Resting Heart Rate and Risk of Cardiovascular Diseases and All-Cause Death: The Kailuan Study

Abstract

BackgroundResting heart rate (RHR) predicts both cardiovascular and noncardiovascular death in different populations. However, the results of the association between RHR and cardiovascular diseases (CVDs) are inconsistent, especially for each subtype of CVDs.ObjectiveThe aim of this study was to prospectively explore the relationship between RHR and CVDs including myocardial infarction (MI), ischemic stroke, and hemorrhagic stroke and all-cause death in a general population.MethodsThe Kailuan study is a prospective longitudinal cohort study on cardiovascular risk factors and cardiovascular or cerebrovascular events. Hazard ratio (HR) with 95% confidence intervals (CI) were calculated using Cox regression modeling.ResultsWe analyzed 92,562 participants (18–98 years old) in the Kailuan Study. CVDs were developed in 1,903 people during follow-ups. In multivariate analysis with adjustment for major traditional cardiovascular risk factors, HRs of the highest quintile group compared with the lowest quintile group of RHR for all-cause CVDs, MI, any stroke, ischemic stroke, hemorrhagic stroke, and all-cause death were 1.03 (95% CI, 0.98–1.07), 1.10 (95% CI, 1.01–1.20), 1.01 (95% CI, 0.97–1.06), 1.02 (95% CI, 0.96–1.07), 1.01 (95% CI, 0.92–1.11) and 1.18, (95% CI, 1.13–1.23), respectively.ConclusionsThe elevated RHR was independently associated with the increased risk for MI and all-cause death, but not for all-cause CVDs, any stroke, ischemic stroke, nor hemorrhagic stroke. This indicates that the elevated RHR might be a risk marker for MI and all-cause death in general populations.

Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis

“…The departure from a linear relation with resting heart rate was not significant for risk of coronary artery disease (15 studies, 13,14,16,21,23,24,26,[28][29][30][31][32]35,36,49 p for nonlinearity = 0.05, Figure 3A), stroke (10 studies, 14,16,23,24,26,28,35,36,50,51 p for nonlinearity > 0.9), noncardiovascular diseases (8 studies, 14,23,30,[42][43][44][45]49 p for nonlinearity = 0.2, Figure 3B), cancer (6 studies, 16,26,42,45,52,53 p for nonlinearity = 0.9), noncardiovascular diseases excluding cancer (3 studies, 16,18,42 p for nonlinearity = 0.4) and sudden death (3 studies, 13,21,23 p for nonlinearity = 0.6). When we used the lowest value in the included s...…”

Resting heart rate predicts incident myocardial infarction, atrial fibrillation, ischaemic stroke and death in the general population: the Tromsø Study

“…Another study found an independent association in men, but not in women 9. Previous studies reported that RHR independently predicted myocardial infarction (MI) and coronary death, but not stroke7; MI and all-cause death, but not ischaemic, haemorrhagic, or any stroke10; premature mortality and stroke, but not coronary heart disease11; and incident coronary heart disease, but not mortality from coronary heart disease 12…”

“…RHR is strongly associated with blood pressure13 and physical activity 14. Thus, studies that record high blood pressure as a yes-no variable,7 10 or that do not adjust for physical activity,1 6 11 may produce biased results. Moreover, when RHR is modelled as a continuous variable,2–5 7 8 10 15 a non-linear relationship with cardiovascular disease could be missed.…”

“…Thus, studies that record high blood pressure as a yes-no variable,7 10 or that do not adjust for physical activity,1 6 11 may produce biased results. Moreover, when RHR is modelled as a continuous variable,2–5 7 8 10 15 a non-linear relationship with cardiovascular disease could be missed. Dividing RHR into quartiles3 11 or quintiles2 4 7 10 12 will not provide estimates for extreme low or high RHR values.…”

“…Moreover, when RHR is modelled as a continuous variable,2–5 7 8 10 15 a non-linear relationship with cardiovascular disease could be missed. Dividing RHR into quartiles3 11 or quintiles2 4 7 10 12 will not provide estimates for extreme low or high RHR values.…”