Key result
Each 10 bpm higher resting heart rate was associated with increased risks of incident heart failure at RHR >75 bpm (HR 1.25; 95% CI 1.17-1.34) and pulmonary heart disease (HR 1.74; 95% CI 1.67-1.81).
Why the study?
To compare the shape and strength of the associations of resting heart rate with incident heart failure and pulmonary heart disease in Chinese adults.
Is resting heart rate associated with incident heart failure and pulmonary heart disease in Chinese adults?
Cohort (n=491,785)
Yes
Is resting heart rate associated with incident heart failure and pulmonary heart disease in Chinese adults?
Effect estimate: HR 1.25 for HF; HR 1.74 for PHD (95% CI 1.17 to 1.34 for HF; 1.67 to 1.81 for PHD)
Higher resting heart rate is a strong predictor of incident pulmonary heart disease and, at rates >75 bpm, incident heart failure in a large Chinese cohort.
May inform HF/PHD risk stratification in Chinese adults; extends observational data but leaves causality and practice change open.
Objectives To compare the shape and strength of the associations of resting heart rate (RHR) with incident heart failure (HF) and pulmonary heart disease (PHD) in Chinese adults. Methods The prospective China Kadoorie Biobank recruited >0.5 million adults from 10 geographically diverse regions (5 urban, 5 rural) of China during 2004–2008. After an 11-year follow-up, 6082 incident cases of HF and 5572 cases of PHD, were recorded among 491 785 participants with no prior history of heart disease or use of beta-blockers at baseline. Cox regression yielded HRs for each disease associated with usual RHR after adjustment for confounding factors. Results The mean (SD) baseline RHR was 79 (12) (men 78 (12); women 80 (11)) bpm, and these decreased with increasing age (by about 1 bpm per 10 years). Usual RHR showed J-shaped associations with HF and log-linear associations PHD. For HF, each 10 bpm higher usual RHR was associated with an adjusted HR of 1.25 (95% CI 1.17 to 1.34) for RHR>75 bpm. For PHD, each 10 bpm higher RHR was associated with HR of 1.74 (1.67–1.81) across the full range of usual RHR. For HF at RHR > 75 bpm but not PHD, the HRs per 10 bpm higher RHR were approximately halved by further adjustment for diabetes and hypertension. Conclusions RHR was strongly positively associated with PHD throughout the range studied, but was only associated with HF at RHR>75 bpm, and the strength of the associations with HF were only one-third of those with PHD.
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Agbor et al. (2022) conducted a cohort in Incident heart failure and pulmonary heart disease (n=491,785). Resting heart rate was evaluated on Incident heart failure (HF) and pulmonary heart disease (PHD) (HR 1.25 for HF; HR 1.74 for PHD, 95% CI 1.17 to 1.34 for HF; 1.67 to 1.81 for PHD). Each 10 bpm higher resting heart rate was associated with increased risks of incident heart failure at RHR >75 bpm (HR 1.25; 95% CI 1.17-1.34) and pulmonary heart disease (HR 1.74; 95% CI 1.67-1.81).
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