Key result
RHR ≥85 bpm linked to ~42% higher all-cause mortality vs 75-80 bpm in hypertensive adults.
Why the study?
The association between baseline resting heart rate and all-cause death in hypertensive adults without cardiovascular disease was unclear.
Does a higher baseline resting heart rate increase the risk of all-cause death in Chinese hypertensive adults without cardiovascular disease?
Cohort (n=20,648)
Does a higher baseline resting heart rate increase the risk of all-cause death in Chinese hypertensive adults without cardiovascular disease?
Hazard Ratio: 1.42 (95% CI 1.03–1.96)
p-value: p=0.031
In Chinese hypertensive adults without prior cardiovascular disease, a baseline resting heart rate ≥85 bpm is associated with a significantly increased risk of all-cause mortality compared to a rate of 75-80 bpm.
May warrant closer monitoring in hypertensive adults with elevated resting heart rate; extends observational data but leaves causality and intervention effects open.
The aim of this study was to investigate the association between baseline resting heart rate (RHR) and all-cause death in the China Stroke Primary Prevention Trial (CSPPT). A post hoc analysis was conducted using data from 20,648 hypertensive adults without cardiovascular disease in the CSPPT and with baseline RHR data available. Over a median follow-up duration of 4.5 years, the baseline RHR and risk for all-cause death had a nonlinear relationship. The risk of all-cause death was higher in participants with an RHR ≥85 bpm (hazard ratio 1.42; 95% confidence interval 1.03-1.96, p = .031) than in those with a baseline RHR of 75-80 bpm. The effect of RHR on all-cause death during the treatment period was modified by the folate level (p = .020) and systolic blood pressure (SBP) during treatment(p = .056). The effect of RHR on the risk of all-cause death was stronger when the folate level was low than when it was high; the risk was higher when the RHR was < 75 bpm or ≥80 bpm than when it was 75-80 bpm. RHR had a greater effect on the risk of all-cause death when SBP during treatment was well controlled than when it was not; again, the risk was higher when the RHR was < 75 bpm or ≥80 bpm than when it was 75-80 bpm. A higher baseline RHR resulted in an increased risk of all-cause mortality in Chinese adults with hypertension but no history of stroke or myocardial infarction.
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Yulong et al. (2022) conducted a cohort in Hypertension (n=20,648). Baseline resting heart rate (RHR) ≥85 bpm vs. Baseline RHR of 75-80 bpm was evaluated on All-cause death (HR 1.42, 95% CI 1.03-1.96, p=0.031). Baseline resting heart rate ≥85 bpm was associated with a higher risk of all-cause death compared to 75-80 bpm in hypertensive adults (HR 1.42; 95% CI 1.03-1.96; p=0.031).
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