An increment of 10 beats/min in resting heart rate significantly increased the risk of coronary artery disease by 12%, stroke by 5%, sudden death by 12%, and noncardiovascular diseases by 16%.
Meta-Analysis
Does higher resting heart rate increase the risk of coronary artery disease, stroke, sudden death, and noncardiovascular diseases in general populations and patients with hypertension or diabetes?
Resting heart rate is an independent predictor of coronary artery disease, stroke, sudden death, and noncardiovascular diseases, supporting its potential role in risk prediction algorithms.
Estimación del efecto: RR 1.12 (95% CI 1.09-1.14)
BACKGROUND: Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. METHODS: We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine study-specific relative risks (RRs). We used restricted cubic splines to assess the dose-response relation. RESULTS: We included 45 nonrandomized prospective cohort studies in the meta-analysis. The multivariable adjusted RR with an increment of 10 beats/min in resting heart rate was 1.12 (95% confidence interval CI 1.09-1.14) for coronary artery disease, 1.05 (95% CI 1.01-1.08) for stroke, 1.12 (95% CI 1.02-1.24) for sudden death, 1.16 (95% CI 1.12-1.21) for noncardiovascular diseases, 1.09 (95% CI 1.06-1.12) for all types of cancer and 1.25 (95% CI 1.17-1.34) for noncardiovascular diseases excluding cancer. All of these relations were linear. In an analysis by category of resting heart rate ( 80 beats/min), the RRs were 0.99 (95% CI 0.93-1.04), 1.08 (95% CI 1.01-1.16) and 1.30 (95% CI 1.19-1.43), respectively, for coronary artery disease; 1.08 (95% CI 0.98-1.19), 1.11 (95% CI 0.98-1.25) and 1.08 (95% CI 0.93-1.25), respectively, for stroke; and 1.17 (95% CI 0.94-1.46), 1.31 (95% CI 1.12-1.54) and 1.57 (95% CI 1.39-1.77), respectively, for noncardiovascular diseases. After excluding studies involving patients with hypertension or diabetes, we obtained similar results for coronary artery disease, stroke and noncardiovascular diseases, but found no association with sudden death. INTERPRETATION: Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all of the studies combined. When the analysis included only studies concerning general populations, resting heart rate was not associated with sudden death.
Zhang et al. (Mon,) conducted a meta-analysis in General populations and patients with hypertension or diabetes mellitus. Resting heart rate vs. Lower resting heart rate was evaluated on Coronary artery disease (RR 1.12, 95% CI 1.09-1.14). An increment of 10 beats/min in resting heart rate significantly increased the risk of coronary artery disease by 12%, stroke by 5%, sudden death by 12%, and noncardiovascular diseases by 16%.
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