Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis

Abstract

Background:Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. Methods:We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine studyspecific relative risks (RRs). We used restricted cubic splines to assess the dose-response relation. Results:We included 45 nonrandomized prospective cohort studies in the meta-analysis. The multivariable adjusted RR with an increment of 10 beats/min in resting heart rate was 1.12 (95% confidence interval [CI] 1.09-1.14) for coronary artery disease, 1.05 (95% CI 1.01-1.08) for stroke, 1.12 (95% CI 1.02-1.24) for sudden death, 1.16 (95% CI 1.12-1.21) for noncardiovascular diseases, 1.09 (95% CI 1.06-1.12) for all types of cancer and 1.25 (95% CI 1.17-1.34) for noncardiovascular diseases excluding cancer. All of these relations were linear. In an analysis by category of resting heart rate (< 60 [reference], 60-70, 70-80 and > 80 beats/min), the RRs were 0.99 (95% CI 0.93-1.04), 1.08 (95% CI 1.01-1.16) and 1.30 (95% CI 1.19-1.43), respectively, for coronary artery disease; 1.08 (95% CI 0.98-1.19), 1.11 (95% CI 0.98-1.25) and 1.08 (95% CI 0.93-1.25), respectively, for stroke; and 1.17 (95% CI 0.94-1.46), 1.31 (95% CI 1.12-1.54) and 1.57 (95% CI 1.39-1.77), respectively, for non cardiovascular diseases. After excluding studies involving patients with hypertension or diabetes, we obtained similar results for coronary artery disease, stroke and noncardiovascular diseases, but found no association with sudden death. Interpretation:Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all of the studies combined. When the analysis included only studies concerning general populations, resting heart rate was not associated with sudden death. AbstractInfographic available at www.cmaj.ca/lookup/suppl

Resting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality

“…The evidence on whether a decrease in RHR over time is associated with lower mortality is inconsistent 17–19. Among the few studies that have assessed the association between temporal changes in RHR and all-cause mortality, some failed to adjust for important confounders like physical activity, alcohol consumption and diet; a meta-analysis found that the association of RHR with cancer mortality was almost twofold higher in less adjusted studies, compared with those including more confounders 12. Some studies were sex-specific or disease-specific,7 19 and others assessed only short-term RHR changes (eg, over weeks/months) 19…”

Role of heart rate in mechanisms of compensation and decompensation in patients with CHF and sinus rhythm or atrial fibrillation and methods for safe and effective control of the heart rhythm. Part 1. Sinus rhythm

“…Связь между ЧСС покоя и риском общей и сердечно-сосудистой (СС) смертности исследовалась за последние четверть века во многих эпидемиологических и популяци-онных исследованиях, причем как у лиц без СС патологии, так и у пациентов с различными заболеваниями сердца [28][29][30][31]. Общим выводом абсолютно всех исследований можно считать наличие прямой связи между повышением ЧСС и увеличением риска смерти.…”

“…Более сложным явля-ется ответ на вопрос: какова оптимальная ЧСС покоя? Для здоровых лиц, как это было показано во французском регистре, повышение риска смерти начинается с ЧСС более 55-60 уд / мин [30][31][32]. Аналогичные результаты были получены и при исследовании пациентов с дока-занной коронарной болезнью сердца [33] и перенесших острый ИМ [34].…”

Vitiligo and quality of life: the dark face of whiteness

“…As increased resting heart rate is associated with increased risk of cardiovascular mortality, Juhl et al concluded that increased heart rate is a potentially important and easily testable marker associated with increased risk of cardiovascular mortality and sudden death. 6 The studies about the association between HS and metabolic syndrome follow the studies about the association between psoriasis and metabolic syndrome. In 2006, the first study described the association between psoriasis and metabolic syndrome.…”

“…Few data are available for more than 5 years of follow-up (n = 25), and recently the validity of the DLQI has been subject to a great deal of criticism. [6][7][8] …”