Higher orthostatic heart rate predicts mortality: The Irish Longitudinal Study on Ageing (TILDA).

ABSTRACT

BACKGROUND: Orthostatic hemodynamic signals may predict adverse outcomes in elders. AIMS: To study the association between orthostatic hemodynamics and incident mortality in The Irish Longitudinal Study on Ageing (TILDA). METHODS: Wave 1 subjects underwent an active stand with non-invasive beat-to-beat blood pressure monitoring. We compared wave 1 active stands, dead vs alive in wave 2. RESULTS: Compared to the 4,415 participants who had not died, the 53 who had died had a higher baseline heart rate [HR mean of 69 vs 65 beats per minute (bpm)] and a higher mean orthostatic HR, especially between 30 and 60 s post-stand (mean of 79 vs 73 bpm). After adjusting for age, sex, baseline HR, mini-mental state examination score and cardiovascular comorbidities and medications, the mean HR between 30 and 60 s post-stand independently predicted mortality (baseline HR did not). DISCUSSION: Higher early orthostatic HR may be an independent risk marker. Further validation is required.