Resting Heart Rate and Incident Heart Failure in Apparently Healthy Men and Women in the EPIC-Norfolk Study
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Aims: Increasing levels of resting heart rate are associated with increased risk of developing hypertension and cardiovascular disease, and seem to play a role in the progression of heart failure. The shape of the association between resting heart rate and risk of developing heart failure has not been examined in healthy individuals of the general population. Methods and results: Hazard ratios (HRs) of heart failure comparing categories of resting heart rate [51–60 b.p.m. (reference), 61–70 b.p.m., 71–80 b.p.m., 81–90 b.p.m., and 91–100 b.p.m.] were calculated in apparently healthy men (9805) and women (12 321) aged 39–79 participating in the ‘European Prospective Investigation into Cancer and Nutrition’ (EPIC) study in Norfolk. During a mean follow-up of 12.9 years, 1356 incident cases of heart failure occurred. In participants without potential heart rate-modifying medication, age- and sex-adjusted incidence rates of heart failure were 3.3, 3.7, 4.0, 5.1, and 5.5 per 1000 person-years for increasing categories of resting heart rate; compared with the reference category, HRs and 95% confidence intervals (CI) for increasing categories of resting heart rate were 1.08 (0.88–1.34), 1.17 (0.94–1.46), 1.39 (1.08–1.79), and 1.42 (1.00–2.03), respectively, in multivariable analysis adjusting for age, sex, body mass index, systolic blood pressure, prevalent diabetes, cholesterol concentration, social class, educational level, smoking, and physical activity. Within the reference range of resting heart rate (50–100 b.p.m.) each 10 b.p.m. increase was associated with an 11% increase in hazard of heart failure in multivariable analysis. The results did not change materially after adjusting for myocardial infarction and coronary heart disease events during follow up (1.12, 1.06–1.18). Conclusion: Resting heart rate shows a graded association with hazard of heart failure in apparently healthy men and women which is not mediated by coronary heart disease. Further study is needed to examine the underlying mechanisms.
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The percentage of heart rates above 90-100 bpm in population studies ranges from 2.1 to 4.6%.
“The percentage of heart rates above 90–100 bpm in population studies ranges from 2.1 to 4.6%.11,13–15”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [14]
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- Authors
- Pfister, R., Michels, G., Sharp, S. J., Luben, R., Wareham, N. J., & Khaw, K.-T.
- Affiliations
- University of Cologne (DE)
- University of Cambridge (GB)
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge , Cambridge ,
- Corresponding author
- Pfister, Roman
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-10-01
- Volume
- 14
- Issue
- 10
- Pages
- 1163-1170
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W2092318115
- Cited by
- 41
- References
- 38
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 5 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Funders
- Cancer Research UK
- University of Cambridge
- Medical Research Council (MC_UU_12015/1)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- resting heart rate, heart failure, incident heart failure, cardiovascular risk, general population, EPIC-Norfolk study, hypertension, coronary artery disease, myocardial infarction, cardiovascular disease progression, sex differences, body mass index, systolic blood pressure, physical activity, smoking, educational attainment, social class, diabetes mellitus, cholesterol, cardiovascular mortality, cardiovascular morbidity
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Heart Failure, Heart Rate, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Incidence, Multivariate Analysis, Proportional Hazards Models
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