Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly
Open accessAbstract
Background and Purpose—: Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke. Methods—: The study cohort consisted of 680 participants (mean age, 73±7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed. Results—: Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was −0.92±0.93 (median, −1.05; min, −5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03–1.61; P =0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct. Conclusions—: In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Pulse rate is an independent risk factor for cardiovascular outcomes and mortality.
“Furthermore, several studies, including the DCCT/EDIC, have established pulse rate as an independent risk factor for cardiovascular outcomes and mortality [23, 25–28].”
From Cardiovascular autonomic neuropathy defined by indices of heart rate variability is associated with cardiovascular disease: a longitudinal cohort study of participants with type 1 diabetes (2025) · cites this paper as [26]
The Discussion (page unavailable) reports that increased heart rate is associated with cardiovascular events and mortality, and cites a study finding an association with cardiovascular events after multivariable adjustment. It does not establish an independent association with mortality; this paper’s own adjusted analysis concerns subclinical cerebrovascular disease, not cardiovascular events or death. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Lang, R., Badano, L., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., Flachskampf, F., Foster, E., Goldstein, S., Kuznetsova, T., et al. (2015) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2014.10.003 · Cited by 10,093 · see citing works
Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method.
Devereux, R. B., & Reichek, N. (1977) · Circulation · doi:10.1161/01.cir.55.4.613 · Cited by 4,499 · see citing works
Pantoni, L. (2010) · The Lancet Neurology · doi:10.1016/s1474-4422(10)70104-6 · Cited by 3,405 · see citing works
Silent Brain Infarcts and the Risk of Dementia and Cognitive Decline
Vermeer, S. E., Prins, N. D., den Heijer, T., Hofman, A., Koudstaal, P. J., & Breteler, M. M. B. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022066 · Cited by 2,313 · see citing works
Heart rate and cardiovascular mortality: The Framingham study
Kannel, W. B., Kannel, C., Paffenbarger, R. S., & Cupples, L. A. (1987) · American Heart Journal · doi:10.1016/0002-8703(87)90666-1 · Cited by 1,292 · see citing works
Resting Heart Rate in Cardiovascular Disease
Fox, K., Borer, J. S., Camm, A. J., Danchin, N., Ferrari, R., Lopez Sendon, J. L., Steg, P. G., Tardif, J.-C., Tavazzi, L., & Tendera, M. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.04.079 · Cited by 1,062 · see citing works
Silent Brain Infarcts and White Matter Lesions Increase Stroke Risk in the General Population
Vermeer, S. E., Hollander, M., van Dijk, E. J., Albert Hofman, D., Koudstaal, P. J., & Breteler, M. M. B. (2003) · Stroke · doi:10.1161/01.str.0000068408.82115.d2 · Cited by 883 · see citing works
Pulse rate, coronary heart disease, and death: The NHANES I Epidemiologic Follow-up Study
Gillum, R. F., Makuc, D. M., & Feldman, J. J. (1991) · American Heart Journal · doi:10.1016/0002-8703(91)90970-s · Cited by 405 · see citing works
Influence of Heart Rate on Mortality in a French Population: Role of Age, Gender, and Blood Pressure
Benetos, A., Rudnichi, A., Thomas, F., Safar, M., & Guize, L. (1999) · Hypertension · doi:10.1161/01.hyp.33.1.44 · Cited by 356 · see citing works
Greenland, P., Daviglus, M. L., Dyer, A. R., Liu, K., Huang, C., Goldberger, J. J., & Stamler, J. F. (1999) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009901 · Cited by 319 · see citing works
White Matter Hyperintensity on Cranial Magnetic Resonance Imaging
Kuller, L. H., Longstreth, W. T., Jr., Arnold, A. M., Bernick, C. B., Bryan, R. N., & Beauchamp, N. J. (2004) · Stroke · doi:10.1161/01.str.0000132193.35955.69 · Cited by 311 · see citing works
Palatini, P., Casiglia, E., Julius, S., & Pessina, A. C. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.6.585 · Cited by 269 · see citing works
Chronic Kidney Disease Is Associated With White Matter Hyperintensity Volume
Khatri, M., Wright, C. B., Nickolas, T. L., Yoshita, M., Paik, M. C., Kranwinkel, G., Sacco, R. L., & DeCarli, C. S. (2007) · Stroke · doi:10.1161/strokeaha.107.493593 · Cited by 254 · see citing works
Self-citationVascular Pathophysiology in Response to Increased Heart Rate
Custodis, F., Schirmer, S. H., Baumhäkel, M., Heusch, G., Böhm, M., & Laufs, U. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.09.014 · Cited by 242 · see citing works
Evolution and testing of the lacunar hypothesis.
Bamford, J., & Warlow, C. P. (1988) · Stroke · doi:10.1161/01.str.19.9.1074 · Cited by 207 · see citing works
Kim, H., Yun, C., THOMAS, R. J., Lee, S. H., Seo, H. S., Cho, E. R., Lee, S. K., Yoon, D. W., Suh, S. A., & Shin, C. (2013) · SLEEP · doi:10.5665/sleep.2632 · Cited by 193 · see citing works
Self-citationTotal Homocysteine Is Associated With White Matter Hyperintensity Volume
Wright, C. B., Paik, M. C., Brown, T. R., Stabler, S. P., Allen, R. H., Sacco, R. L., & DeCarli, C. S. (2005) · Stroke · doi:10.1161/01.str.0000165923.02318.22 · Cited by 190 · see citing works
Self-citationHeart rate-dependence of arterial distensibility in vivo
Mangoni, A. A., Mircoli, L., Giannattasio, C., Ferrari, A. U., & Mancia, G. (1996) · Journal of Hypertension · doi:10.1097/00004872-199607000-00013 · Cited by 182 · see citing works
Julius, S., Palatini, P., Kjeldsen, S. E., Zanchetti, A., Weber, M. A., McInnes, G. T., Brunner, H. R., Mancia, G., Schork, M. A., Hua, T. A., et al. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.10.025 · Cited by 179 · see citing works
Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study
Hsia, J. A., Larson, J. C., Ockene, J. K., Sarto, G. E., Allison, M., Hendrix, S. L., Robinson, J. G., LaCroix, A. Z., & Manson, J. E. (2009) · BMJ · doi:10.1136/bmj.b219 · Cited by 152 · see citing works
Johansen, C. D., Olsen, R. H., Pedersen, L. R., Kumarathurai, P., Mouridsen, M. R., Binici, Z., Intzilakis, T., Køber, L., & Sajadieh, A. (2013) · European Heart Journal · doi:10.1093/eurheartj/ehs449 · Cited by 151 · see citing works
Blunted Heart Rate Dip During Sleep and All-Cause Mortality
Ben‐Dov, I. Z., Kark, J. D., Ben‐Ishay, D., Mekler, J., Ben-Arie, L., & Bursztyn, M. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.19.2116 · Cited by 149 · see citing works
Lonn, E., Rambihar, S., Gao, P., Custodis, F., Sliwa, K. S., Teo, K. K., Yusuf, S., & Böhm, M. (2013) · Clinical Research in Cardiology · doi:10.1007/s00392-013-0644-4 · Cited by 146 · see citing works
Cassaglia, P. A., Griffiths, R. I., & WALKER, A. M. (2008) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00332.2007 · Cited by 146 · see citing works
Association of tachycardia with morbidity and mortality: pathophysiological considerations.
Palatini, P., & Julius, S. (1997) · PubMed · Cited by 117 · see citing works
Heistad, D. D., & Marcus, M. L. (1979) · Circulation Research · doi:10.1161/01.res.45.3.331 · Cited by 110 · see citing works
Improving Global Vascular Risk Prediction With Behavioral and Anthropometric Factors
Sacco, R. L., Khatri, M., Rundek, T., Xu, Q., Gardener, H. E., Boden-Albala, B. M., Tullio, M. R. D., Homma, S., Elkind, M. S. V., & Paik, M. C. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.07.047 · Cited by 105 · see citing works
Self-citationLower prevalence of silent brain infarcts in the physically active
Willey, J. Z., Moon, Y. P., Paik, M. C., Yoshita, M., DeCarli, C. S., Sacco, R. L., Elkind, M. S. V., & Wright, C. B. (2011) · Neurology · doi:10.1212/wnl.0b013e31821f4472 · Cited by 100 · see citing works
Self-citationPrognostic Value of Ambulatory Heart Rate Revisited in 6928 Subjects From 6 Populations
Hansen, T. W., Thijs, L., Boggia, J. G., Li, Y., Kikuya, M., Björklund‐Bodegârd, K., Richart, T., Ohkubo, T., Jeppesen, J., Torp-Pedersen, C. T., et al. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.113191 · Cited by 98 · see citing works
Association of Resting Heart Rate With Carotid and Aortic Arterial Stiffness
Whelton, S. P., Blankstein, R., Al-Mallah, M. H., Lima, J. A. C., Bluemke, D. A., Hundley, W. G., Polak, J. F., Blumenthal, R. S., Nasir, K., & Blaha, M. J. (2013) · Hypertension · doi:10.1161/hypertensionaha.113.01605 · Cited by 98 · see citing works
Palatini, P., Reboldi, G., Beilin, L. J., Eguchi, K., Imai, Y., Kario, K., Ohkubo, T., Pierdomenico, S. D., Saladini, F., Schwartz, J. E., et al. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.12.103 · Cited by 82 · see citing works
Hypertension and Cerebral Vasoreactivity
Hajjar, I. M., Zhao, P., Alsop, D. C., & Novak, V. (2010) · Hypertension · doi:10.1161/hypertensionaha.110.160002 · Cited by 82 · see citing works
Cassaglia, P. A., Griffiths, R. I., & WALKER, A. M. (2009) · Journal of Applied Physiology · doi:10.1152/japplphysiol.91349.2008 · Cited by 66 · see citing works
Martin Liebetrau, A., Steen, B. C., Hamann, G. F., & Skoog, I. G. (2004) · Stroke · doi:10.1161/01.str.0000131928.47478.44 · Cited by 66 · see citing works
Obstructive Sleep Apnea Is Associated With Future Subclinical Carotid Artery Disease
Gunnarsson, S. I., Peppard, P. E., Korcarz, C. E., Barnet, J. H., Aeschlimann, S. E., Hagen, E. W., Young, T. B., Hla, K. M., & Stein, J. H. (2014) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.114.303965 · Cited by 63 · see citing works
Vasoreactivity and peri-infarct hyperintensities in stroke
Zhao, P., Alsop, D. C., Abduljalil, A., Selim, M. H., Lipsitz, L. A., Novák, P., Caplan, L. R., Hu, K., & Novak, V. (2009) · Neurology · doi:10.1212/01.wnl.0000342473.65373.80 · Cited by 63 · see citing works
Association between resting heart rate and arterial stiffness in Korean adults
Park, B., Lee, H.-R., Shim, J., Lee, J., Jung, D., & Lee, Y. (2010) · Archives of cardiovascular diseases · doi:10.1016/j.acvd.2010.03.004 · Cited by 61 · see citing works
Nakagawa, T., Hasegawa, Y., Uekawa, K., Ma, M., Katayama, T., Sueta, D., Toyama, K., Kataoka, K., Koibuchi, N., Maeda, M., et al. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.113.000375 · Cited by 55 · see citing works
Galluzzi, S., Nicosia, F., Geroldi, C., et al. (2009) · The Journals of Gerontology Series A · doi:10.1093/gerona/glp105 · Cited by 43 · see citing works
Heart rate influence on incidence of cardiovascular disease among adults in China
Mao, Q., Huang, J., Lu, X., Wu, X., Chen, J., Cao, J., Li, J., & Gu, D. (2010) · International Journal of Epidemiology · doi:10.1093/ije/dyq119 · Cited by 32 · see citing works
O’Neal, W. T., Qureshi, W., Judd, S. E., Meschia, J. F., Howard, V. J., Howard, G., & Soliman, E. Z. (2015) · International Journal of Stroke · doi:10.1111/ijs.12620 · Cited by 29 · see citing works
Relationship between ambulatory blood pressure and aortic arch atherosclerosis
Iwata, S., Jin, Z., Schwartz, J. E., et al. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.01.010 · Cited by 28 · see citing works
Self-citationNakanishi, K., Jin, Z., Homma, S., Elkind, M. S. V., Rundek, T., Tuğcu, A., Yoshita, M., DeCarli, C. S., Wright, C. B., Sacco, R. L., et al. (2016) · American Heart Journal · doi:10.1016/j.ahj.2016.11.010 · Cited by 28 · see citing works
Self-citationSympathetic nervous control of the cerebral circulation in sleep
Loos, N., Grant, D., Wild, J., Paul, S. L., Barfield, C. P., Zoccoli, G., Franzini, C., & WALKER, A. M. (2005) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2005.00464.x · Cited by 20 · see citing works
Özeke, Ö., Güngör, M., Hızel, S. B., et al. (2011) · The Anatolian Journal of Cardiology · doi:10.5152/akd.2011.135 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Braffett, B. H., El ghormli, L., Martin, C., White, N. H., Hirsch, I. B., Bantle, A., Carlson, A., Leschek, E., Gubitosi-Klug, R., Soliman, E. Z., et al. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02856-9 · Cited by 5 · see citing works
- Authors
- Nakanishi, K., Jin, Z., Homma, S., Elkind, M. S. V., Rundek, T., Lee, S. C., Tugcu, A., Yoshita, M., DeCarli, C., Wright, C. B., Sacco, R. L., & Di Tullio, M. R.
- Affiliations
- University of Miami (US)
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology...
- ORCID
- Venue
- Stroke
- Published
- 2018-02
- Volume
- 49
- Issue
- 2
- Pages
- 319-324
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC5870891
- OpenAlex
- W2775847610
- Cited by
- 30
- References
- 45
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 1
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Aging (P30AG010129)
- National Institute of Neurological Disorders and Stroke (R56NS029993, R37NS029993, R01NS036286, R01NS083784)
- National Center for Research Resources (C06RR018898)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Keywords
- heart rate, subclinical cerebrovascular disease, white matter hyperintensity volume, silent cerebral infarction, heart rate variability, older adults, ambulatory blood pressure monitoring, cardiovascular risk factors
- MeSH terms
- Aged, Aged, 80 and over, Aging, Cerebrovascular Disorders, Female, Heart Rate, Humans, Male, Middle Aged, Risk Factors, Blood Pressure Monitoring, Ambulatory, Brain Infarction, Stroke
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
