Xiaotong Cui1,2, Zacharias Mandalenakis2,3, Erik Thunström2,3, Michael Fu2,3, Kurt Svärdsudd4, Per-Olof Hansson5,6. 1. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China. 2. Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden. 3. Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra, Diagnosvägen 11, Göteborg, Region Västra Götaland, 416 85, Gothenburg, Sweden. 4. Department of Public Health and Caring Sciences, Family Medicine Section, Uppsala University, Uppsala, Sweden. 5. Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden. per-olof.hansson@vgregion.se. 6. Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra, Diagnosvägen 11, Göteborg, Region Västra Götaland, 416 85, Gothenburg, Sweden. per-olof.hansson@vgregion.se.
Abstract
BACKGROUND: A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort. METHODS: A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models. RESULTS: A baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60-70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17-2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07-1.85, P = 0.014) and a time-updated RHR of 70-80 bpm (HR 1.34, 95% CI 1.02-1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60-70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference. CONCLUSION: In this middle-aged male cohort, a time-updated RHR of 60-70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population.
BACKGROUND: A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort. METHODS: A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models. RESULTS: A baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60-70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17-2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07-1.85, P = 0.014) and a time-updated RHR of 70-80 bpm (HR 1.34, 95% CI 1.02-1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60-70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference. CONCLUSION: In this middle-aged male cohort, a time-updated RHR of 60-70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population.
Entities:
Keywords:
Cohort study; General population; Heart rate; Mortality
Authors: Michael Fu; Annika Rosengren; Erik Thunström; Zacharias Mandalenakis; Lennart Welin; Kenneth Caidahl; Aldina Pivodic; You Zhong; Constantinos Ergatoudes; David Morales; Catharina Welin; Kurt Svärdsudd; Mikael Dellborg; Per-Olof Hansson Journal: J Am Heart Assoc Date: 2018-04-19 Impact factor: 5.501