The impact of time-updated resting heart rate on cause-specific mortality in a random middle-aged male population: a lifetime follow-up
Background A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohor...
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| Published in | Clinical research in cardiology Vol. 110; no. 6; pp. 822 - 830 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.06.2021
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort.
Methods
A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models.
Results
A baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60–70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17–2.19,
P
= 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07–1.85,
P
= 0.014) and a time-updated RHR of 70–80 bpm (HR 1.34, 95% CI 1.02–1.75,
P
= 0.036) were both associated with higher CV mortality as compared with an RHR of 60–70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference.
Conclusion
In this middle-aged male cohort, a time-updated RHR of 60–70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population.
Graphic abstract |
|---|---|
| AbstractList | Background
A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort.
Methods
A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models.
Results
A baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60–70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17–2.19,
P
= 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07–1.85,
P
= 0.014) and a time-updated RHR of 70–80 bpm (HR 1.34, 95% CI 1.02–1.75,
P
= 0.036) were both associated with higher CV mortality as compared with an RHR of 60–70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference.
Conclusion
In this middle-aged male cohort, a time-updated RHR of 60–70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population.
Graphic abstract A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort.BACKGROUNDA high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort.A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models.METHODSA random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models.A baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60-70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17-2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07-1.85, P = 0.014) and a time-updated RHR of 70-80 bpm (HR 1.34, 95% CI 1.02-1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60-70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference.RESULTSA baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60-70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17-2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07-1.85, P = 0.014) and a time-updated RHR of 70-80 bpm (HR 1.34, 95% CI 1.02-1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60-70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference.In this middle-aged male cohort, a time-updated RHR of 60-70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population.CONCLUSIONIn this middle-aged male cohort, a time-updated RHR of 60-70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population. Background A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort. Methods A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models. Results A baseline RHR of >= 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60-70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17-2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07-1.85, P = 0.014) and a time-updated RHR of 70-80 bpm (HR 1.34, 95% CI 1.02-1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60-70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference. Conclusion In this middle-aged male cohort, a time-updated RHR of 60-70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population. Background A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort. Methods A random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models. Results A baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60–70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17–2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07–1.85, P = 0.014) and a time-updated RHR of 70–80 bpm (HR 1.34, 95% CI 1.02–1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60–70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference. Conclusion In this middle-aged male cohort, a time-updated RHR of 60–70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population. BackgroundA high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear. We aimed to investigate the impact of RHR, based on both baseline and time-updated values, on mortality in a middle-aged male cohort.MethodsA random population sample of 852 men, all born in 1913, was followed from age 50 until age 98, with repeated examinations including RHR over a period of 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazard models and cubic spline models.ResultsA baseline RHR of ≥ 90 beats per minute (bpm) was associated with higher all-cause mortality, as compared with an RHR of 60–70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17–2.19, P = 0.003), but not with cardiovascular (CV) mortality. A time-updated RHR of < 60 bpm (HR 1.41, 95% CI 1.07–1.85, P = 0.014) and a time-updated RHR of 70–80 bpm (HR 1.34, 95% CI 1.02–1.75, P = 0.036) were both associated with higher CV mortality as compared with an RHR of 60–70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference.ConclusionIn this middle-aged male cohort, a time-updated RHR of 60–70 bpm was associated with the lowest CV mortality, suggesting that a time-updated RHR could be a useful long-term prognostic index in the general population.Graphic abstract |
| Author | Thunström, Erik Mandalenakis, Zacharias Hansson, Per-Olof Cui, Xiaotong Svärdsudd, Kurt Fu, Michael |
| Author_xml | – sequence: 1 givenname: Xiaotong surname: Cui fullname: Cui, Xiaotong organization: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy – sequence: 2 givenname: Zacharias surname: Mandalenakis fullname: Mandalenakis, Zacharias organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra – sequence: 3 givenname: Erik surname: Thunström fullname: Thunström, Erik organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra – sequence: 4 givenname: Michael surname: Fu fullname: Fu, Michael organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra – sequence: 5 givenname: Kurt surname: Svärdsudd fullname: Svärdsudd, Kurt organization: Department of Public Health and Caring Sciences, Family Medicine Section, Uppsala University – sequence: 6 givenname: Per-Olof orcidid: 0000-0001-6323-0506 surname: Hansson fullname: Hansson, Per-Olof email: per-olof.hansson@vgregion.se organization: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra |
| BackLink | https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-434822$$DView record from Swedish Publication Index https://gup.ub.gu.se/publication/295257$$DView record from Swedish Publication Index |
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| CitedBy_id | crossref_primary_10_4093_dmj_2023_0305 crossref_primary_10_1038_s41598_021_95210_4 crossref_primary_10_3389_fendo_2024_1385143 crossref_primary_10_1136_bmjopen_2024_093662 crossref_primary_10_59322_90_7186_LR5 crossref_primary_10_2147_IJGM_S333971 |
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| ContentType | Journal Article |
| Copyright | The Author(s) 2020 The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Snippet | Background
A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is... BackgroundA high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is... A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is unclear.... Background A high resting heart rate (RHR) is associated with an increase in adverse events. However, the long-term prognostic value in a general population is... |
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| SubjectTerms | Cardiology Cardiology and Cardiovascular Disease Cardiovascular diseases Cell and Molecular Biology Cell- och molekylärbiologi Cohort analysis Cohort study Confidence intervals General population Heart rate Kardiologi och kardiovaskulära sjukdomar Medicine Medicine & Public Health Middle age Mortality Original Paper Population Statistical models |
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| Title | The impact of time-updated resting heart rate on cause-specific mortality in a random middle-aged male population: a lifetime follow-up |
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