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Bradycardia is associated with future cardiovascular diseases and death in men from the general population
Shinji Makita1, Toshiyuki Onoda2, Masaki Ohsawa2
1Division of Cardioangiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
Insights
Both low and high resting pulse rates (RPRs) are associated with increased cardiovascular disease (CVD) risk in men. This study suggests that bradycardia, like a fast heart rate, may independently predict future CVD events in healthy men.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- Elevated heart rate is a known cardiovascular disease (CVD) risk factor.
- The association between bradycardia (low heart rate) and CVD risk remains under-investigated.
- Resting pulse rate (RPR) variations may impact cardiovascular health.
Purpose of the Study:
- To investigate the association between resting pulse rate (RPR) and cardiovascular disease (CVD) risk.
- To determine if both low and high RPRs are linked to adverse cardiovascular outcomes.
- To analyze RPR as a potential independent risk factor for CVD events.
Main Methods:
- A community-based prospective cohort study analyzed 17,766 subjects aged 40-79.
- Exclusion criteria included atrial fibrillation, prior CVD, and antihypertensive treatment.
- RPR was categorized into four groups (<60, 60-69.5, 70-79.5, ≥80 bpm); composite CVD outcomes (myocardial infarction, stroke, sudden death) were tracked over a mean of 5.6 years.
Main Results:
- In men, both RPR <60 bpm and RPR ≥80 bpm were associated with significantly increased CVD risk compared to the 60-69.5 bpm reference group (HRs 1.73 and 2.01, respectively).
- These associations remained significant after adjusting for age and other CVD risk factors (HRs 1.55 and 1.72, respectively).
- No significant associations between RPR and CVD risk were observed in women.
Conclusions:
- Bradycardia (low RPR) and high RPR may serve as independent risk factors for cardiovascular events in apparently healthy men.
- The findings highlight the importance of considering both extremes of RPR in cardiovascular risk assessment for men.
- Further research may be warranted to explore the underlying mechanisms and implications for women.
Background:
Although a higher heart rate is known to be a risk factor for cardiovascular disease (CVD) events, there have been no reports concerning bradycardia. Whether lower and higher resting pulse rates (RPRs) are associated with cardiovascular risk was investigated in subjects from a community-based, prospective cohort study.
Methods:
After subjects with atrial fibrillation, subjects with a history of CVD, and subjects receiving antihypertensive treatment were excluded, 17,766 subjects (5958 men), aged 40-79 (mean 61.5) years, were analyzed. The RPR at baseline was categorized into four groups (RPR<60, 60-69.5, 70-79.5, ≥80 beats per minute (bpm)) using the average value of two consecutive measurements. The endpoint was set as the composite outcome of myocardial infarction, stroke, or sudden death.
Results:
During a mean follow-up of 5.6 years, there were 213 events in men and 186 events in women. In Cox regression models, increased risks of CVD were found in the men group with RPR<60 bpm, as well as the group with RPR≥80 bpm, compared with the reference group with RPR 60-69.5 bpm (hazard ratio [HR] = 1.73, p = 0.005 and HR = 2.01, p < 0.001). These increased risks were found even when adjusted for age and other CVD risk factors (HR = 1.55, p = 0.026 with RPR<60 bpm and HR = 1.72, p = 0.009 with RPR≥80 bpm). In women, there were no significant associations between RPR and CVD risk.
Conclusion:
Bradycardia, as well as a higher pulse rate, may be an independent risk factor for future cardiovascular events in apparently healthy men.
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