O'Hare, C;
Kuh, D;
Hardy, R;
(2018)
Association of Early-Life Factors With Life-Course Trajectories of Resting Heart Rate More Than 6 Decades of Follow-up.
JAMA Pediatrics
, 172
(4)
10.1001/jamapediatrics.2017.5525.
(In press).
Text
jamapediatrics_OHare_2018_oi_170110.pdf - Published Version Access restricted to UCL open access staff Download (383kB) |
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.
Type: | Article |
---|---|
Title: | Association of Early-Life Factors With Life-Course Trajectories of Resting Heart Rate More Than 6 Decades of Follow-up |
DOI: | 10.1001/jamapediatrics.2017.5525 |
Publisher version: | http://dx.doi.org/10.1001/jamapediatrics.2017.5525 |
Language: | English |
Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
Keywords: | Science & Technology, Life Sciences & Biomedicine, Pediatrics, SYMPATHETIC-NERVOUS-SYSTEM, ADULT-BLOOD PRESSURE, BRITISH BIRTH COHORT, MENDELIAN RANDOMIZATION, CARDIOVASCULAR-DISEASE, RISK-FACTORS, CHILDHOOD, WEIGHT, EPIDEMIOLOGY, DETERMINANTS |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science |
URI: | https://discovery.ucl.ac.uk/id/eprint/10048113 |
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