Association of Asymptomatic XXXX With Incident @entity65 and Mortality: The Multi-Ethnic Study of @entity731 (MESA).

@entity1 @entity731 @entity1168 @entity65
Importance: @entity1168 has been associated with lower @entity65 ( @entity65 ) risk in selected populations. There is a paucity of information available about heart rate (HR) less than 50 beats per minute (bpm) among middle-aged or older adults. Objective: To determine whether asymptomatic @entity1168 was associated with a lower cardiovascular risk profile, less subclinical @entity731 , and decreased incident @entity65 and mortality. Design, Setting, and @entity1 : This retrospective analysis includes 6733 @entity1 of the Multi-Ethnic Study of @entity731 , which recruited @entity1 and @entity1 free of clinical @entity65 ages 45 to 84 years from 2000 to 2002 and followed them over 10 years for incident @entity65 events and mortality. The HR was measured by baseline electrocardiogram. The analysis was performed in June 2014. Main Outcomes and Measures: The association between HR categories with @entity65 events and all-cause mortality were examined using Cox proportional hazards models adjusted for potential confounders and mediators. Results: The 6733 @entity1 had a mean (SD) age of 62 (10.2) years; 47% were male. The mean (SD) HR was 63 (9.5) bpm among the 5831 @entity1 not taking an HR-modifying drug; 5.3% had an HR lower than 50 bpm. Preliminary results revealed significant interaction for HR categories according to use of HR-modifying drugs for mortality (P   =   .002); thus, all further analyses were stratified. An HR of less than 50 bpm was not associated with incident @entity65 in either subgroup ( @entity1 taking or not taking HR-modifying drugs). Among @entity1 not taking HR-modifying drugs, the fully adjusted mortality risk was not different for an HR less than 50 bpm (hazard ratio, 0.71 [95% CI, 0.41-1.09]; P   =   .12) and increased among those with an HR greater than 80 bpm (hazard ratio, 1.49 [95% CI, 1.08-2.05]; P   =   .01) (reference HR, 60-69 bpm). Among the 902 @entity1 taking HR-modifying drugs there was an elevated mortality risk associated with an HR less than 50 bpm (hazard ratio, 2.42 [95% CI, 1.39-4.20]; P   =   .002) and with an HR greater than 80 bpm (hazard ratio, 3.55 [95% CI, 1.65-7.65]; P   =   .001) (reference HR, 60-69 bpm). Conclusions and Relevance: In a contemporary, community-based cohort, @entity1168 was generally not associated with incident @entity65 or mortality except for a potential adverse association between @entity1168 among those taking HR-modifying drugs.
