Elevated Resting Heart Rate Is Associated with Carotid Atherosclerosis in Middle-Aged and Elderly Chinese Population

Elevated resting heart rate predicts poor cardiovascular and cerebrovascular outcomes. Atherosclerosis may be a mediator linking this relationship. In a Chinese population, we investigated whether resting heart rate was associated with carotid atherosclerosis as indicated by elevated carotid intima-media thickness (CIMT) and presence of carotid plaque.

A total of 1557 participants older than 50 years old from a community-based population without known cardiovascular diseases were included. All participants provided detailed lifestyle and medical information, and blood samples for biochemical measurements. The participants were categorized according to resting heart rate quartiles (<67, 67-73, 74-81, >81 beats per minute [bpm]). CIMT and presence of carotid plaque were determined using B-mode ultrasonography. Elevated CIMT was defined as the upper quartile of CIMT.

We observed positively graded associations between resting heart rate quartiles and carotid atherosclerosis. Participants with resting heart rates higher than 81 bpm had an odds ratio of 2.82 (95% confidence interval 1.92-4.13) for elevated CIMT, and an odds ratio of 2.00 (1.36-2.92) for carotid plaque, compared to participants with resting heart rates lower than 67 bmp. Each 10-bpm increase in resting heart rate was associated with an odds ratio of 1.47 (1.29-1.68) for elevated CIMT and an odds ratio of 1.40 (1.23-1.60) for carotid plaque. The associations were independent of conventional cardiovascular risk factors.

Elevated resting heart rate was strongly and independently associated with carotid atherosclerosis in the middle-aged and elderly Chinese population. Atherosclerosis may be a potential mediator between resting heart rate and adverse cardiovascular outcomes.