The association between resting heart rate, cardiovascular disease and mortality: evidence from 112,680 men and women in 12 cohorts
Open accessAbstract
BACKGROUND: 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. DESIGN AND 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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Pulse rate is an independent risk factor for cardiovascular outcomes and mortality.
“Furthermore, several studies, including the DCCT/EDIC, have established pulse rate as an independent risk factor for cardiovascular outcomes and mortality [23, 25–28].”
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“has corrected for regression dilution bias.(25) Finally, while many studies have examined the links between RHR and total and CVD mortality, its relationships with stroke (including its major sub-types) have yet to be reliably explored.”
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“Furthermore, several studies, including the DCCT/EDIC, have established pulse rate as an independent risk factor for cardiovascular outcomes and mortality [23, 25–28].”
- Authors
- Woodward, M., Webster, R., Murakami, Y., Barzi, F., Lam, T.-H., Fang, X., Suh, I., Batty, G. D., Huxley, R., & Rodgers, A.
- Affiliations
- The University of Sydney (AU)
- University of Hong Kong (HK)
- Capital Medical University (CN)
- Yonsei University (KR)
- Corresponding author
- Woodward, Mark
- ORCID
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-06-20
- Volume
- 21
- Issue
- 6
- Pages
- 719-726
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W1966710424
- Cited by
- 117
- References
- 31
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 9 · 2023: 8 · 2022: 6 · 2021: 12 · 2020: 8 · 2019: 11 · 2018: 11 · 2017: 9 · 2016: 12 · 2015: 7 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 2.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- eSpace (Curtin University) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Funders
- Servier
- Medical Research Council
- National Health and Medical Research Council (571281)
- 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- resting heart rate, cardiovascular disease, all-cause mortality, stroke, heart failure, coronary artery disease, ischemic stroke, hemorrhagic stroke, sex differences, Asia-Pacific population, pooled cohort analysis
- MeSH terms
- Adult, Aged, Aged, 80 and over, Asia, Australia, Cardiovascular Diseases, Cause of Death, Female, Heart Rate, Humans, Male, Middle Aged, Risk Factors, Cohort Studies, Proportional Hazards Models, Young Adult
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