Resting heart rate and decline in cognitive function: observations from the ONTARGET/TRANSCEND studies
Bibliographic record
Abstract
Background: Higher resting heart rate (RHR), even within the normal range, has been associated with adverse cardiovascular outcomes. Recently, RHR was shown predictive of cognitive decline among patients with ischaemic stroke. It is not known whether RHR is linked with cognitive decline in a broader population. Purpose: We hypothesised that RHR is independently associated with decline in cognitive function in patients with elevated cardiovascular risk. Methods: We conducted a post hoc analysis of patients enrolled in parallel multicentre trials that randomised participants with vascular disease or diabetes mellitus to telmisartan, ramipril, or their combination; and to telmisartan or placebo in those intolerant of angiotensin converting enzyme inhibitors. Cognitive function was evaluated by Mini-Mental State Examination (MMSE) at randomisation, 2 years, and at final follow-up (median 4.7 years). Cognitive decline was defined as a fall of ≥3 points from baseline to either follow-up MMSE. RHR was categorised by quartiles (<60, 60-66, 67-74, and ≥75bpm). Multiple logistic regression was performed with adjustment for baseline covariates including demographics, cardiovascular comorbidities, tobacco use, alcohol consumption, pharmacotherapy (including negative chronotropes), physical activity level, ethnicity, education level, depressive symptoms, dietary habits, blood pressure, anthropometrics, renal function, serum lipid concentrations, left ventricular hypertrophy and baseline MMSE score. Results: In 27 860 subjects with baseline and follow-up MMSE, mean age was 66±7.1 years and 8146 (29%) were female. Baseline MMSE score in ascending RHR groups was 27.8±2.60; 27.7±2.80; 27.6±2.92; and 27.4±3.22. Over follow-up, 4699 (17%) subjects exhibited cognitive decline. Compared with RHR <60bpm, the adjusted odds ratios (95% CI) for cognitive decline were 1.04 (0.940-1.15) for RHR 60-66; 1.16 (1.05-1.28) for HR of 67-74; and 1.15 (1.04-1.28) for HR ≥75bpm respectively. For every 10bpm increase in RHR, the unadjusted and adjusted odds ratios (95% CI) for cognitive decline were 1.08 (1.05-1.11); and 1.04 (1.01-1.08) respectively. Conclusions: RHR is independently associated with cognitive decline and may be an important risk marker. Further research is needed to determine the nature of this association and whether RHR represents a therapeutic target to prevent cognitive decline.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".