http://heart.bmj.com/content/early/2013/03/21/heartjnl-2012-303375
Abstract
Objective To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical
fitness (VO2Max).
Methods
This was a prospective cohort study: the Copenhagen Male Study, a
longitudinal study of healthy middle-aged employed men.
Subjects with sinus rhythm and
without known cardiovascular disease or diabetes were included. RHR was
assessed from a resting
ECG at study visit in 1985–1986. VO2Max
was determined by the Åstrand bicycle ergometer test in 1970–1971.
Subjects were classified into categories according
to level of RHR. Associations with
mortality were studied in multivariate Cox models adjusted for physical
fitness, leisure-time
physical activity and conventional
cardiovascular risk factors.
Results
2798 subjects were followed for 16 years. 1082 deaths occurred. RHR was
inversely related to physical fitness (p<0.001).
Overall, increasing RHR was highly
associated with mortality in a graded manner after adjusting for
physical fitness, leisure-time
physical activity and other
cardiovascular risk factors. Compared to men with RHR ≤50, those with
RHR >90 had an HR (95% CI)
of 3.06 (1.97 to 4.75). With RHR as a
continuous variable, risk of mortality increased with 16% (10–22) per
10 beats per minute
(bpm). There was a borderline
interaction with smoking (p=0.07); risk per 10 bpm increase in RHR was
20% (12–27) in smokers,
and 14% (4–24) in non-smokers.
Conclusions Elevated RHR is a risk factor for mortality independent of physical fitness, leisure-time physical activity and other major
cardiovascular risk factors.
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