Heart rate and completed suicide: evidence from the IPC cohort study

Many suicide-related features such as affective disorders, impulsivity, and hostility have been associated with an aberrant regulation of heart rate (HR) and blood pressure (BP). Moreover, the neural bases of HR and BP regulation are similar to those of emotion regulation. The present study examined whether high resting HR or BP would be associated with an increased risk of suicide.

Resting HR and BP were measured among 204,600 men (mean [standard deviation] age = 44.5 [12.1] years) and 119,110 women (mean [standard deviation] age = 45.0 [14.0] years), together with depressive mood and perceived stress. Age, marital status, working status, socioeconomic status, physical activity, alcohol intake, and current medications were self-reported. Dates and causes of death were obtained from the French National Institute of Statistics and Economic Studies and the French National Cause-of-Death Registry, respectively.

During a mean follow-up of 9.1 years, 133 participants (106 men) completed suicide. Resting HR, but not BP, was positively associated with suicide, together with depressive mood, perceived stress, low body mass index, male sex, status as a current smoker, and taking a psychotropic medication. Adjusting for these covariates, resting HR still independently predicted suicide. Ten additional beats per minute increased the risk of suicide by 19% in the unadjusted model and by 24% to 37% in the adjusted models.

Resting HR and suicide risk may share some biologic determinants, such as genetic factors or neural bases. These results may inform further attempts to understand how suicide is mediated at a brain level.