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Association of Early-Life Factors With Life-Course Trajectories of Resting Heart Rate

Authors
  • O’Hare, Celia1
  • Kuh, Diana1
  • Hardy, Rebecca1
  • 1 Medical Research Council Unit for Lifelong Health and Ageing at University College London, United Kingdom
Type
Published Article
Journal
JAMA Pediatrics
Publisher
American Medical Association
Publication Date
Feb 12, 2018
Volume
172
Issue
4
Identifiers
DOI: 10.1001/jamapediatrics.2017.5525
PMID: 29435577
PMCID: PMC5875352
Source
PubMed Central
License
Unknown
External links

Abstract

Importance Higher resting heart rate (RHR) is associated with increased risk of cardiovascular and all-cause mortality. Limited attention has been paid to early-life determinants of life-course RHR. Objective To describe trajectories of RHR in the same individuals from age 6 to 69 years. Design, Setting, and Participants Data were from the Medical Research Council National Survey of Health and Development population-based cohort of individuals who were followed up from birth in 1946 until 2015. Analysis was conducted between September 2016 and June 2017. Multilevel models were used to estimate life-course mean RHR trajectory by sex and to investigate associations with early childhood factors. The maximal sample included participants who had at least 1 measure of RHR since study entry and a measure of birth weight (N = 4779; observations = 26 182). Exposures Information on early-life factors was ascertained prospectively: childhood socioeconomic position, birth weight, body mass index (calculated as weight in kilograms divided by height in meters squared) change from age 2 to 6 years (conditioned on body mass index at age 2 years), duration of breastfeeding, and markers of neurodevelopment (age at first walking independently and cognitive ability at age 8 years). Main Outcomes and Measures Resting heart rate measured on 8 occasions between age 6 and 69 years (3 occasions in childhood and 5 in adulthood). Results Of 4779 participants, 2492 (52.1%) were women, and 2287 (47.9%) were men. Mean estimated RHR decreased with increasing age and plateaued in adulthood. In sex-adjusted analyses, higher birth weight and conditional body mass index change were associated with lower RHR at age 6 years and across the life course (–0.56 bpm [95% CI, –0.95 to –0.17] per 1 kg higher birth weight and –0.30 bpm [95% CI, –0.48 to –0.13] per 1 kg/m2 change in body mass index). Associations between socioeconomic position and breastfeeding on RHR trajectory emerged in adulthood such that by age 69 years, RHR was 1.48 bpm (95% CI, 0.45 to 2.51) higher in participants from a disadvantaged vs advantaged background and –1.34 bpm (95% CI, –2.39 to –0.29) lower for those who were breastfed for 8 months or longer vs never. A later age at first walking was associated with higher RHR at age 6 years (1.49 bpm [95% CI, 0.39 to 2.59] higher for those 18 months or older vs those younger than 12 months) but with lower RHR in adulthood (–1.18 bpm [95% CI, –2.75 to 0.39] at age 69 years). Conclusions and Relevance Early life is a key period in determining future RHR trajectories with associations with potentially modifiable factors persisting into the seventh decade of life.

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