A high triglyceride-to-HDL cholesterol ratio was associated with a significantly higher prevalence of abnormal heart rate recovery (40% vs. 30%; prevalence ratio 1.18; 95% CI 1.01-1.39; P=0.04).
Cohort (n=4,963)
Yes
Is a high triglyceride-to-HDL cholesterol ratio associated with abnormal heart rate recovery and increased mortality in healthy adults?
A high triglyceride-to-HDL cholesterol ratio, a marker of insulin resistance, is associated with abnormal heart rate recovery and identifies patients at increased risk of death.
Relative Risk: 1.18 (95% CI 1.01–1.39)
Absolute Event Rate: 40% vs 30%
p-value: p=0.04
OBJECTIVE: Insulin resistance is associated with autonomic dysfunction. An attenuated decrease in heart rate after exercise (or heart rate recovery HRR) predicts all-cause mortality and is believed to reflect decreased parasympathetic activity. Utilizing triglyceride/HDL cholesterol concentration as a marker of insulin resistance, we sought to assess the association between insulin resistance and HRR. RESEARCH DESIGN AND METHODS: Our study population included 4,963 healthy adults who participated in the Lipid Research Clinics Prevalence Study and underwent exercise testing. HRR was considered abnormal if it did not drop > or = 42 bpm 2 min after completion of exercise. Fasting blood specimens were drawn. RESULTS: Individuals in the highest quartile of triglyceride/HDL cholesterol had a significantly higher prevalence of abnormal HRR (40 vs. 30%, multivariable-adjusted prevalence ratio 1.18, 95% CI 1.01-1.39; P = 0.04). As a continuous variable, an increase in 1 SD of triglyceride-to-HDL cholesterol ratio was associated with a greater likelihood of an abnormal HRR, even after adjusting for >20 covariates (adjusted OR 1.16, 95% CI 1.07-1.25; P < 0.001). During 12 years of follow-up, there were 284 deaths. In age- and sex-adjusted analysis, participants with an abnormal HRR and high triglyceride-to-HDL cholesterol ratio had significantly higher mortality than those with a normal HRR and high triglyceride-to-HDL cholesterol ratio (hazard ratio = 1.49, 95% CI 1.08-2.04; P = 0.015). CONCLUSIONS: HRR is associated with triglyceride-to-HDL cholesterol ratio and identifies patients with insulin resistance who are at increased risk of death.
Shishehbor et al. (Thu,) conducted a cohort in Healthy adults (n=4,963). High triglyceride-to-HDL cholesterol ratio vs. Lower triglyceride-to-HDL cholesterol ratio was evaluated on Abnormal heart rate recovery (prevalence ratio 1.18, 95% CI 1.01-1.39, p=0.04). A high triglyceride-to-HDL cholesterol ratio was associated with a significantly higher prevalence of abnormal heart rate recovery (40% vs. 30%; prevalence ratio 1.18; 95% CI 1.01-1.39; P=0.04).