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Reference ranges for ambulatory heart rate measurements in a middle-aged population

Persson, Anders Paul LU orcid ; Måneheim, Alexandra LU ; Economou Lundeberg, Johan LU orcid ; Fedorowski, Artur LU orcid ; Healey, Jeff S ; Sundström, Johan ; Engström, Gunnar LU and Johnson, Linda S B LU (2024) In Heart p.1-7
Abstract

BACKGROUND: Elevated heart rate (HR) predicts cardiovascular disease and mortality, but there are no established normal limits for ambulatory HR. We used data from the Swedish CArdioPulmonary Imaging Study to determine reference ranges for ambulatory HR in a middle-aged population. We also studied clinical correlates of ambulatory HR.

METHODS: A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50-65 years. A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease).Minimum HR was defined as the lowest 1-minute HR. Reference ranges are... (More)

BACKGROUND: Elevated heart rate (HR) predicts cardiovascular disease and mortality, but there are no established normal limits for ambulatory HR. We used data from the Swedish CArdioPulmonary Imaging Study to determine reference ranges for ambulatory HR in a middle-aged population. We also studied clinical correlates of ambulatory HR.

METHODS: A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50-65 years. A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease).Minimum HR was defined as the lowest 1-minute HR. Reference ranges are reported as means±SDs and 2.5th-97.5th percentiles. Clinical correlates of ambulatory HR were analysed with multivariable linear regression.

RESULTS: The average mean and minimum HRs were 73±9 and 48±7 beats per minute (bpm) in men and 76±8 and 51±7 bpm in women; the reference range for mean ambulatory HR was 57-90 bpm in men and 61-92 bpm in women. Average daytime and night-time HRs are also reported. Clinical correlates, including age, sex, height, body mass index, physical activity, smoking, alcohol intake, diabetes, hypertension, haemoglobin level, use of beta-blockers, estimated glomerular filtration rate, per cent of predicted forced expiratory volume in 1 s and coronary artery calcium score, explained <15% of the interindividual differences in HR.

CONCLUSION: Ambulatory HR varies widely in healthy middle-aged individuals, a finding with relevance for the management of patients with a perception of tachycardia. Differences in ambulatory HR between individuals are largely independent of common clinical correlates.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Heart
pages
1 - 7
publisher
BMJ Publishing Group
external identifiers
  • scopus:85189967515
  • pmid:38580434
ISSN
1355-6037
DOI
10.1136/heartjnl-2023-323681
language
English
LU publication?
yes
additional info
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
id
45f2b045-4703-4978-a9e3-049b3a9e4b1f
date added to LUP
2024-04-08 18:17:28
date last changed
2024-04-16 04:00:18
@article{45f2b045-4703-4978-a9e3-049b3a9e4b1f,
  abstract     = {{<p>BACKGROUND: Elevated heart rate (HR) predicts cardiovascular disease and mortality, but there are no established normal limits for ambulatory HR. We used data from the Swedish CArdioPulmonary Imaging Study to determine reference ranges for ambulatory HR in a middle-aged population. We also studied clinical correlates of ambulatory HR.</p><p>METHODS: A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50-65 years. A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease).Minimum HR was defined as the lowest 1-minute HR. Reference ranges are reported as means±SDs and 2.5th-97.5th percentiles. Clinical correlates of ambulatory HR were analysed with multivariable linear regression.</p><p>RESULTS: The average mean and minimum HRs were 73±9 and 48±7 beats per minute (bpm) in men and 76±8 and 51±7 bpm in women; the reference range for mean ambulatory HR was 57-90 bpm in men and 61-92 bpm in women. Average daytime and night-time HRs are also reported. Clinical correlates, including age, sex, height, body mass index, physical activity, smoking, alcohol intake, diabetes, hypertension, haemoglobin level, use of beta-blockers, estimated glomerular filtration rate, per cent of predicted forced expiratory volume in 1 s and coronary artery calcium score, explained &lt;15% of the interindividual differences in HR.</p><p>CONCLUSION: Ambulatory HR varies widely in healthy middle-aged individuals, a finding with relevance for the management of patients with a perception of tachycardia. Differences in ambulatory HR between individuals are largely independent of common clinical correlates.</p>}},
  author       = {{Persson, Anders Paul and Måneheim, Alexandra and Economou Lundeberg, Johan and Fedorowski, Artur and Healey, Jeff S and Sundström, Johan and Engström, Gunnar and Johnson, Linda S B}},
  issn         = {{1355-6037}},
  language     = {{eng}},
  month        = {{04}},
  pages        = {{1--7}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Heart}},
  title        = {{Reference ranges for ambulatory heart rate measurements in a middle-aged population}},
  url          = {{http://dx.doi.org/10.1136/heartjnl-2023-323681}},
  doi          = {{10.1136/heartjnl-2023-323681}},
  year         = {{2024}},
}