Association of resting heart rate and its change with incident cardiovascular events in the middle-aged and older Chinese

Jing Tian,Huan Guo,Miaoyan Shen,Yu Yuan,Xiaomin Zhang,Meian He,Tangchun Wu,Handong Yang

doi:10.1038/s41598-019-43045-5

Abstract

Whether heart rate change is associated with cardiovascular disease (CVD) in the general population is unclear. We conducted a prospective cohort study to assess the association of resting heart rate and its change with incident CVD in the middle-aged and older Chinese. Resting heart rate was measured during the baseline survey (September 2008 to June 2010) and the resurvey (2013). Incident CVD was followed up until December 31, 2016. Finally, a total of 20,828 participants were included in the analyses of baseline heart rate and 9132 participants were included in the analyses of heart rate change. The associations of baseline heart rate and heart rate change with incident CVD were assessed with multivariable Cox proportional hazards models. Compared with moderate baseline heart rate (65 to 80 bpm), low baseline heart rate (<65 bpm) was associated with higher risk of CVD (HR, 1.19; 95% CI, 1.07–1.32). Compared with stable heart rate (−5 to 15 bpm) in the moderate baseline heart rate group (65 to 80 bpm), an increase of heart rate (>15 bpm) in high baseline heart rate group (>80 bpm) (HR, 1.67; 95% CI, 1.02–2.71) or a decrease of heart rate (<−5 bpm) in low baseline heart rate group (<65 bpm) (HR, 2.48; 95% CI, 1.27–4.82) was associated with higher risk of CVD. In conclusion, low resting heart rate is associated with higher risk of CVD. Both continuous increase in high baseline heart rate and decrease in low baseline heart rate are associated with higher risk of CVD.

Highlights

As a low-tech indicator of cardiac function, resting heart rate reflects the balance of sympathetic and parasympathetic activity[1]
In this large population-based cohort of the middle-aged and older Chinese, we found that low baseline heart rate was associated with higher risk of cardiovascular disease (CVD), coronary heart disease (CHD) and acute coronary syndrome (ACS), high baseline heart rate was associated with higher risk of mortality after adjustment of established confounders
Increase in heart rate was associated with higher risk of mortality, we did not find any significant association of change of heart rate with cardiovascular events

Summary

Introduction

As a low-tech indicator of cardiac function, resting heart rate reflects the balance of sympathetic and parasympathetic activity[1]. Paul et al found elevated heart rate was associated with higher risk of all-cause mortality among 4065 hypertensive patients[5]. The CHARM study included 7599 patients with HF, and found that every 5-bpm increases in heart rate was associated with 9% higher risk of all-cause mortality[9]. P Valuea groups[5,9,10,11] It is lack of study investigating the association of heart rate change with CVD in the general population. The objective of this study was to prospectively examine the associations of resting heart rate and its change with incident CVD and its subtypes (including CVD, CHD, ACS, ischemic stroke and hemorrhagic stroke) in a large population-based cohort of the middle-aged and older Chinese

Objectives

Methods

Results

Conclusion