High heart rate before exercise doubles heart attack risk in later life

French researchers have discovered a simple and cheap method of predicting who is at greater risk of dying suddenly and unexpectedly from a heart attack.

In a study of 7746 French male civil servants, published in Europe’s leading cardiology journal, the European Heart Journal, the researchers found that men whose heart rate increased the most during mild mental stress just before an exercise test had twice the risk of dying of a sudden heart attack in later life than men whose heart rate did not increase as much.

The study is the first to discover this association and since taking a patient’s pulse is an easy and inexpensive procedure, it suggests a way of identifying people who may be at increased risk.

Professor Xavier Jouven, of the Hopital Europ?en Georges Pompidou (Paris, France), who led the research, said the findings have significant clinical implications. “People who showed a higher heart rate increase with mild mental stress could be considered for additional investigations and for tailored preventive strategies, aimed in the first place at reducing the probability of heart disease,” he said.

Prof Jouven said: “This study shows that the heart rate increase during a mild mental stress in preparation for exercise is a strong predictor of sudden death. These findings may carry significant clinical implications.

Prof Jouven and his colleagues believe that the mechanism behind this effect has to do with interaction between the vagus nerves (which are an important part of the autonomic nervous system that controls the body’s unconscious functions such as the heart beat) and sympathetic activation (activation of the sympathetic nervous system, which is one half of the autonomic nervous system and is responsible for increasing the heart rate, widening blood vessels in the muscles and constricting them in the skin and intestines).

The researchers say that, as the study was carried out in men only, it is possible that findings in women may be different and this should be the subject of future research.

Source: European Society of Cardiology, France

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