Resting Heart Rate and Risk of Incident Venous Thromboembolism: The Tromsø Study

While resting heart rate (RHR) is associated with multiple diseases, conflicting information exists on the association between RHR and venous thromboembolism (VTE). We, therefore, aimed to investigate the association between RHR and risk of VTE in a population-based cohort.Participants (n = 36,395) were followed from inclusion in the Tromsø 4 to 7 surveys (1994-2016) throughout 2020. RHR was measured in beats per minute (bpm) at each survey (repeated measurements for those attending several surveys). All first-time VTEs during follow-up were recorded. Hazard ratios (HR) for VTE with 95% confidence intervals (CIs) according to RHR categories (61-70, 71-80, and >80 bpm) with ≤60 bpm as reference were estimated using Cox regression models, and adjusted for age, sex, body mass index, cardiovascular disease, cancer, and physical activity. We also performed age-stratified analyses (<60 and ≥60 years).During a median of 6.6 years of follow-up, 1,072 participants experienced a VTE. Fully adjusted HRs (95% CI) for overall VTE were 1.12 (0.93-1.35), 1.35 (1.11-1.63), and 1.19 (0.97-1.47) for RHR categories 61 to 70, 71 to 80, and >80 bpm, respectively. Corresponding HRs for unprovoked VTE were 1.56 (1.14-2.14), 1.76 (1.28-2.43), and 1.60 (1.13-2.25), whereas no association was observed for provoked VTE. The association was more consistent in those ≥60 years, with HRs for overall VTE, >80 bpm versus ≤60 bpm of 1.30 (1.02-1.65) and for unprovoked VTE of 1.86 (1.24-2.81).Our findings suggest that higher RHR may be a risk factor for VTE and more consistently so for those ≥60 years. The VTE risk by higher RHR was particularly pronounced for unprovoked events.