BEAT-HTN India: Burden, Epidemiology, and Trends of Hypertension - A Nationwide Survey

Office and out of office heart rate measurements: which clinical value?

As reports show cardiovascular (CV) risks in first-degree relatives (FDR) of type2 diabetics, and autonomic imbalance predisposing to CV risks, in the present study we have assessed the contribution of sympathovagal imbalance (SVI) to CV risks in these subjects. Body mass index (BMI), waist-to-hip ratio (WHR), basal heart rate (BHR), blood pressure (BP), rate pressure product (RPP), and spectral indices of heart rate variability (HRV) were reordered and analyzed in FDR of type2 diabetics (study group, n=293) and in subjects with no family history of diabetes (control group, n=405). The ratio of low-frequency (LF) to high-frequency (HF) power of HRV (LF-HF), a sensitive marker of SVI, was significantly increased (P<0.001) in the study group compared with the control group. The SVI in the study group was due to concomitant sympathetic activation (increased LF) and vagal inhibition (decreased HF). In the study group, the LF-HF ratio was significantly correlated with BMI, WHR, BHR, BP and RPP. Multiple regression analysis showed an independent contribution of LF-HF to hypertension status (P=0.000), and bivariate logistic regression showed significant prediction (odds ratio 2.16, confidence interval 1.130-5.115) of LF-HF to increased RPP, the marker of CV risk, in the study group. Sympathovagal imbalance in the form of increased sympathetic and decreased parasympathetic activity is present in FDR of type2 diabetics. Increased resting heart rate, elevated hypertension status, decreased HRV and increased RPP in these subjects make them vulnerable to CV risks. SVI in these subjects contributes to CV risks independent of the degree of adiposity.

Background: Temperature, heart rate (HR) and heart rate variability (HRV) are known to be hormonally influenced and fluctuate across the menstrual cycle. However, the association of sleep resting heart rate (RHR) and the nuanced thermal patterns indicative of changing progesterone levels relative to cycle type and age remains less studied. Hypothesis: We hypothesize that RHR segregates in discrete patterns in different cycle types for menstrual cycles that can be mapped by nocturnal thermal patterns. Methods: In this study, we used specific thermally-derived patterns or “Cycle Flags (CF)” and examined how these associate with sleep RHR in regular and irregular menstrual cycles. We examined 1492 de-identified, randomly-selected cycles of Ultrahuman Ring AIR users (N=1263, ages 20-50 years) between September 2024 and March 2025. Data aggregation was carried out in accordance with Ultrahuman’s privacy policy. Nocturnal skin temperatures were processed through the OvuSense algorithm to generate CFs. The mode of night RHR per cycle was categorized into typical (&lt;60 bpm), elevated (60-75 bpm), and high RHR (&gt;75 bpm). Odds ratios (OR) with 95% confidence intervals were computed for associations between cycle flags and RHR. Results: In pooled cycles, Anovulation (non-ovulatory cycle) CF was consistently associated with higher RHR. False Start (early progesterone spike without ovulation) demonstrated an inverse association with elevated RHR (OR=0.13, p&lt;0.05). In regular-cycling younger women (20-30 y), Slow Rise (weak progesterone response) was significantly linked to elevated RHR (OR=4.97, p&lt;0.05), while those with irregular cycles displayed a connection with typical RHR levels (OR=9.00, p&lt;0.05). In the 30-40 y group, Fall After Ovulation (possible luteal phase insufficiency) in regular cycles (OR=2.89, p&lt;0.05) and Anovulation in irregular cycles (OR=6.31, p&lt;0.05) were both associated with higher RHR. In older women (40-50 y), Fall After Ovulation in regular cycles displayed a near-significant association with elevated RHR (OR=3.53, p=0.051). Conclusions: Combinatorial signatures of elevated RHR and temperature patterns have the potential to identify cycle types with fluctuating hormone levels. Age-wise analyses indicated that CFs are the most pronounced in women aged 20-40 years. Hence, longitudinal tracking via continuous-use wearables provides valuable support for cardiovascular and reproductive health awareness in real-world settings.

Elevated heart rate is also a risk factor after cardiac transplantation: Time to slow down?

P3821Resting heart rate in late adolescence and long term risk of cardiomyopathy - A nationwide study of one million Swedish men

Heart rate and adverse outcomes in patients with atrial fibrillation: A combined AFFIRM and AF-CHF substudy

To investigate the association between exposure to the famine during early life and elevated resting heart rate (RHR) in adulthood. From June 2006 to October 2007, the employees of kailuan group who took part in the health examination were selected. Of those, 18 619 cases who was born during October 1, 1956 to September 30, 1964 in Hebei province were finally included in the analysis based on the inclusion and exclusion criteria. All the subjects were received questionnaire survey, smoking and drinking, physical examination, Lab examination and the measurement of RHR. The subjects of famine exposure group (3 190 cases) were born from October 1, 1959 to September 30, 1961, semi-exposure group (3 851 cases) were born from October 1, 1958 to September 30, 1959 and from October 1, 1961 to September 30, 1962, control group (11 578 cases) were born from October 1, 1956 to September 30, 1958 and from October 1, 1962 to September 30, 1964. The RHR and the detection rate of elevated RHR were compared among the three groups. The Multivariate logistic regression model was used to analyze the association between of exposure to famine during early life and elevated RHR in adulthood. The RHR level was higher in famine exposure group and semi-exposed group than control group, which were (74.34 ± 9.71), (74.41 ± 9.48) and (73.90 ± 9.45) beat per minute (bpm) (P values were 0.003 and 0.020, respectively). In all of the subjects. The results of multivariate logistic regression showed that exposure of famine during early life increased the risk of elevated RHR in adulthood after adjustment for age, gender and other confounders (OR = 1.10, 95% CI: 1.01-1.21). In men, exposure of famine during early life also increased the risk of elevated RHR in adulthood (OR = 1.15, 95% CI: 1.04-1.28); In women, there was no association between the famine exposure and elevated RHR (OR = 0.92, 95% CI: 0.74-1.14). Exposure of famine during early life increases the risk of elevated RHR in adulthood. This negative effect existed mainly in the male.

Clinical perspective: the importance of heart rate reduction in heart failure

Elevated resting heart rate (RHR) predicts all-cause death. However, the relationship between RHR variation over years and mortality are still unknown. We aimed to analyze the association between RHR variation and all-cause mortality in the general population without cardiovascular diseases. A total of 46,873 subjects were included from the Kailuan Study (2006–2011). RHR readings were taken during three separate examinations and the RHR variation was defined using the standard deviation (RHR-SD) and the coefficient of variation. Participants were divided into four groups according to the quartiles of RHR-SD. All subjects were followed for a median of 49.4 months from the date of the 3rd examination to December 31, 2014. Up until the follow-up examinations, 973 (2.08%) participants had died. In a multivariate analysis, adjusting for variables potentially associated with death, the highest quartile of RHR-SD remained an independent predictor of all-cause mortality (Hazards ratio = 1.43, 95% confidence interval 1.18–1.74, P < 0.001). These findings suggest that an elevated long-term RHR variation is an independent risk marker for all-cause mortality in the general population without known cardiovascular diseases.

Association between resting heart rate, metabolic syndrome and cardiorespiratory fitness in Korean male adults

Resting Heart Rate as a Cardiovascular Risk Factor in Hypertensive Patients: An Update.

BackgroundAutonomic disorders of the cardiovascular system, such as orthostatic hypotension and elevated resting heart rate, predict mortality and cardiovascular events in the population. Low-energy-fractures constitute a substantial clinical problem that may represent an additional risk related to such autonomic dysfunction.AimsTo test the association between orthostatic hypotension, resting heart rate and incidence of low-energy-fractures in the general population.Methods and ResultsUsing multivariable-adjusted Cox regression models we investigated the association between orthostatic blood pressure response, resting heart rate and first incident low-energy-fracture in a population-based, middle-aged cohort of 33 000 individuals over 25 years follow-up.The median follow-up time from baseline to first incident fracture among the subjects that experienced a low energy fracture was 15.0 years. A 10 mmHg orthostatic decrease in systolic blood pressure at baseline was associated with 5% increased risk of low-energy-fractures (95% confidence interval 1.01–1.10) during follow-up, whereas the resting heart rate predicted low-energy-fractures with an effect size of 8% increased risk per 10 beats-per-minute (1.05–1.12), independently of the orthostatic response. Subjects with a resting heart rate exceeding 68 beats-per-minute had 18% (1.10–1.26) increased risk of low-energy-fractures during follow-up compared with subjects with a resting heart rate below 68 beats-per-minute. When combining the orthostatic response and resting heart rate, there was a 30% risk increase (1.08–1.57) of low-energy-fractures between the extremes, i.e. between subjects in the fourth compared with the first quartiles of both resting heart rate and systolic blood pressure-decrease.ConclusionOrthostatic blood pressure decline and elevated resting heart rate independently predict low-energy fractures in a middle-aged population. These two measures of subclinical cardiovascular dysautonomia may herald increased risks many years in advance, even if symptoms may not be detectable. Although the effect sizes are moderate, the easily accessible clinical parameters of orthostatic blood pressure response and resting heart rate deserve consideration as new risk predictors to yield more accurate decisions on primary prevention of low-energy fractures.

Although lifestyle factors are associated with resting heart rate (RHR), its association with mortality in colorectal cancer (CRC) patients has not been fully understood. Therefore, we sought to determine whether RHR is associated with all-cause and CRC-specific mortality in stage 1-3 CRC patients. We included a total of 3,631 patients from the Severance Hospital Colorectal Cancer Registry (Seoul, South Korea) who underwent surgery for stage 1-3 CRC. RHR data were collected on the day of surgery. We utilized multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between RHR and all-cause and CRC-specific mortality. During a median follow-up of 3.0 years, there were 292 all-cause and 177 CRC-specific deaths. Patients in the highest quintile of RHR (≥88 bpm) (≤66 bpm) vs. patients in the lowest quintile of RHR showed a 3.33-fold increased risk of all-cause mortality (95% CI:1.85-5.99) and a 2.98-fold increased risk of CRC-specific mortality (95% CI:1.74-5.05). For every 10-bpm increase in RHR, there was a 1.44-fold increase in all-cause mortality (95% CI:1.32-1.58) and a 1.50-fold increase in CRC-specific mortality (95% CI:1.33-1.69). Elevated RHR on the day of surgery for CRC is associated with higher risk of all-cause/CRC-specific mortality. Our data suggest that RHR may serve as a clinically relevant predictor of mortality in patients who undergo surgery for CRC.

The current definition of sinus tachycardia is a heart rate >100 beats per minute (bpm).1 This limit was set arbitrarily when heart rate was not yet regarded as a risk factor for cardiovascular disease, probably with the main purpose of distinguishing between a disease state (fever, thyrotoxicosis, anemia, congestive heart failure, etc) and a normal condition. In recent years, interest has been aroused by the awareness that fast heart rate is a potent precursor of hypertension, atherosclerosis, and their sequelae.2 3 4 5 6 7 8 9 10 In addition, many leading epidemiological studies have shown that tachycardia is associated with an increased risk of death from cardiovascular and noncardiovascular causes. This relationship has been found in general populations,3 4 5 6 7 in elderly individuals,9 and in hypertensive cohorts.10 In all of these studies, the heart rate value above that in which a significant increase in risk was observed was below the 100 bpm threshold (Table 1⇓). Only in the study by Levy et al3 was tachycardia defined as a heart rate >99 bpm, but in that study the cutoff between normal and high heart rate was chosen arbitrarily, and the highest heart rate value measured during the examination was taken to define the subject’s heart rate. In all the other studies, the threshold level between normal and fast heart rate was between 79 and 90 bpm. View this table: Table 1. Heart Rate Values Above Which a Significant Increase in Risk Was Found: Data From 9 Epidemiological Studies The normalcy limits of a clinical variable can be established according to different criteria. For many parameters, such as most biochemical indexes, the 95% confidence interval is calculated to identify the upper normal limit of the variable. This statistical approach does not appear suitable for those clinical variables …

BackgroundPrevious epidemiologic studies have shown that elevated resting heart rate (HR) is associated with higher cardiovascular disease (CVD) morbidity and mortality. Although the relationship between elevated HR and CVD is well established, the association between resting HR and diabetes has been relatively understudied, particularly in non-Western populations.ObjectivesWe confirmed the association between the presence of type 2 diabetes and resting HR in the Korean adult population using data from the 2010–2013 Korea National Health and Nutrition Examination Survey (KNHANES).MethodsAmong 25,712 adults (≥ 19 years of age) who participated in the 2010–2013 KNHANES, a total of 22,512 subjects completed laboratory examinations and were included in this analysis. The fasting plasma glucose (FPG) level was categorized into the following five groups: normal fasting glucose (NFG) 1 (<90 mg/dL), NFG 2 (90–99 mg/dL), impaired fasting glucose (IFG) 1 (100–110 mg/dL), IFG 2 (111–125 mg/dL), and diabetes (≥ 126 mg/dL).ResultsThe unadjusted weighted resting HRs were 69.6, 69.4, 69.8, 70.1, and 72.0 beats per minute (bpm) in the NFG 1, NFG 2, IFG 1, IFG 2, and diabetes groups, respectively (P<0.001). We assessed the adjusted weighted resting HR according to the FPG level after adjusting for age, sex, smoking history, high risk alcohol drinking, daily energy intake, waist circumference, serum total cholesterol level, serum triglyceride (TG) level, serum white blood cell (WBC) count, serum hemoglobin (Hb), and the presence of hypertension. The adjusted weighted resting HR significantly increased across the FPG groups (P<0.001). The weighted prevalence rates of diabetes were 6.8% (6.2–7.5%), 7.6% (6.7–8.5%), 8.0% (7.0–9.1%), and 11.8% (10.8–12.7%) in subjects with HR ≤ 64, 65–69, 70–75, and ≥ 76 bpm, respectively (P<0.001), after adjusting for the confounding factors mentioned above. Using resting HR ≤ 64 bpm as the control, resting HR ≥ 76 bpm was correlated with the presence of diabetes (adjusted OR 1.83, 95% CI 1.55–2.16, P<0.001). Each 10 bpm increment of HR increased the risk of the presence of diabetes by 35% (P<0.001). This association of high resting HR with the presence of diabetes was not influenced by the status of blood pressure (BP) medication.ConclusionWe demonstrated that higher HR was associated with diabetes in a representative sample of Korean adults. These positive associations were independent of age, sex, current smoking, high risk alcohol drinking, daily energy intake, waist circumference, and the presence of hypertension and other potential confounders. This study suggests that individuals with higher resting HR are at risk of diabetes and that HR might provide an easy and simple surrogate marker for the risk of diabetes.