Key result
High resting heart rate plus low physical activity is linked to ~71% higher CKD mortality.
Why the study?
The independent and combined associations of resting heart rate and physical activity with mortality in diverse chronic kidney disease populations remain unclear.
Does higher physical activity attenuate the risk of all-cause and cardiovascular mortality associated with elevated resting heart rate in patients with chronic kidney disease?
Cohort (n=12,042)
Yes
Does higher physical activity attenuate the risk of all-cause and cardiovascular mortality associated with elevated resting heart rate in patients with chronic kidney disease?
Hazard Ratio: 1.708 (95% CI 1.42–2.054)
Higher levels of physical activity are independently protective and significantly attenuate the increased risk of all-cause and cardiovascular mortality associated with elevated resting heart rate in patients with chronic kidney disease.
The independent and combined associations of resting heart rate (RHR) and physical activity (PA) with mortality in diverse chronic kidney disease (CKD) populations remain unclear. We analyzed 12,042 patients from three cohorts using Cox regression, restricted cubic splines, joint-effect, mediation, and meta-analytic approaches. Elevated RHR was associated with increased risks of all-cause and cardiovascular mortality, whereas higher PA levels showed consistent protective associations across cohorts. Combined analyses demonstrated that high RHR with low PA was associated with the greatest mortality risk, while high PA attenuated the adverse association of elevated RHR with mortality. Mediation analyses suggested that RHR partially contributed to the association between PA and mortality. RHR and PA are independent and modifiable risk markers for mortality in patients with CKD. Promoting PA and monitoring RHR should be integrated into CKD management to improve survival.
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Zhan et al. (2026) conducted a cohort in Chronic kidney disease (n=12,042). High resting heart rate and low physical activity vs. Low resting heart rate and high physical activity was evaluated on All-cause mortality (HR 1.708, 95% CI 1.420-2.054). In adults with chronic kidney disease, the combination of high resting heart rate and low physical activity was associated with a 70.8% increased risk of all-cause mortality compared to those with low resting heart rate and high physical activity.
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