AIMS: Elevated resting heart rate (RHR) is a known, independent cardiovascular (CV) risk factor, but is not included in risk estimation systems, including Systematic COronary Risk Evaluation (SCORE). We aimed to derive risk estimation systems including RHR as an extra variable and assess the value of this addition. METHODS AND RESULTS: The National FINRISK study (including 14,997 men and 15,861 women) was used to derive two formulas for estimation of 10 year risk of CV disease (CVD) mortality. The first formula contained current SCORE variables-total cholesterol, systolic blood pressure, smoking, age and gender. Inclusion of RHR resulted in only minor improvements in discrimination, based on both area under receiver operating characteristic curve (AUROC, men: 0.840 from 0.838, P = 0.5038; women: 0.87 from 0.865, P = 0.0522) and net reclassification index (NRI). The second, simplified formula contained only, age, smoking, gender, and body mass index. Addition of RHR to this simplified formula resulted in a statistically significant and meaningful improvement in AUROC (men: 0.819 from 0.812, P = 0.037; women: 0.862 from 0.827, P = 0.023) and NRI (0.05). Calibration also improved. A simple chart for estimating 10 year risk of fatal CVD including RHR is presented. CONCLUSION: Addition of RHR to formulas already containing lipid and blood pressure measures does not appreciably improve risk estimation. However, inclusion of RHR in simple systems, which can potentially enhance cost-effectiveness and accessibility of risk estimation, is useful.
AIMS: Elevated resting heart rate (RHR) is a known, independent cardiovascular (CV) risk factor, but is not included in risk estimation systems, including Systematic COronary Risk Evaluation (SCORE). We aimed to derive risk estimation systems including RHR as an extra variable and assess the value of this addition. METHODS AND RESULTS: The National FINRISK study (including 14,997 men and 15,861 women) was used to derive two formulas for estimation of 10 year risk of CV disease (CVD) mortality. The first formula contained current SCORE variables-total cholesterol, systolic blood pressure, smoking, age and gender. Inclusion of RHR resulted in only minor improvements in discrimination, based on both area under receiver operating characteristic curve (AUROC, men: 0.840 from 0.838, P = 0.5038; women: 0.87 from 0.865, P = 0.0522) and net reclassification index (NRI). The second, simplified formula contained only, age, smoking, gender, and body mass index. Addition of RHR to this simplified formula resulted in a statistically significant and meaningful improvement in AUROC (men: 0.819 from 0.812, P = 0.037; women: 0.862 from 0.827, P = 0.023) and NRI (0.05). Calibration also improved. A simple chart for estimating 10 year risk of fatal CVD including RHR is presented. CONCLUSION: Addition of RHR to formulas already containing lipid and blood pressure measures does not appreciably improve risk estimation. However, inclusion of RHR in simple systems, which can potentially enhance cost-effectiveness and accessibility of risk estimation, is useful.
Authors: Matthew A Allison; Joann E Manson; Aaron Aragaki; Charles B Eaton; Judith Hsai; Lawrence Phillips; Lewis Kuller; Maurizio Trevisan Journal: J Womens Health (Larchmt) Date: 2011-03-25 Impact factor: 2.681
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Authors: Allan Linneberg; Rikke K Jacobsen; Tea Skaaby; Amy E Taylor; Meg E Fluharty; Jørgen L Jeppesen; Johan H Bjorngaard; Bjørn O Åsvold; Maiken E Gabrielsen; Archie Campbell; Riccardo E Marioni; Meena Kumari; Pedro Marques-Vidal; Marika Kaakinen; Alana Cavadino; Iris Postmus; Tarunveer S Ahluwalia; S Goya Wannamethee; Jari Lahti; Katri Räikkönen; Aarno Palotie; Andrew Wong; Christine Dalgård; Ian Ford; Yoav Ben-Shlomo; Lene Christiansen; Kirsten O Kyvik; Diana Kuh; Johan G Eriksson; Peter H Whincup; Hamdi Mbarek; Eco J C de Geus; Jacqueline M Vink; Dorret I Boomsma; George Davey Smith; Debbie A Lawlor; Aliaksei Kisialiou; Alex McConnachie; Sandosh Padmanabhan; J Wouter Jukema; Chris Power; Elina Hyppönen; Martin Preisig; Gerard Waeber; Peter Vollenweider; Tellervo Korhonen; Tiina Laatikainen; Veikko Salomaa; Jaakko Kaprio; Mika Kivimaki; Blair H Smith; Caroline Hayward; Thorkild I A Sørensen; Betina H Thuesen; Naveed Sattar; Richard W Morris; Pål R Romundstad; Marcus R Munafò; Marjo-Riitta Jarvelin; Lise Lotte N Husemoen Journal: Circ Cardiovasc Genet Date: 2015-11-04