Relation of Higher Resting Heart Rate to Risk of Cardiovascular Versus Noncardiovascular Death

Published on Apr 1, 2017in American Journal of Cardiology2.84
· DOI :10.1016/j.amjcard.2016.11.059
Lubna Alhalabi1
Estimated H-index: 1
Matthew Singleton1
Estimated H-index: 1
(Wake Forest University)
+ 3 AuthorsElsayed Z. Soliman47
Estimated H-index: 47
(Wake Forest University)
Higher resting heart rate (RHR) is associated with increased risk of all-cause and cardiovascular mortality, with some reports showing the magnitude of association with all-cause mortality being stronger than that with cardiovascular mortality. This suggests that RHR association with mortality may not be limited to cardiovascular death. We compared the association between RHR with cardiovascular and noncardiovascular mortality in 6,743 participants (mean age 58.7 years, 52% women, 48% non-Hispanic whites) from the Third National Health and Nutrition Examination Survey (NHANES-III) after excluding those on antiarrhythmic drugs or with missing data. RHR data were obtained from standard 12-lead electrocardiogram recorded on the NHANES participants during a physical examination. National Death Index was used to identify the date and cause of death. Multivariable Cox proportional hazards analysis was used to calculate the hazard ratios (HRs) and 95% CIs for cardiovascular mortality and noncardiovascular mortality, separately, associated with 10 beats/min increase in RHR. During a median follow-up of 13.9 years, 906 cardiovascular deaths and 1,306 noncardiovascular deaths occurred. In models adjusted for age, gender, race, hypertension, diabetes, obesity, dyslipidemia, previous cardiovascular disease, smoking, cancer, chronic obstructive airway disease, thyroid disease, and serum creatinine, higher RHR was associated with increased risk of both cardiovascular mortality and noncardiovascular mortality with a relatively similar magnitude of risk (HR 1.19, 95% CI 1.12 to 1.26 and HR 1.23, 95% CI 1.17 to 1.29, respectively). In conclusion, higher RHR is associated with both cardiovascular mortality and noncardiovascular mortality suggesting that RHR is probably a marker of overall well-being rather than a marker of cardiovascular health.
  • References (29)
  • Citations (8)
Published on Feb 16, 2016in Canadian Medical Association Journal6.94
Dongfeng Zhang16
Estimated H-index: 16
(Qingdao University),
Xiaoli Shen1
Estimated H-index: 1
(Qingdao University),
Xin Qi1
Estimated H-index: 1
(Qingdao University)
Background: Data on resting heart rate and risk of all-cause and cardiovascular mortality are inconsistent; the magnitude of associations between resting heart rate and risk of all-cause and cardiovascular mortality varies across studies. We performed a meta-analysis of prospective cohort studies to quantitatively evaluate the associations in the general population. Methods: We searched PubMed, Embase and MEDLINE from inception to Jan. 1, 2015. We used a random-effects model to combine study-spe...
Published on Sep 18, 2014in The New England Journal of Medicine70.67
Kim Fox28
Estimated H-index: 28
(Imperial College London),
Ian Ford105
Estimated H-index: 105
+ 3 AuthorsRoberto Ferrari79
Estimated H-index: 79
BACKGROUND An elevated heart rate is an established marker of cardiovascular risk. Previous analyses have suggested that ivabradine, a heart-rate–reducing agent, may improve outcomes in patients with stable coronary artery disease, left ventricular dysfunction, and a heart rate of 70 beats per minute or more. METHODS We conducted a randomized, double-blind, placebo-controlled trial of ivabradine, added to standard background therapy, in 19,102 patients who had both stable coronary artery disease...
Published on Feb 1, 2012in European Journal of Preventive Cardiology5.64
Magnus Thorsten Jensen12
Estimated H-index: 12
(Copenhagen University Hospital),
Jacob Louis Marott26
Estimated H-index: 26
(Copenhagen University Hospital)
+ 2 AuthorsGorm Boje Jensen19
Estimated H-index: 19
(Copenhagen University Hospital)
Aims: To investigate the association between resting heart rate (RHR) and markers of chronic low-grade inflammation. Also, to examine whether elevated resting heart rate is independently associated with cardiovascular and all-cause mortality in the general population, or whether elevated RHR is merely a marker of chronic low-grade inflammation.Methods and results: A group of 6518 healthy subjects from the the Danish general population were followed for 18 years during which 1924 deaths occurred....
Published on Sep 1, 2010in The Lancet59.10
Michael Böhm120
Estimated H-index: 120
Karl Swedberg90
Estimated H-index: 90
(University of Gothenburg)
+ 5 AuthorsLuigi Tavazzi96
Estimated H-index: 96
Summary Background Raised resting heart rate is a marker of cardiovascular risk. We postulated that heart rate is also a risk factor for cardiovascular events in heart failure. In the SHIFT trial, patients with chronic heart failure were treated with the selective heart-rate-lowering agent ivabradine. We aimed to test our hypothesis by investigating the association between heart rate and events in this patient population. Methods We analysed cardiovascular outcomes in the placebo (n=3264) and iv...
Published on Apr 1, 2010in American Heart Journal4.02
Marie Therese Cooney16
Estimated H-index: 16
Erkki Vartiainen85
Estimated H-index: 85
(National Institute for Health and Welfare)
+ 3 AuthorsI. Graham45
Estimated H-index: 45
Background Elevated resting heart rate (RHR) is known to be associated with reduced survival but inconsistencies remain, including lack of significance in most studies of healthy women, lack of independence from systolic blood pressure (SBP) in some, and the suggestion that RHR is merely functioning as a marker of physical inactivity or other comorbidities. We aimed to clarify these inconsistencies. Methods We analyzed the effect of RHR on end points in the National FINRISK Study; a representati...
Published on May 30, 2008in European Heart Journal23.24
Aage Tverdal51
Estimated H-index: 51
(FHI: Norwegian Institute of Public Health),
Vidar Hjellvik11
Estimated H-index: 11
(FHI: Norwegian Institute of Public Health),
Randi Selmer44
Estimated H-index: 44
(FHI: Norwegian Institute of Public Health)
Aim To study the relationship between heart rate and (a) all deaths and (b) cardiovascular deaths in a large cohort of middle-aged Norwegian men and women. Methods and results A prospective study of participants in cardiovascular surveys that were carried out in 1985–1999 and covered men and women aged 40–45 years in all counties except the capital, Oslo. In total, 180 353 men and 199 490 women aged 40–45 years without cardiovascular history or diabetes accrued 4 775 683 years of follow-up. Ther...
Published on Oct 1, 2006in American Heart Journal4.02
Simon Thackray18
Estimated H-index: 18
(Castle Hill Hospital),
Justin Ghosh8
Estimated H-index: 8
+ 6 AuthorsJohnGFCleland112
Estimated H-index: 112
Background β-Blockers are effective for the treatment of heart failure, but their mechanism of action is unresolved. Heart rate reduction may be a central mechanism or a troublesome side effect. Methods A randomized, double-blind, parallel group study comparing chronic higher-rate (80 pulses per minute) with lower-rate (60 pulses per minute) pacing in pacemaker-dependent patients with symptomatic left ventricular (LV) systolic dysfunction, receiving β-blockers. Gated radionuclide ventriculograph...
Published on Oct 1, 2005in American Journal of Preventive Medicine4.43
Estimated H-index: 65
(Queen's University),
Peter T. Katzmarzyk81
Estimated H-index: 81
(Queen's University)
+ 1 AuthorsSteven N. Blair140
Estimated H-index: 140
Background Clinical measures that are used to identify risk for specific diseases may also help physicians predict overall mortality risk in their patients. This study derived and validated a clinical scoring system that can be used to predict all-cause mortality risk in men using age, resting heart rate, blood pressure, total cholesterol, HDL-cholesterol, triglycerides, diabetes, obesity, smoking status, and cardiorespiratory fitness categories. Methods This was a cohort-based prospective study...
Published on May 1, 2005in European Heart Journal23.24
Ariel Diaz6
Estimated H-index: 6
Martial G. Bourassa88
Estimated H-index: 88
+ 1 AuthorsJean-Claude Tardif79
Estimated H-index: 79
Aims Heart rate reduction is the cornerstone of the treatment of angina. The purpose of this study was to explore the prognostic value of heart rate in patients with stable coronary artery disease (CAD). Methods and results We assessed the relationship between resting heart rate at baseline and cardiovascular mortality/morbidity, while adjusting for risk factors. A total of 24 913 patients with suspected or proven CAD from the Coronary Artery Surgery Study registry were studied for a median foll...
Published on Aug 18, 2004in Journal of the American College of Cardiology18.64
Stephen D. Wiviott67
Estimated H-index: 67
(Brigham and Women's Hospital),
David A. Morrow97
Estimated H-index: 97
(Brigham and Women's Hospital)
+ 6 AuthorsEugene Braunwald208
Estimated H-index: 208
(Brigham and Women's Hospital)
Objectives We sought to evaluate a simple risk index based on age and vital signs in a community sample of patients with ST-segment elevation myocardial infarction (STEMI). Background A simple risk index based on age and vital signs (heart rate × [age/10] 2 /systolic blood pressure) developed from patients with STEMI accurately predicts mortality in clinical trials of fibrinolysis. The application of such a tool in an unselected population is necessary to evaluate its utility in clinical practic...
Cited By8
Published on May 13, 2019in Scientific Reports4.01
Sangsang Li (Zhengzhou University), Bingxin Guo (Zhengzhou University)+ 4 AuthorsSonghe Shi (Zhengzhou University)
This study aimed to evaluate the role of the triglyceride (triacylglycerol) glucose (TyG) index in predicting and mediating the development of cardiovascular disease (CVD). This cohort study included 6078 participants aged over 60 years who participated in a routine health check-up programme from 2011 to 2017. The competing risk model, cox regression model and multimediator analyses were performed. TyG was calculated as ln [fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. During...
Yu-Jin Kwon3
Estimated H-index: 3
Hye Sun Lee45
Estimated H-index: 45
+ 4 AuthorsJi-Won Lee21
Estimated H-index: 21
Previous studies evaluating associations between resting heart rate (RHR) and cancer-related mortality/prognosis have yielded conflicting results. We investigated whether elevations in RHR are associated with colorectal cancer (CRC). We conducted a case-controlled study involving 1241 CRC patients and 5909 cancer-free controls from the Korean National Health and Nutrition Examination Survey. After propensity score (PS) matching, 1207 CRC patients and 1207 matched controls were analyzed. Associat...
V Velle‐Forbord1
Estimated H-index: 1
(NTNU: Norwegian University of Science and Technology),
Ragnhild Bergene Skråstad6
Estimated H-index: 6
(NTNU: Norwegian University of Science and Technology)
+ 3 AuthorsEszter Vanky19
Estimated H-index: 19
(NTNU: Norwegian University of Science and Technology)
Published on Nov 1, 2018in Clinica Chimica Acta2.73
Mi Kyung Lee20
Estimated H-index: 20
(Yonsei University),
Dong-Hoon Lee32
Estimated H-index: 32
(Harvard University)
+ 2 AuthorsJustin Y. Jeon26
Estimated H-index: 26
(Yonsei University)
Abstract Background Higher resting heart rate (RHR) was associated with poor prognosis in breast cancer survivors, but the mechanism underlying such association has not been fully studied. We investigated the association between RHR and metabolic risk factors in stage I-III breast cancer survivors. Methods Among 11,013 women diagnosed with breast cancer between 2005 and 2013 at the Severance hospital in Seoul, Korea, a total of 4980 patients met our inclusion criteria for the final analysis. Mul...
Published on Jun 28, 2018in Wireless Networks2.40
Emi Yuda4
Estimated H-index: 4
(Nagoya City University),
Yutaka Yoshida5
Estimated H-index: 5
(Nagoya City University),
Junichiro Hayano39
Estimated H-index: 39
(Nagoya City University)
Using Allostatic State Mapping by Ambulatory ECG Repository (ALLSTAR) 24-h ECG big data, we investigated the effects of the time of sleep during the day on the occurrence time and value of basal heart rate (BHR), i.e., the minimum heart rate of the day. We found that the timing of BHR shifts slightly but significantly with the time of sleep (P < 0.0001); BHR occurs at 03:18 for nighttime sleepers on average, while it occurs at 02:35 for evening sleepers and 01:30 for daytime sleepers. The level ...
Published on Mar 1, 2018in European Journal of Clinical Investigation2.78
Marijana Tadic16
Estimated H-index: 16
Cesare Cuspidi42
Estimated H-index: 42
(University of Milan),
Guido Grassi76
Estimated H-index: 76
(University of Milano-Bicocca)
Published on Sep 5, 2017in PLOS ONE2.78
Michele Orini15
Estimated H-index: 15
Andrew Tinker28
Estimated H-index: 28
+ 1 AuthorsPier D. Lambiase28
Estimated H-index: 28
This research has been conducted using the UK Biobank Resource and supported in part by Medical Research Council grant MR/N025083/1. PD Lambiase acknowledges support from the UCLH Biomedicine NIHR. PB Munroe and A Tinker wish to acknowledge the support of the NIHR Cardiovascular Biomedical Research Unit at Barts and Queen Mary University of London, UK. MO is supported by an IEF 2013 Marie Curie fellowship
Published on Jun 1, 2017in Nutrition Metabolism and Cardiovascular Diseases3.34
Dagfinn Aune37
Estimated H-index: 37
(Imperial College London),
Edward Giovannucci175
Estimated H-index: 175
(Harvard University)
+ 7 AuthorsSerena Tonstad49
Estimated H-index: 49
(Oslo University Hospital)
Abstract Background and aim Epidemiological studies have reported increased risk of cardiovascular disease, cancer and all-cause mortality with greater resting heart rate, however, the evidence is not consistent. Differences by gender, adjustment for confounding factors, as well as the potential impact of subclinical disease are not clear. A previous meta-analysis missed a large number of studies, and data for atrial fibrillation have not been summarized before. We therefore aimed to clarify the...
View next paperResting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality