Article

Multiple studies have examined the relationship between heart rate
and mortality; however, there are discrepancies in results. Our aim was to
describe the relationship between resting heart rate (RHR) and both major
cardiovascular (CV) outcomes, as well as all-cause mortality in the Asia-Pacific
region. METHODS: Individual data from 112,680 subjects in 12 cohort
studies were pooled and analysed using Cox models, stratified by study and sex,
and adjusted for age and systolic blood pressure. RESULTS: During a mean 7.4
years follow-up, 6086 deaths and 2726 fatal or nonfatal CV events were recorded.
There was a continuous, increasing association between having a RHR above
approximately 65 beats/min and the risk of both CV and all-cause mortality, yet
there was no evidence of associations below this threshold. The hazard ratio (95%
CI) comparing the extreme quarters of RHR (80+ v <65 beats/min) was 1.44
(1.29-1.60) for CV and 1.54 (1.43-1.66) for total mortality. These associations
were not materially changed by adjustment for other risk factors and exclusion of
the first 2 years of follow-up. Hazard ratios of a similar magnitude were found
for ischemic and hemorrhagic stroke, but the hazard ratio for heart failure was
higher (2.08, 95% CI 1.07-4.06) and for Coronary Heart Disease (CHD) was lower
(1.11, 95% CI 0.93-1.31) than for stroke. CONCLUSIONS: RHR of above 65 beats/min
has a strong independent effect on premature mortality and stroke, but a lesser
effect on CHD. Lifestyle and pharmaceutical regimens to reduce RHR may be
beneficial for people with moderate to high levels of RHR.
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Langue : ANGLAIS