Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population

Xavier Jouven, Peter J. Schwartz, Sylvie Escolano, Céline Straczek, Muriel Tafflet, Michel Desnos, Jean Philippe Empana, Pierre Ducimetire

Research output: Contribution to journalArticlepeer-review

Abstract

AimsThe aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk.Methods and resultsData from 7746 civil servants participating in the Paris Prospective Study I, followed-up for 23 years, allowed to compare heart rate changes between rest and mild mental stress (preparation prior to an exercise test) between subjects who suffered sudden cardiac death (n = 81), non-sudden (n = 129) coronary death, or death from any cause (n = 1306). The mean heart rate increase during mild mental stress was 8.9 ± 10.8 b.p.m. Risk of sudden cardiac death increased progressively with heart rate increase during mental stress and the relative risk of the third vs. the first tertile was 2.09 (95 confidence interval, 1.13-3.86) after adjustment for confounders. This relationship was not observed for non-sudden coronary death.ConclusionAn important heart rate increase produced by a mild mental stress predicts long-term risk for sudden cardiac death. Heart rate changes before an exercise test may provide a simple tool for risk stratification. All rights reserved.

Original languageEnglish
Pages (from-to)1703-1710
Number of pages8
JournalEuropean Heart Journal
Volume30
Issue number14
DOIs
Publication statusPublished - Jul 2009

Keywords

  • Epidemiology
  • Heart rate
  • Population study
  • Risk factors
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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