Journal
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
Volume 21, Issue 6, Pages 719-726Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/2047487312452501
Keywords
Resting heart rate; myocardial infarction; stroke; heart failure; Asia; Australia; mortality; cardiovascular disease; coronary heart disease
Categories
Funding
- Australian National Health and Medical Research Council (NHMRC) [571281]
- Servier
- Banyu Fellowship Program of Banyu Life Science Foundation International
- Korean Health 21 RD Project [0412-CR02-0704-0001]
- Wellcome Trust [WBS U.1300.00.006.00012.01]
- NHMRC [1020812]
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Background: Multiple studies have examined the relationship between heart rate and mortality; however, there are discrepancies in results. Our aim was to describe the relationship between resting heart rate (RHR) and both major cardiovascular (CV) outcomes, as well as all-cause mortality in the Asia-Pacific region. Design and methods: Individual data from 112,680 subjects in 12 cohort studies were pooled and analysed using Cox models, stratified by study and sex, and adjusted for age and systolic blood pressure. Results: During a mean 7.4 years follow-up, 6086 deaths and 2726 fatal or nonfatal CV events were recorded. There was a continuous, increasing association between having a RHR above approximately 65 beats/min and the risk of both CV and all-cause mortality, yet there was no evidence of associations below this threshold. The hazard ratio (95% CI) comparing the extreme quarters of RHR (80+ v <65 beats/mm) was 1.44 (1.29-1.60) for CV and 1.54 (1.43-1.66) for total mortality. These associations were not materially changed by adjustment for other risk factors and exclusion of the first 2 years of follow-up. Hazard ratios of a similar magnitude were found for ischemic and hemorrhagic stroke, but the hazard ratio for heart failure was higher (2.08, 95% CI 1.07-4.06) and for Coronary Heart Disease (CHD) was lower (1.1 I, 95% CI 0.93-1.31) than for stroke. Conclusions: RHR of above 65 beats/nnin has a strong independent effect on premature mortality and stroke, but a lesser effect on CHD. Lifestyle and pharmaceutical regimens to reduce RHR may be beneficial for people with moderate to high levels of RHR.
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