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Heart rate and mortality
A Reunanen1, J Karjalainen, P Ristola
1National Public Health Institute, Helsinki, Central Military Hospital, Helsinki, Finland. anti.reunanen@ktl.fi
Insights
High resting heart rate is a significant predictor of mortality from all causes, particularly non-cardiovascular, non-malignant diseases. While linked to cardiovascular disease, this association is explained by blood pressure.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Resting heart rate is a potential predictor of mortality, but its association with cardiovascular disease and other causes of death is debated.
- Previous studies have yielded conflicting results regarding the predictive value of heart rate for mortality.
Purpose of the Study:
- To clarify the role of heart rate as a predictor of all-cause mortality.
- To investigate the association between heart rate and specific causes of death in a large population.
Main Methods:
- Prospective population study with a 23-year follow-up period.
- Inclusion of 5598 men and 5119 women aged 30-59 years at baseline.
- Resting electrocardiograms (ECGs) were used to measure heart rate.
Main Results:
- A total of 1848 men and 840 women died during follow-up.
- Elevated heart rate was significantly associated with increased mortality from all causes, cardiovascular causes, and natural non-cardiovascular, non-malignant causes.
- The association between high heart rate and cardiovascular mortality was explained by high blood pressure; however, the link to non-cardiovascular mortality remained significant after adjusting for risk factors.
Conclusions:
- High resting heart rate is a clinically observable, albeit nonspecific, predictor of mortality.
- The increased cardiovascular mortality risk associated with high heart rate is largely attributable to its correlation with elevated blood pressure.
- Elevated heart rate is primarily linked to an increased risk of death from non-cardiovascular or non-malignant diseases.
Objectives:
Increased heart rate has shown to be associated with risk of mortality from cardiovascular diseases in some studies, but not in others. Increased heart rate has also been linked to causes of death other than cardiovascular. To clarify the role of heart rate as a predictor of death we studied its predictive value in a large population study.
Design:
A prospective population study with a follow-up time of 23 years.
Subjects And Methods:
The study population comprised 5598 men and 5119 women 30-59 years of age on entry. Heart rate was measured from resting ECGs.
Main Outcome Measure:
Mortality from specified causes.
Results:
A total of 1848 men and 840 women died during the follow-up period. Increased heart rate was significantly associated with death from all causes, cardiovascular causes, and natural noncardiovascular, nonmalignant causes of death. Increased heart rate was associated with death from cancer in men with heart disease but not in men without heart disease on entry into the study. The increase in cardiovascular mortality with high heart rate was explained by the close association between heart rate and blood pressure. Adjustment for risk factors did not alter the significance of the association between increased heart rate and mortality from noncardiovascular causes.
Conclusions:
High heart rate is simple to observe clinically and a significant if nonspecific predictor of mortality. Increased risk of mortality from cardiovascular diseases can be explained by association with high blood pressure. The increased mortality risk associated with high heart rate related mainly to a group of diseases of noncardiovascular or nonmalignant origin.