Why the study?
Elevated long-term systolic blood pressure and resting heart rate variability increase all-cause mortality risk, but the link between increased resting heart rate and pulse pressure for all-cause mortality remained unclear.
Does elevated long-term resting heart rate variability and pulse pressure variability increase the risk of all-cause mortality in a general cohort?
Cohort (n=46,751)
Does elevated long-term resting heart rate variability and pulse pressure variability increase the risk of all-cause mortality in a general cohort?
Elevated long-term resting heart rate variability and pulse pressure variability are independently associated with an increased risk of all-cause mortality, with age-specific patterns.
Age-specific variability signals mortality risk in this cohort; hypothesis-generating and requires prospective validation before any clinical use.
Background Elevated long-term systolic blood pressure and resting heart rate (RHR) variability are suggested to amplify the risk of all-cause mortality (ACM). However, the link between increased RHR and pulse pressure for ACM remained unclear. Methods and Results This study analyzed 46 751 individuals from Kailuan Cohort Study for the end outcome of ACM. A Cox regression model was used to estimate hazard ratios for death events. Kaplan-Meier analysis was performed to study the differences in survival as stratified by the SD, coefficient of variation, and average real variability of RHR and pulse pressure quartiles. A total of 1667 deaths (<65 years of age=866/40351, ≥65 years of age=801/6400) were recorded over 4.97±0.69 years follow-up. Participants under the age of 65 years in the third and fourth quartiles of pulse pressure SD had an independent increase in risk for ACM (hazard ratio [95% CI], 1.16 [1.06-1.28]; and 1.19 [1.05-1.35], respectively). Additionally, participants >65 years of age had a higher risk for ACM across quartiles of RHR-SD. The hazard ratio (95% CI) for the subjects in quartiles 2, 3, and 4 were 1.81 (1.10-2.97), 2.31 (1.37-1.3.90), and 2.64 (1.63-4.29), respectively. Conclusions An elevated long-term RHR variability combined with an increased pulse pressure variability or vice versa amplifies the risk of ACM.
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Yang et al. (2020) reported a cohort. Elevated long-term resting heart rate variability and pulse pressure variability vs. Lower quartiles of variability was evaluated on All-cause mortality (HR 2.64, 95% CI 1.63-4.29).
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