Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis

Abstract

Interpretation: Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This indicates that resting heart rate is a predictor of all-cause and cardiovascular mortality in the general population. Abstract Research E54CMAJ, February 16, 2016, 188(3) traditional risk factors of cardiovascular disease on the association of resting heart rate with risk of all-cause and cardiovascular mortality. Methods Literature search and selectionWe searched PubMed, Embase and MEDLINE from inception to Jan. 1, 2015, restricting the search to studies involving humans and published in English or Chinese. Details of the search strategy are shown in Appendix 1 (available at www.cmaj.ca/lookup/suppl/doi:10.1503/ cmaj.150535/-/DC1). We reviewed the reference lists from retrieved articles to search for further relevant studies. Studies were included if they met the following criteria: the study group was the general population (i.e., excluding studies in disease-specific populations); the exposure of interest was resting heart rate; the outcome of interest was all-cause or cardiovascular mortality; age-or multivariateadjusted relative risk estimates with 95% confidence intervals (CIs) were provided; and the study used a prospective design. If data were duplicated in more than 1 study, we included the study with the longest follow-up duration. Two investigators (D.Z. and X.S) independently conducted the literature search and selection.

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

“…Compared with 70 beats/min, a linear dose-response analysis indicated a significantly protective effect of lower resting heart rates on the risk of all-cause mortality in general populations in our previous study. 6 The results of the current meta-analysis showed that, compared with 70 beats/min, lower resting heart rate was also associated with a significantly decreased risk of mortality from noncardio vascular diseases. These findings indicate the possibility that "the slower the heart rate, the better" 58 for all-cause mortality and mortality from noncardiovascular diseases in general populations.…”

“…6 In brief, we combined study-specific logarithms of RRs for an increment of 10 beats/min in resting heart rate using a random-effects model. We used the I 2 statistic to evaluate between-study hetero geneity.…”

“…We previously found that resting heart rate was an independent predictor of total mortality related to cardiovascular disease in the general population. 6 However, the predictive values of resting heart rate for cardio vascular-specific outcomes, including coronary artery disease, stroke and sudden death, as well as noncardiovascular diseases, have not been quantified in the general population. Although the potential importance of resting heart rate has been recognized, 7 it has not been included for cardiovascular risk assessment in European and US guidelines 7,8 because the benefit of a reduction in resting heart rate for noncardiac patients is unknown.…”

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].…”