–619.e613. doi:10.1016/j.ahj.2009.12.029

    Article  PubMed  Google Scholar 

  6. Dzau VJ (2001) Theodore Cooper Lecture: tissue angiotensin and pathobiology of vascular disease: a unifying hypothesis. Hypertension 37(4):1047–1052

    Article  CAS  PubMed  Google Scholar 

  7. Feldman CL, Ilegbusi OJ, Hu Z, Nesto R, Waxman S, Stone PH (2002) Determination of in vivo velocity and endothelial shear stress patterns with phasic flow in human coronary arteries: a methodology to predict progression of coronary atherosclerosis. Am Heart J 143(6):931–939

    Article  PubMed  Google Scholar 

  8. Giannoglou GD, Chatzizisis YS, Zamboulis C, Parcharidis GE, Mikhailidis DP, Louridas GE (2008) Elevated heart rate and atherosclerosis: an overview of the pathogenetic mechanisms. Int J Cardiol 126(3):302–312. doi:10.1016/j.ijcard.2007.08.077

    Article  PubMed  Google Scholar 

  9. Libby P (2002) Inflammation in atherosclerosis. Nature 420(6917):868–874. doi:10.1038/nature01323

    Article  CAS  PubMed  Google Scholar 

  10. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832

    Article  CAS  PubMed  Google Scholar 

  11. Wexler L, Brundage B, Crouse J, Detrano R, Fuster V, Maddahi J, Rumberger J, Stanford W, White R, Taubert K (1996) Coronary artery calcification: pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation 94(5):1175–1192

    Article  CAS  PubMed  Google Scholar 

  12. Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS (1995) Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation 92(8):2157–2162

    Article  CAS  PubMed  Google Scholar 

  13. Sangiorgi G, Rumberger JA, Severson A, Edwards WD, Gregoire J, Fitzpatrick LA, Schwartz RS (1998) Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol 31(1):126–133

    Article  CAS  PubMed  Google Scholar 

  14. Breen JF, Sheedy PF 2nd, Schwartz RS, Stanson AW, Kaufmann RB, Moll PP, Rumberger JA (1992) Coronary artery calcification detected with ultrafast CT as an indication of coronary artery disease. Radiology 185(2):435–439. doi:10.1148/radiology.185.2.1410350

    Article  CAS  PubMed  Google Scholar 

  15. Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291(2):210–215. doi:10.1001/jama.291.2.210

    Article  CAS  PubMed  Google Scholar 

  16. Taylor AJ, Bindeman J, Feuerstein I, Cao F, Brazaitis M, O’Malley PG (2005) Coronary calcium independently predicts incident premature coronary heart disease over measured cardiovascular risk factors: mean three-year outcomes in the Prospective Army Coronary Calcium (PACC) project. J Am Coll Cardiol 46(5):807–814. doi:10.1016/j.jacc.2005.05.049

    Article  CAS  PubMed  Google Scholar 

  17. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345. doi:10.1056/NEJMoa072100

    Article  CAS  PubMed  Google Scholar 

  18. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F (2012) European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 33(13):1635–1701. doi:10.1093/eurheartj/ehs092

    Article  CAS  PubMed  Google Scholar 

  19. Goff DC, Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith SC, Jr., Sorlie P, Stone NJ, Wilson PW, Jordan HS, Nevo L, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC, Jr., Tomaselli GF, American College of Cardiology/American Heart Association Task Force on Practice Guidelines (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129 (25 Suppl 2):S49–S73. doi:10.1161/01.cir.0000437741.48606.98

    Article  PubMed  Google Scholar 

  20. Jenny NS, Brown ER, Detrano R, Folsom AR, Saad MF, Shea S, Szklo M, Herrington DM, Jacobs DR Jr (2010) Associations of inflammatory markers with coronary artery calcification: results from the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 209(1):226–229. doi:10.1016/j.atherosclerosis.2009.08.037

    Article  CAS  PubMed  Google Scholar 

  21. Raaz-Schrauder D, Klinghammer L, Baum C, Frank T, Lewczuk P, Achenbach S, Cicha I, Stumpf C, Wiltfang J, Kornhuber J, Daniel WG, Garlichs CD (2012) Association of systemic inflammation markers with the presence and extent of coronary artery calcification. Cytokine 57(2):251–257. doi:10.1016/j.cyto.2011.11.015

    Article  CAS  PubMed  Google Scholar 

  22. Hamirani YS, Pandey S, Rivera JJ, Ndumele C, Budoff MJ, Blumenthal RS, Nasir K (2008) Markers of inflammation and coronary artery calcification: a systematic review. Atherosclerosis 201(1):1–7. doi:10.1016/j.atherosclerosis.2008.04.045

    Article  CAS  PubMed  Google Scholar 

  23. Palatini P (2009) Elevated heart rate: a “new” cardiovascular risk factor? Prog Cardiovasc Dis 52(1):1–5. doi:10.1016/j.pcad.2009.06.001

    Article  PubMed  Google Scholar 

  24. Budoff MJ, Nasir K, McClelland RL, Detrano R, Wong N, Blumenthal RS, Kondos G, Kronmal RA (2009) Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 53(4):345–352. doi:10.1016/j.jacc.2008.07.072

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Mohlenkamp S, Lehmann N, Schmermund A, Roggenbuck U, Moebus S, Dragano N, Bauer M, Kalsch H, Hoffmann B, Stang A, Brocker-Preuss M, Bohm M, Mann K, Jockel KH, Erbel R (2009) Association of exercise capacity and the heart rate profile during exercise stress testing with subclinical coronary atherosclerosis: data from the Heinz Nixdorf Recall study. Clin Res Cardiol 98(10):665–676. doi:10.1007/s00392-009-0054-9

    Article  PubMed  Google Scholar 

  26. Rubin J, Blaha MJ, Budoff MJ, Rivera JJ, Shaw LJ, Blankstein R, Mallah MA, Carr JJ, Jones DL, Blumenthal RS, Nasir K (2012) The relationship between resting heart rate and incidence and progression of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 220(1):194–200. doi:10.1016/j.atherosclerosis.2011.06.033

    Article  CAS  PubMed  Google Scholar 

  27. o Hartaigh B, Bosch JA, Carroll D, Hemming K, Pilz S, Loerbroks A, Kleber ME, Grammer TB, Fischer JE, Boehm BO, Marz W, Thomas GN (2013) Evidence of a synergistic association between heart rate, inflammation, and cardiovascular mortality in patients undergoing coronary angiography. Eur Heart J 34(12):932–941. doi:10.1093/eurheartj/ehs396

    Article  CAS  PubMed  Google Scholar 

  28. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ (2000) The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 525(Pt 1):263–270

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Nauman J, Janszky I, Vatten LJ, Wisloff U (2011) Temporal changes in resting heart rate and deaths from ischemic heart disease. JAMA 306(23):2579–2587. doi:10.1001/jama.2011.1826

    Article  CAS  PubMed  Google Scholar 

  30. Makita S, Onoda T, Ohsawa M, Tanno K, Tanaka F, Omama S, Yoshida Y, Ishibashi Y, Itai K, Sakata K, Ohta M, Kuribayashi T, Ogasawara K, Ogawa A, Okayama A, Nakamura M (2014) Bradycardia is associated with future cardiovascular diseases and death in men from the general population. Atherosclerosis 236(1):116–120. doi:10.1016/j.atherosclerosis.2014.06.024

    Article  CAS  PubMed  Google Scholar 

  31. Vogel CU, Wolpert C, Wehling M (2004) How to measure heart rate? Eur J Clin Pharmacol 60(7):461–466. doi:10.1007/s00228-004-0795-3

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (MSIP; 2012027176) and funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation.

Author information

Authors and Affiliations

  1. Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medicine, 413 E. 69th Street, New York, NY, 10021, USA

    Donghee Han, Ji Hyun Lee, Asim Rizvi, Lohendran Baskaran, James K. Min & Bríain ó Hartaigh

  2. Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Donghee Han, Ji Hyun Lee & Hyuk-Jae Chang

  3. Department of Internal Medicine, Seoul National University Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Republic of Korea

    Hyo Eun Park & Su-Yeon Choi

  4. Department of Radiology, Seoul National University Bundang Hospital, Seoul, Republic of Korea

    Eun Ju Chun

  5. Division of Cardiology, Department of Medicine, Heart Stroke & Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jidong Sung

  6. Department of Radiology, Gangnam Heartscan Clinic, Seoul, Republic of Korea

    Sung Hak Park

  7. Department of Internal Medicine, Gangnam Heartscan Clinic, Seoul, Republic of Korea

    Hae-Won Han

Authors
  1. Donghee Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ji Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Asim Rizvi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lohendran Baskaran
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hyo Eun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Su-Yeon Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eun Ju Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jidong Sung
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sung Hak Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hae-Won Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. James K. Min
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hyuk-Jae Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Bríain ó Hartaigh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Hyuk-Jae Chang or Bríain ó Hartaigh.

Ethics declarations

Conflict of interest

All authors declare that they have no conflicts.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Han, D., Lee, J.H., Rizvi, A. et al. Associations between elevated resting heart rate and subclinical atherosclerosis in asymptomatic Korean adults undergoing coronary artery calcium scoring. Int J Cardiovasc Imaging 32, 1587–1593 (2016). https://doi.org/10.1007/s10554-016-0944-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-016-0944-7

Keywords

Search

Navigation