Association of resting heart rate and physical activity with cardiovascular mortality: A population-based cohort study of Korean adults

Abstract

ABSTRACT To examine the independent and combined association of resting heart rate (RHR) and physical activity (PA) with risk of cardiovascular disease (CVD) mortality. RHR was categorized as < 60, 60–69, 70–79, and ≥ 80 bpm. Meeting PA guidelines was defined as ≥ 150 min/week of moderate to vigorous physical activity (MVPA). Cox proportional hazard models were used to calculate hazard ratios (HRs) for CVD mortality associated with RHR and PA. Among 31,697 participants, 311 CVD deaths occurred during 9.2 years of follow-up. Compared to RHR of 60–69 bpm, the risk of CVD mortality was higher in RHR of < 60 bpm (HR, 1.48; 95% CI, 1.05–2.10) and ≥ 80 bpm (HR, 1.42; 95% CI, 1.06–1.91). Participants who met PA guidelines had a lower risk of CVD mortality (HR, 0.59; 95% CI, 0.44–0.78). Among physically inactive adults compared to participants in RHR of 60–69 bpm with meeting PA guidelines, the adjusted HR for CVD mortality was 2.41 (95% CI, 1.42–4.08) for RHR of < 60 bpm, 1.59 (95% CI, 1.01–2.49) for RHR of 60–69 bpm, 1.98 (95% CI, 1.23–3.20) for RHR of 70–79 bpm and 2.41 (95% CI, 1.50–3.89) for RHR of ≥ 80 bpm Exceeding the minimum level of PA guidelines may attenuate the risk of CVD mortality associated with RHR.