abstract and keys words for the abstract

SLIDE # 1

Results:

· 523 records were reviewed in full.

· 478 records were excluded for other reasons

· 45 prospective cohort studies were included in this meta-analysis

· 5 studies (38 studies in general populations and 7 studies in populations of patients with hypertension or diabetes

· 30 provided results for coronary artery disease (1 227 511 participants and 18 364 cases)

· 17 provided results for stroke (1 002 667 participants and 11 515 cases

· 12 provided results for non-cardiovascular diseases (443 192 participants and 12 749 cases)

· 10 pro- vided results for all types of cancer (115 388 participants and 5714 cases),

· 7 provided results for non-cardiovascular diseases excluding cancer (81 332 participants and 2174 cases)

· 7 provided results for sudden death (426 332 participants and 563 deaths).

Follow-up duration ranged from 2 to 40 years.

SLIDE # 2

Discussion:

· High resting heart rate is a marker of sympa-thetic overactivity

· Insulin resistance

· High levels of uric acid

· Lipid abnormalities

· Hypertension

· High resting heart rate could increase hemodynamic stress and shorten the diastolic phase

· Increase mechanical load,

· tensile stress

· low and oscillatory shear stress

· blood pressure and cardiac work

· Increased oxygen consumption

· These direct detrimental effects could cause coronary athero- sclerosis and myocardial ischemia

Group Presentation

Literature Review

Key Points for PowerPoint:

· Heart rate reflects the balance on sympathetic and parasympathetic activity.

· High natural resting heart rate is associated with risk factors.

· Importance of resting heart rate has been recognized.

· High Resting heart rate is a sign of over activity which is associated with an increased risk of sudden death

Heart rate reflects the balance on sympathetic and parasympathetic activity. High natural resting heart rate is associated with traditional risk factors for cardiovascular diseases, levels of inflammatory markers, and functional decline. A high rate can be a marker of sympathetic overactivity, which is associated with an increased risk of sudden death that usually results from ventricular fibrillation. Sympathetic overactivity may increase risk of obesity that could induce insulin resistance. A high resting heart rate could increase stress which can increase mechanical load, tensile stress, blood pressure, and cardiac work.

Research Method

Key points for PowerPoint:

· Meta-analysis method. Virtual library through MRU home page. Researcher accessed EBSCOhost and selected both Medline and CINAHL. Following keywords were entered “Heart rate”, “Coronary artery disease”, and “Non-cardiovascular”. Search was limited to full text, peer reviews, and abstract available. Published within the last five years.

For this study, a meta-analysis method was used to synthesize different results found among several studies. The researcher accessed the virtual library through the MRU home page. Then, the researcher accessed the EBSCOhost databases. Once there, the researcher selected both MEDLINE Complete and CINAHL Complete. An advanced search was performed, for which the following keywords were entered in the Boolean search: “Heart rate”, “Coronary artery disease”, and “non-cardiovascular” The search was limited to references providing full text, peer reviewed, and abstract available. A limitation was set for research published within the last five years, from March 2016 to March 2021. Additionally, researcher consulted only articles published in English and Spanish. The search provided access to a total of 4 articles, of which only seven (1) studies were selected based on their relevance with the topic; the other 3 were discarded.

Limitation and Implications

This study suffered some limitations first a meta-analysis method was used to synthesize different results found among several studies.

2nd night-time heart rate has better prognostic value than resting heart rate in a population with no apparent heart diseases and in people with hypertension.

In addition, some studies did not exclude participants with prevalent cardiovascular diseases and noncardiovascular diseases.

As such, we were not studying the incidence of disease.

However, we obtained similar cardiovascular-specific results after excluding participants with cardiovascular diseases

Because of the small sample size, no association with heart failure was found in the sensitivity analysis.

In addition, a positive association was detected in 2 studies that did not meet the criteria for the inclusion in this meta-analysis.

Conclusion

Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all the studies combined.

When the analysis included only studies concerning general populations, resting heart rate was not associated with sudden death.

Further studies are fair to confirm the findings in patients with hypertension or diabetes (because of the importance of reducing heart rate in these patients) and to explore the association between resting heart rate and sudden death,

Measuring resting heart rate is worth considering in risk prediction algorithms for coronary artery disease and cancer.

Although there were no trials available focusing on the effect of heart rate reduction on outcomes in the general population, our results indicate the need to consider such a trial.