Resting heart rate – The forgotten risk factor? Comparison of resting heart rate and hypertension as predictors of all-cause mortality in 692,217 adults in Asia and Europe

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases Pub Date : 2025-03-01 DOI:10.1016/j.pcad.2025.01.007

Chi Pang Wen , Chien Hua Chen , Javaid Nauman , Jackson Pui Man Wai , Min Kuang Tsai , Jun-Han Lee , Ta-Wei David Chu , Emma Maria Lovisa Ingestroem , Hong Yi Chiou , Chih Cheng Hsu , Christopher Wen , Xifeng Wu , Atefe R. Tari , Ulrik Wisloff

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引用次数: 0

Abstract

Background

Resting Heart Rate (RHR) is commonly viewed as a reflection of underlying co-morbidities and not an independent risk factor. Here we compared whether high RHR (80–99 beats/min) and hypertension (blood pressure, BP ≥140/90 mmHg) independently predict all-cause mortality in 692,217 adults from Asia and Europe.

Methods

Taiwan MJ cohort constituted of 636,064 adults (1994–2017) and the HUNT cohort of 56,153 Norwegian adults (1995–1997). Both cohorts were followed for about 25 years. We report adjusted hazard ratios (HRs) for all-cause mortality, and life expectancy were calculated.

Results

The prevalence of high RHR changed little between those aged 20–29 years (21.2 %) and ≥ 70 years (25.2 %, ns.), whereas hypertension prevalence increased from 4.5 % to 57.3 %, respectively. We observed similar all-cause mortality among those with a high RHR and a normal BP and those with hypertension and normal RHR of 60–69 beats/min. We observed higher all-cause mortality among those with normal BP (≤120/80 mmHg) but high RHR than among those with hypertension and normal RHR. All-cause mortality risk associated with hypertension was not significant for those <40 years of age, whereas risk associated with high RHR remained significant across all age groups. Reductions in life expectancy was larger among individuals with normal BP, but high RHR (10.29 years, 95 % CI 8.09–12.49) compared with those with hypertension but normal RHR (5.53 years, 95 % CI 3.57–7.59).

Conclusions

Our data clearly demonstrate that elevated RHR should be considered as an independent risk factor for all-cause mortality. The observation that elevated RHR in young adulthood to middle age (20–50 years of age) served as better predictor of all-cause mortality than hypertension calls for a paradigm shift particularly among these age groups, and we suggest it is time that RHR should be regarded as a vital clinical sign measured and evaluated at all clinical visits.

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静息心率——被遗忘的危险因素？亚洲和欧洲692217名成年人静息心率和高血压作为全因死亡率预测因子的比较

背景：静息心率（RHR）通常被视为潜在合并症的反映，而不是一个独立的危险因素。在这里，我们比较了高RHR（80-99次/分钟）和高血压（血压，血压≥140/90 mmHg）是否能独立预测来自亚洲和欧洲的692,217名成年人的全因死亡率。方法：台湾MJ队列包括636,064名成年人（1994-2017），HUNT队列包括56,153名挪威成年人（1995-1997）。两组受试者都被随访了大约25 年。我们报告了全因死亡率的调整风险比（hr），并计算了预期寿命。结果：高RHR患病率在20-29岁 （21.2% %）和 ≥ 70 （25.2% %,ns.）之间变化不大，而高血压患病率分别从4.5 %增加到57.3% %。我们观察到，在RHR高且血压正常的患者和RHR为60-69次/分的高血压患者中，全因死亡率相似。我们观察到血压正常（≤120/80 mmHg）但RHR高的患者的全因死亡率高于RHR正常的高血压患者。结论：我们的数据清楚地表明，RHR升高应被视为全因死亡率的独立危险因素。观察到青壮年至中年（20-50 岁）的RHR升高比高血压更能预测全因死亡率，这需要一种模式转变，特别是在这些年龄组中，我们建议RHR应该被视为在所有临床就诊中测量和评估的重要临床体征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Progress in cardiovascular diseases 医学-心血管系统

CiteScore

10.90

自引率

6.60%

发文量

审稿时长

7 days

期刊介绍： Progress in Cardiovascular Diseases provides comprehensive coverage of a single topic related to heart and circulatory disorders in each issue. Some issues include special articles, definitive reviews that capture the state of the art in the management of particular clinical problems in cardiology.